Document Type:

Document Code INS-F04

FORM Revision No. 00
ISO 9001:2015
Document Title:
Effective Date June 1,2018

SUBSTITUTION FORM Page 1 of 2

________________________________
Dean
Dumarao Satellite College
Dumarao, Capiz

Thru: ______________________________
Program Coordinator

Madam/Sir:

May I have the privilege to request for the services of Prof.______________________________

to be my substitute in teaching on ____________________________, 2017 at _______________
(AM/PM) relative to my leave of absence due
to:_______________________________________.

Very Respectfully,

______________________
Printed Name/Signature

Recommending Approval:

_____________________________
Program Coordinator

APPROVED:

_____________________________________
Dean
(To be filled out by the Requesting Faculty and Substitute)