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    Republic of the Philippines

    Sorsogon State University


    Office of the Student Development and Services
    STUDENT COUNCIL AFFAIRS SERVICES UNIT
    Magsaysay Street, Salog (Pob.), Sorsogon City, Sorsogon
    Tel. No.; 056 211-0103; Email Address: sas@sorsu.edu.ph

    PARENTS’/GUARDIANS’ PERMIT FORM


    1st Semester, S.Y. 2024-2025

    TO WHOM IT MAY CONCERN:

    This certifies that I am allowing my son/daughter, ____________________________________________,


    (Name of Student)
    BSHM____ to participate and or attend in the Hospitality and Tourism Industry Immersion Seminar with
    Historical & Cultural Familiarization Tour on December 09-13, 2024 in Metro Manila, Philippines.

    I am fully aware that I will be responsible to his/her personal conduct while he/she is on the Hospitality
    and Tourism Industry Immersion Seminar with Historical & Cultural Familiarization Tour and shall be liable
    thereof in consonance with the pertinent provisions of the Student Handbook and CMO No. 63, series of 2017.

    _____________________________ __________ ____________________________ _______


    Parent/Guardian Signature Over Printed Name Date Parent/Guardian Signature Over Printed Name Date

    Further, safety precautionary measures have been instituted by the faculty members accompanying the
    event.

    ALYSSA MAE H. ATUN __________ NOVIE F. EVASCO _________


    Faculty Signature Over Printed Name Date Faculty Signature Over Printed Name Date

    AUNEL D. DINGLASAN
    _______________________ __________ JOHN ARVIC E. POLICARPIO
    _________________________ _________
    Faculty Signature Over Printed Name Date Faculty Signature Over Printed Name Date

    REY R. RODRIGUEZ
    _______________________ __________ KRISTY H. RANERA
    _________________________ _________
    Faculty Signature Over Printed Name Date Faculty Signature Over Printed Name Date

    SUBSCRIBE AND SWORN TO BEFORE ME this _____________ day of _____________________, 20 ______ at


    _____________________________________ Philippines.

    Notary Signature: ______________________


    Notary Printed Name: __________________
    My commission expires: _________________

    Doc. Code FM-STC-002 Revision No. 02


    Effectivity Date Sept. 06, 2024 Pages 1 of 1

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