BPSU-SAF-036 (Revision 0; January 2018)

ACCREDITATION FORM 1

BATAAN PENINSULA STATE UNIVERSITY

OFFICE OF STUDENT AFFAIRS
Checklist for Accreditation of an Organization

Name of Organization: __________________________________________________________________

Date: ____________________________

I. REQUIREMENTS (to be checked by OSA)

Have the following required documents been submitted?
______ List of officers (Officer’s Profile)
______ List of members (Member’s Profile) at least 15
______ Faculty adviser’s letter of acceptance of nomination
______ Action on the designation of adviser
______ Duly ratified Constitution and By-laws
______ Proposed activities for the school year
______ Proposed community project for the school year
______ Manifesto of Commitment (Accreditation F2), signed by all officers.
(Requirements for renewal of accreditation)
______ List of activities accomplished in the preceding year with proofs attached.
______ Community project accomplished in the preceding school year.
______ Audited financial statement/unaudited FS with official receipts (for with membership fee).

II. OBJECTIVES OF THE ORGANIZATION

1. Are the organization’s objectives clearly stated in its Constitution? Yes ____ No ____
2. Are its objectives consistent with the University’s Vision and Mission? Yes ____ No ____
3. Are the officers aware of the objectives of the organization? Yes ____ No ____
4. Are the officers aware of Vision & Mission of the University? Yes ____ No ____

III. MEMBERSHIP
1. What are the qualifications of the members? __________________________________
2. How do they recruit members? _____________________________________________
3. How do they initiate members? _____________________________________________
4. Do they have membership fees? Yes ____ No____ If yes, how much? ___________
5. Do they have monthly dues? Yes ____ No ____ If yes, how much? ___________
6. Are there more or fewer members this year than last year? More ______ Fewer ______
7. Why __________________________________________________________________
_________________________________________________________________

Comments:
_________________________________________________________________________
___________________________________________________________________
Evaluator:
_________________
Approved:

SISENANDO C. MASANGCAP JR. MBA

Director, Student Affairs

BPSU-SAF-036 (Revision 0; January 2018)

VISION MISSION
AA recognized
A leading university in the Philippines university
university of
ofits
for excellence
excellence
proactive acknowledged
acknowledged in
in
Provide
To developthe
the
Provide
quality
quality
and
competitiveand relevant
relevantcommunity
empowered education
educationmembers
that
that will
willby
develop
develop
contribution to Sustainable Development through equitable country
country
and highly
highly
qualified
qualified
providing relevant,innovativeand andandcompetitive
competitive
transformative human
human
knowledge, resources
resources
research,
inclusive programs and and
services
inand
the
byin
Asia-Pacific
2030
the Asia-Pacific
RegionRegion extension
for quality
for qualityand production programsresponsive
graduates and servicesthroughprogressive
responsive
Vision
and knowledge responsive
and knowledge responsive
enhancement of itstohuman
graduatesto socio-economic
needs to socio-economic
to
national
national and
Mission
resourcecapabilities
and
mechanisms
regional
regional and institutional
development
development
BPSU-SAF-036 (Revision 0; January 2018)
ACCREDITATION FORM 2

BATAAN PENINSULA STATE UNIVERSITY

Main Campus, City of Balanga, Bataan

MANIFESTO OF COMMITMENT

We, the Officers and Members of the Organization _______________________

do hereby pledge our commitment to serve our members, in particular, and all students of
this University, in general through the achievement of our Organization’s objectives and by
ensuring that our actions and activities do not in any way harm anyone and cause disruption
of classes. We reiterate our commitment by peaceful means and to resort, democratic and
free dialogue as the only acceptable means of solving our differences among ourselves and
with other groups. Finally, we renounce all violent actions including acts that violate the
right of students.

