Republic of the Philippines

UNIVERSITY OF EASTERN PHILIPPINES

University Town, Northern Samar, Philippines
Web: http://uep.edu.ph; Email: ueppres06@gmail.com
COLLEGE OF ENGINEERING

REQUEST FOR THESIS DEFENSE

Date: _______

BENJAMIN D. VARELA, PhD.

Dean, College of Engineering
University of Eastern Philippines
University Town, Northern Samar

Sir:

The undersigned student/s of the CE Department, College of Engineering,

would like to ask permission to present/defend his/her/their thesis proposal entitled:

at on in the
(Time) (Date) (Place)

Thank you very much for your favorable action on this request.

Respectfully yours,

________________________ ________________________ ________________________

Signature of Student Over Printed Name
________________________
Signature of Student Over Printed Name
________________________
Signature of Student Over Printed Name
Signature of Student Over Printed Name
________________________
Signature of Student Over Printed Name
________________________
Signature of Student Over Printed Name
Signature of Student Over Printed Name
________________________
Signature of Student Over Printed Name

RECOMMENDING APPROVAL:

Thesis Adviser Department Chairman

Date: _________ Date: _________

RECOMMENDING APPROVAL: APPROVED:

ENGR DEODATUS G. SAGADAL BENJAMIN D. VARELA PhD.

College Research Coordinator Dean, College of Engineering

CoE Research Form No. 3

Note: To be accomplished in quadruplicate. When APPROVED, one (1) copy stays with the College
Dean/College Secretary, one (1) copy is for the department chairman, one (1) copy goes to the
College Research Coordinator, and one (1) copy is given back to the thesis student/s.
 Republic of the Philippines
UNIVERSITY OF EASTERN PHILIPPINES
University Town, Northern Samar, Philippines
Web: http://uep.edu.ph; Email: ueppres06@gmail.com
Date: _________ Date: _________

CoE Research Form No. 3

Note: To be accomplished in quadruplicate. When APPROVED, one (1) copy stays with the College
Dean/College Secretary, one (1) copy is for the department chairman, one (1) copy goes to the
College Research Coordinator, and one (1) copy is given back to the thesis student/s.