VINZONS HALL

UP Diliman
Student Org Copy
RESERVATION FORM

[ ] Rooftop (4th floor) [ ] Activity Center (4th floor) [ ] Alcantara Hall (2nd floor) [ ] Lorena Barros Hall (LBH)

Name of Student Organization: Date & Time Filed:

Name & Contact Number of Person making the reservation: Signature:

Time and Date/s of the Reservation/s:

Brief Description of the Activity:

Endorsed by: Certified Recognized Student Organization:

________________________________________________

_________________________________________________
Adviser Dr. MA. ALTHEA T. ENRIQUEZ
(Printed Name & Signature) Coordinator, Office of Student Activities (OSA)

Action of the Building Administrator:

University Student Council
(Printed Name & Signature) [ ] Approved [ ] Disapproved

Josephine P. Esteban
Building Administrator

VINZONS HALL
UP Diliman
Building Administrator’s Copy
RESERVATION FORM

[ ] Rooftop (4th floor) [ ] Activity Center (4th floor) [ ] Alcantara Hall (2nd floor) [ ] Lorena Barros Hall (LBH)

Name of Student Organization: Date & Time Filed:

Name & Contact Number of person making the reservation: Signature:

Time and Date/s of the Reservation/s:

Brief Description of the Activity:

Endorsed by: Certified Recognized Student Organization:

_________________________________________________ Dr. MA. ALTHEA T. ENRIQUEZ

Adviser Coordinator, Office of Student Activities (OSA)
(Printed Name & Signature)

Action of the Building Administrator:

[ ] Approved [ ] Disapproved
University Student Council
(Printed Name & Signature)
Josephine P. Esteban
Building Administrator