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11 Request for Extension of Volunteer Assignment

PNVSCA request form for extension of volunteer assignment

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Republic of the Philippines
National Economic and Development Authority

REQUEST FOR EXTENSION OF
VOLUNTEER ASSIGNMENT

Philippine National Volunteer
Service Coordinating Agency

(To be submitted two (2) months before end of
volunteer assignment)

G/F, Philippine Sugar Center Building
North Avenue, Diliman, Quezon City
Telehone No.: (02)4534726; Telefax: (02)927-6847

Reference No. _____________

Email Address: international@pnvsca.gov.phph

1. Name and Address of Local Partner Institution:_____________________________________________
____________________________Email Add:___________________ Contact Nos.: ________________
2. Name of Volunteer: ____________________________________________________________________
3. Project Title and Location: ______________________________________________________________
4. Initial Duration of Volunteer Assignment: __________________________________________________
5. Period of Extension Requested: __________________________________________________________
6. Reasons for Requesting Extension:(Please attach project accomplishment report and volunteer’s work
plan for the duration of extension requested )
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
___________________________________________________________________________________

Prepared by :

Concurred:
_________________________________

___________________________
Printed Name and Signature of
Program /Project Supervisor

Signature of Volunteer

Submitted by:
_____________________________

________________________________

Printed Name and Signature of
Head of the Institution

Signature of Head of FVO

ACTION TAKEN BY PNVSCA (for PNVSCA use only)
Date: _______________________________

Date: ____________________________

Deferred due to (state reason) __________________________________________________________
__________________________________________________________________________________
Disapproved (state reason) ____________________________________________________________
Approved/Endorsed to __________________for the period _________________ ________________

_______________________
Date

PNVSCA Request for Extension of Volunteer Assignment

JOSELITO C. DE VERA
Executive Director
 
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