Student Leadership Development Program

Student Activities and Leadership Development Office of Student Affairs, Xavier University Ateneo de Cagayan Rm 204, 2/F Magis Student Complex / Tel (088) 858-3116 locals 3330, 3312

CONFIRMATION FORM
Module 2b: Strategic Planning and Alignment 18 May 2013 / 8:00 AM to 5:00 PM / AVR 1, Xavier University Main Campus TO THE STUDENT LEADER:
Please accomplish this form and submit to SACDEV-OSA on or before 12:00 NN on Friday (17 May 2013). Please write legibly in print. This will serve as basis for your nametag and certificate.
Last Name: First Name: Middle Initial: Sex:

Organization:

Designation:

Mobile Number:

Landline:

Email Address:

Food Restriction: (If any)

To SACDEV-OSA: This is to confirm my participation in the aforementioned activity.

________________________________ Signature over Printed Name

Student Leadership Development Program

Student Activities and Leadership Development Office of Student Affairs, Xavier University Ateneo de Cagayan Rm 204, 2/F Magis Student Complex / Tel (088) 858-3116 locals 3330, 3312

CONFIRMATION FORM
Module 2b: Strategic Planning and Alignment 18 May 2013 / 8:00 AM to 5:00 PM / AVR 1, Xavier University Main Campus TO THE STUDENT LEADER:
Please accomplish this form and submit to SACDEV-OSA on or before 12:00 NN on Friday (17 May 2013). Please write legibly in print. This will serve as basis for your nametag and certificate.
Last Name: First Name: Middle Initial: Sex:

Organization:

Designation:

Mobile Number:

Landline:

Email Address:

Food Restriction: (If any)

To SACDEV-OSA: This is to confirm my participation in the aforementioned activity.

________________________________ Signature over Printed Name