OFFICERS

Name Position Signature

BPSU-SAF-036 (Revision 0; January 2018)

BPSU-SAF-036 (Revision 0; January 2018)

ACCREDITATION FORM 3

BATAAN PENINSULA STATE UNIVERSITY

Main Campus, City of Balanga, Bataan
GREGORIO J. RODIS, Ph. D.
University President

THRU:
Director of Student Affairs & Services

NOMINATION AS ADVISER OF STUDENT ORGANIZATION

In behalf of the ____________________________________________________________

(Name of Organization)

in the ________________ _____________ , we, their officers respectfully nominate

(Campus)

________ ____________________ as our adviser for the Academic Year, __________.

(Name of Faculty)

Respectfully yours,

NAME OF OFFICERS POSITION SIGNATURE

1. _____________________________ ___________________ __________________

2. _____________________________ ___________________ __________________

3. _____________________________ ___________________ __________________

4. _____________________________ ___________________ __________________

5. _____________________________ ___________________ __________________

6. _____________________________ ___________________ __________________

7. _____________________________ ___________________ __________________

8. _____________________________ ___________________ __________________

9. _____________________________ ___________________ __________________

10. _____________________________ ___________________ __________________

BPSU-SAF-036 (Revision 0; January 2018)

BPSU-SAF-036 (Revision 0; January 2018)

ACCREDITATION FORM 4

BATAAN PENINSULA STATE UNIVERSITY

 Main Campus, City of Balanga, Bataan

LETTER OF ACCEPTANCE AS ADVISER

______________________
Date

TO: OFFICE OF STUDENT AFFAIRS

Madam:

I, ______________________________ hereby accept my nomination as Faculty

Adviser of the ________ ______________.
(Name of Organization)

As adviser, I am aware of my duties and responsibilities and I declare my

commitment to fulfill them for the welfare of the members of the organization, to wit:

1. Make myself available for consultation officer to all members of the organization.
2. Attend regular/special meetings of the organization.
3. Assist in planning of activities related to the objectives of the organization and
come out with laudable projects.
4. Monitor/Supervise activities held in-campus and out-campus or when the
organization represents the school.
5. Note all letters and documents of the organization.
6. Sign request forms (use of school activities)
7. Assume responsibility for the decision and action of the organization.

Respectfully yours,

____________________
Faculty Adviser

BPSU-SAF-036 (Revision 0; January 2018)

BPSU-SAF-036 (Revision 0; January 2018)

BATAAN PENINSULA STATE UNIVERSITY

OFFICE OF STUDENT AFFAIRS
 OFFICER’S PROFILE
A.Y. __________

___________________________
(Name of Organization)

Name:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
Name:
E-mail Address:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
E-mail Address:
Name:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
Name:
E-mail Address:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
E-mail Address:
Name:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
E-mail Address:

BPSU-SAF-036 (Revision 0; January 2018)

BPSU-SAF-036 (Revision 0; January 2018)

BATAAN PENINSULA STATE UNIVERSITY

OFFICE OF STUDENT AFFAIRS

MEMBER’S PROFILE
A.Y. __________

___________________________
(Name of Organization)

Name:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
E-mail Address:
 Name:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
E-mail Address:
Name:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
Name:
E-mail Address:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
E-mail Address:
Name:
Position:
Course/Year & Section:
Student ID Number:
Address:
Contact Number:
E-mail Address:
BPSU-SAF-036
(Revision 0; January 2018)

BPSU-SAF-036 (Revision 0; January 2018)

Accreditation Form 5

Action on the designation as Student Organization Adviser

____________
(Date)

_________________
_________________
_________________

Through: _______________

Mr. / Ms. _______________

Your nomination/Designation as a adviser of ____________________________________

(Name of Organization)
in _____________________________________ as shown by your nomination and acceptance
(campus)
of the Adviserhip for a period of one (1) Academic Year ______________ is hereby:

Confirmed Renewed Deferred

 Recommending Approval:

SISENANDO C. MASANGCAP JR.

Director, Office of Student Affairs & Services

Noted:

EMMANUEL C. MACARAEG, Ph. D.

Vice President, Academic & Student Affairs

Approved:

DR. GREGORIO J. RODIS

University President

BPSU-SAF-036 (Revision 0; January 2018)