PSHS 00 F DSA 01 Ver02 Rev02 Activity Proposal Form
PSHS 00 F DSA 01 Ver02 Rev02 Activity Proposal Form
PSHS 00 F DSA 01 Ver02 Rev02 Activity Proposal Form
CAMPUS: ___________________________
AP NO.: _______________________
(EC/CC-YYYY-NNN-VVV)
TITLE OF ACTIVITY:
RATIONALE:
VENUE:
TARGET ACCOMPLISHMENT:
PSHS-00-F-DSA-01-Ver02-Rev02-03/05/22 Page 1 of 2
LINE-ITEM BUDGET:
Source of Funds
Items Quantity Total Remarks
PSHS Other sources*
TOTAL
* Note: <Indicate source of funds for outside funding; indicate if there is contribution/collection
from students.>
____________________________________ ____________________________________
Organizer Adviser/Sponsor/Coordinator
Date: Date:
Recommending Approval:
__________________________________ _____________________________
DSA Chief RPAD Chief (For OED-initiated activity)
________________________ _________
Accountant/Budget Officer Date
________________________ _________
FAD Chief Date
________________________ ________________________
Campus Director (For campus-initiated activity) Executive Director (For OED-initiated activity)
Date: Date:
PSHS-00-F-DSA-01-Ver02-Rev02-03/05/22 Page 2 of 2