Reference No.: BatStateU-FO-REQ-01 Effectivity Date: January 3, 2017 Revision No.

: 00

REQUEST FOR PARTICIPATION IN SEMINARS, CONFERENCES, TRAININGS, WORKSHOPS AND

SIMILAR ACTIVITIES TO BE HELD OUTSIDE THE UNIVERSITY

Name of Faculty Member / Employee : Lucille Evangelista

College / Office: Office of Student Affairs and
Employment Status: Permanent
Services
Campus: Main I Position/Designation: Director

55th Psychological Association of the Philippines Annual

Title of Seminar/ Conference/ Training/ Symposia/
Convention
Workshop:

Level: Local Regional National International

Participant Presenter Officer

Nature of Participation:
Speaker Facilitator Organizer

Date: September 20-22, 2018 Actual No. of Hours: 24 hours

Philippine International Convention Psychological Association of the
Venue: Sponsor Agency/ Organizer:
Center Philippines
Is the activity endorsed by CHED/ a recognized or
Yes No
registered professional organization?
Is the nature of the activity within the participant’s
field of specialization/ current teaching load or Yes No
work load?
Is financial assistance requested from the
Yes No
University?
If Yes, how much is the total amount being
requested? Php 9,938.00
Coverage: Registration Accommodation Materials/ Kit
Speaker’s Fee Meals/ Snacks Transportation
Others, specify:
Has the faculty/ employee previously attended a
seminar/conference/workshop outside the Yes No
University within the current school year?
If Yes, how much did the University shoulder for If Yes, what are the topics of the seminars attended within the
that activity? (If more than one activity was current school year?
participated in, please indicate the total expenses  Seminar-Workshop in counseling documentation and
for all activities.): psychological assessment

Php 0.00

Does the faculty have any unliquidated cash

Yes No
advance?
Requested by: Reviewed and Verified:

Dr. LUCILLE D. EVANGELISTA Assoc. Prof. ROMEO C. DE CASTRO

Director, Office of Student Affairs and Services Executive Director
Recommending Approval:

Dr. ERMA B. QUINAY Atty. LUZVIMINDA C. ROSALES

VP for Academic Affairs VP for Administration and Finance
Approved: Remarks:

Dr. TIRSO A. RONQUILLO

University President
Required Attachments: (1) Official CHED endorsement, if any/ invitation from prof. organization; (2) official invitation/ call for participation, (3)
program of activities; (4) breakdown of estimated expenses with signature, if requesting for financial support

cc: HRMO/ FTDC

Tracking Number: _____________