__________________ __________________

(Date) (Date)

Certification from the Dean Certification from the Adviser

(Sample Pattern Only) (Sample Pattern Only)
This is to certify that the ________________________________ to This is to certify that the ________________________________ to
(Name of Activity) (Name of Activity)
be conducted by _________________________________________ on be conducted by _________________________________________ on
(Name of Organization) (Name of Organization)
_____________ at _______________________________________ is a _____________ at _______________________________________ is
(Date) (Place) (Date) (Place)
co-curricular activity that aims to reinforce classroom learning and to enrich part of the organization plan of activities that was submitted to the Office of
the skills of our students. the Student Organizations.
As Dean of the College of ______________, I am ensuring that this As the adviser of the organization, I am ensuring that this activity will
(Name of College)
activity will observe the guidelines and rules set by Bulacan State observe the guidelines and rules set by Bulacan State University.
University.

_______________________________
_______________________________ (Signature over printed name)
(Signature over printed name)
Adviser, Student Organization
Dean, College

BulSU-OP-OSO-02F3 Page 1 of 1 BulSU-OP-OSO-02F4 Page 1 of 1

Revision: 1 Revision: 1