Dr.

Ofelia Sisno
Dean – College of Nursing
Cebu Doctor’s University
North Reclamation Area
Mandaue City

Dear Madam:

I, _______________, a level IV nursing student would like to ask from your good office to allow
me to go on-call / volunteer duty on _________________, at _________________________.
This is for the completion of my Delivery Room Requirements. I am currently residing in
__________________________________________. My father,________________________ ,
will bring me to the birthing center and will fetch me from the said area of assignment. Should
you wish to contact me, I can be reached at this number:______________________________. I
understand that the school will not be held responsible for any untoward event as a consequence
of this on-call / volunteer duty.

I am hoping for a positive response.

Thank you and God Bless.

Respectfully yours,

________________
CDU-CN BSN 4 - N

________________
Parent/ Guardian

Noted by:

Mrs. Nanette Torrequemada

Clinical Teacher

Mrs. Dolores M. Saldivia

Clinical Coordinator