FORM: PARENT’S PERMIT

Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
2700 Ilocos Sur

College of Arts and Sciences

Website: www.unp.edu.ph Mail: cas66@yahoo.com
Tel #: (077) 674-0872

________________________________
Name of the Organization

_______________
DATE

TO WHOM IT MAY CONCERN:

I hereby grant permission to ________________________________ _____________ ____

(Name of Student) (Course & Year) (Section)
my son/daughter, to participate in the following activity:

Title of Activity :____________________________________________________________

Sponsoring Organization :____________________________________________________________
Place/Venue :____________________________________________________________
Date :____________________________________________________________

I realize that activities like the above-mentioned contribute to the total development of the students and
I am willing to pay the fee/expenses related to the above activity, itemized as follows:

Fare/Bus : ₱_________________
Board/Lodging : ₱_________________
Contingency Fund : ₱_________________
TOTAL : ₱_________________

I understand that the University and its officials/faculty who are responsible for the said activity and the
sponsoring organization shall take all necessary measures to ensure the safety of my child and that I shall not
hold them responsible for any untoward incident beyond their control that may happen to my son/daughter
during the said activity.

________________________________
(Signature over Printed Name of Parent)

Noted:

__________________________________
(Signature over Printed Name of Adviser)

FATIMA F. ROCAMORA, ED.D.

Dean, CAS