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ST. MARY’S COLLEGE OF TAGUM, INC.

TAGUM CITY
COLLEGE DEPARTMENT
OFF-CAMPUS AND IN- CAMPUS AFFILIATION FORM

Name: ________________________________________ OFF- Campus Organizations: (Please Indicate Position and Number of Years
Holding such position)_____________________________________
Course/Year: ___________________________________
IN- Campus Organizations: ________________________________________
_______________________________________________________
OFF- CAMPUS:

Name/ Title of Activity Date and Avenue Position taken Attached Document Adviser/Moderator/Chairman/Head

Note: (Seminars, Trainings, Note: Address/ Location (Planner/ Organizer/ Speaker/ (Certificates/Citations, etc). (Signature over Printed Name)
Workshops, Conferences, Facilitator/ Participant/ Lecturer…
Conventions, Congress…etc). etc).

IN CAMPUS:
ST. MARY’S COLLEGE OF TAGUM, INC.
TAGUM CITY
COLLEGE DEPARTMENT
OFF-CAMPUS AND IN- CAMPUS AFFILIATION FORM

Name: ________________________________________ OFF- Campus Organizations: ___________________________________________


Course/Year: ___________________________________ ___________________________________________________________

IN- Campus Organizations: ____________________________________________


___________________________________________________________
OFF- CAMPUS:

Name/ Title of Activity Date and Avenue Position taken Attached Document Adviser/Moderator/Chairman/Head

Note: (Seminars, Trainings, Note: Address/ Location (Planner/Organizations/ Speaker/ (Certificates/Citations, etc). (Signature over Printed Name)
Workshops, Conferences, Facilitator/ Participants.)
Conventions, Congress…etc)

IN CAMPUS:

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