UST ANGELICUM COLLEGE
112 MJ Cuenco St., Barangay Sto. Domingo, Quezon City 1114
Tel. No. 712-1745
FETCHER’S PASS APPLICATION FORM
Name of learner: _____________________________YS ________ Moderator _____________
Name of Parent: _______________________________ Contact number: _______________
Address: ____________________________________________________________________
May I request from your good office an official fetcher’s pass in order for me/my
authorized fetcher to stay at the Angelicum College WAITING AREA due to the
____________________________________________________________________________
____________________________________________________________________________
(State the reason above.)
I/we promise to abide school regulations to be observed in relation to the use of fetcher’s pass.
____________________________________________
Printed Name and Signature of Parent
_____________________________________________
Printed Name and Signature of Authorized Fetcher/Guardian
ACTION TAKEN BY THE OSDS
The OSDS do hereby: approved the request
disapproved
Remarks: ____________________________________________________________________
____________________________________________________________________
__________________________________
Member, Team Principal
If approved, follow the following procedure:
1. Affix the signature in the agreement if conform.
2. Pay Five Hundred Pesos (Php 500.00) at the Accounting Office.
3. Submit the receipt of payment including the approved application form to the Office of
Student Development and Services (OSDS) for processing and Issuance of Fetchers
pass.
