NAME OF ORGANIZATION

University of St. La Salle Organization

1st Semester logo
A.Y. 2018-2019

ACTIVITY FORM (1)

Dr. Rowela A. Chiu

c/o Ms. Ann Gladys Ponteras
Office for Student Affairs
Date Filed:
Name of Activity: Date of Activity:

ORGANIZATION SPONSORED ACTIVITY (AT COST)

Please attach: a.) Cover letter, b.) Minutes of the meeting
Type of Activity:
o Acquaintance Party o Club Sponsored Activity:
o Organization Night
o Club Shirt o Others (please specify):
o Collection (Membership fee, organization dues)
o
FUNDRAISING ACTIVITY
Please attach: a.) Cover letter, b.) Minutes of the meeting
Type of Activity:
o Solicitation o Novelty Selling
o Raffle/Bingo Type o Entertainment
o Souvenir Program o T-Shirt Selling
o Food Stall o Others(please specify):

Beneficiary: Telephone Number:

Contact Person: Position:
Address:
Projected Donation (stated in percentage of net cash receipts):

FINANCIAL PROJECTION

Total Tickets Produced @Php = Php

Other Sources of Income @Php = Php

PROJECTED GROSS CASH RECEIPTS Php

Less: Projected Expenses

a) Php
b) Php
c) Php

TOTAL PROJECTED EXPENSES Php

PROJECTED NET INCOME Php

We understand that we are required to comply with the condition that comes with the approval including the
accomplishment of related reports and documents which shall be submitted not later than five school days after
the activity.
Prepared by: Noted by:

(Insert Treasurer’s name) (Insert President’s name) (Insert Moderator’s name)

(Organization) Treasurer (Organization) President (Organization) Moderator

Noted by: Endorsed by: Approved by:

(Insert Commissioner’s name) Ms. Ann Gladys Ponteras Dr. Rowela A. Chiu
Commission on Audit Administrative Assistant Dean of Student Affairs
(College) Commissioner for Student Activities
CF: COA, OSA, File