SDF Form 1Republic of the Philippines

CENTRAL LUZON STATE UNIVERSITY

Science City of Muoz, Nueva Ecija

STUDENT DEVELOPMENT FUND

STUDENT DELEGATE FORM

Date filed: ____________________Name: ________________________________________________________________________ Course/Year: _________________Sex: ___________ Age: ________ Status: _______________Birth Place: ______________________________________ Birth Date: ____________________Organizations: ____________________________________ Position: _____________________Address while in CLSU: _________________________________________________________Home Address: _________________________________________________________________Name of Parents:

Occupation

Father: ____________________________________________________________

Mother: _____________________________

______________________________Special talents/abilities: __________________________________________________________Dialect/Language Spoken: ________________________________________________________

Attended training, seminar, conference, symposium and workshop (if there is any)

Theme

Place

Date

Sponsor/s

___________________ __________________ __________________ __________________

___________________ __________________ __________________ __________________

___________________ __________________ __________________ _____________________________________ __________________ __________________ __________________

___________________ __________________ __________________ __________________Title of the seminar, workshop, conference, training, convention search, contest, quiz bee or symposium to be attended:

Title: _________________________________________________________________________Place: ______________________________________________ Date: _____________________Sponsor/s: _____________________________________________________________________Objective/s: ___________________________________________________________________

____________________________________________________________________

____________________________________________________________________Objective/s of the Delegate: _______________________________________________________

__________________________________________________________________

__________________________________________________________________

Expectation/s from the activity: ____________________________________________________

__________________________________________________________________

_________________________________

Signature Contact #________________________

SDF Form 2Republic of the Philippines

CENTRAL LUZON STATE UNIVERSITY

Science City of Muoz, Nueva Ecija

STUDENT DEVELOPMENT FUND

GROUP FORM

Date filed: _____________

Sponsors: _____________________

_____________________

____________________

Title of the Activity/Program

______________________________________________________________________________

______________________________________________________________________________

Date: ___________________________________ Time: ________________________________

Venue: _______________________________________ Clientele:________________________

Rationale:_____________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Objective/s: ___________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

Methodology/Mechanics: ________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

Title:_________________________________________________________________________Place: ________________________________________ Date/Time: _____________________BUDGETARY PLANGross Receipt/Sources:

_SDF____________________

P_________________________________________________

P________________________

_________________________

P________________________

TOTAL

________________________

Less Expenses:

______________________________

P________________________

______________________________

P_______________________

P________________________

TOTAL

P ________________________Net Income:

P___________________________________________

____________________________ Project Coordinator

Adviser

____________________________

_____________________________

Project Coordinator

Adviser

Approved Budget: P__________Recommending Approval:

DEVIN CARL P. SAGUN

ERNESTO T. JIMENEZ, JR. USSC Chairperson

SOU Officer

Approved by:

ELIZABETH S. SUBA

TERESO A. ABELLA Dean of Student

VPAA

Note: Narrative report/documents, photocopies of training materials must be submitted to the USSC office within ten (10) working days. SDF used intended for the activity must be properly liquidated.