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2 - MENTOR'S PROFILE
MENTOR'S PROFILE
I. PERSONAL DATA
Name: _______________________________
Age: _______
Course & Year: ____________
Birthdate: ____________________________
Birthplace: _______________________________
Home Address: ____________________________________________________________________
Contact Number: ______________________
Email Address: ___________________________
II. POSITION/AVAILABILITY
Position Applied For
_____________________________________
Days/Hours Available
DATE
MORNING
AFTERNOON
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
I certify that information contained in this form is true and complete. I understand that false
information may be grounds for immediate termination of assignment at any point in the future if I am
given the responsibility. I authorize the verification of any or all information listed above.
Signature: __________________
Date: ______________________
NAMES
MENTORS
STUD. NO.
SIGNATURE
Subject: ___________________
Venue: ____________________
4. _______________________
5. _______________________
The following Tutorial program beneficiaries have been accepted as enrollees of the Review Circle:
NAME
STUDENT NO.
COURSE-YR.
Note: Please type or print legibly in black ink the information required. Thank you.
CONTACT NO.
SIGNATURE
TUTORIAL SESSION
Civil Engineering Review and Enhancement Program
___ Semester, S/Y 200_ - 200_
Facilitator/Lecturer:_________________________
Venue:____________________________________
Date:_____________________
Time:_____________________
ATTENDANCE SHEET
NAME
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SIGNATURE