Last Name: LAUS Proposal Final Date: __________ First Name: ABIGAIL Middle Name: MAYLED Factors affecting the Non-Scalpel Vasectomy ACADEMIC INFORMATION Acceptors among Males living in a Selected Student Number: 2016-2300-276 Barangay Setting Degree Program/Major: MSPH CONTACT INFORMATION Telephone No.: N/A Mobile No.: 0995 746 7964 PANEL COMPOSITION Email Address: amlaus@uerm.edu.ph EVALUATION OF RECORDS (DO NOT FILL) Adviser: DR. JENNIFER NAILES
Completed Coursework Yes Date: _________ No Panel Chair: DR. RAMON JASON JAVIER Passed Comprehensive Exam Yes Date: _________ No Member: DR. PENAFRANCIA ADVERSARIO Enrolled in Thesis/Residency Yes Date: _________ No Member: DR. JONATHAN FLAVIER APPROVED FOR DEFENSE Passed Proposal Defense Yes Date: _________ No
Granted Ethics Approval Yes Date: _________ No ADVISER
I certify that the Thesis manuscript is ready for defense. Evaluated by: _________________________________________ PROGRAM COORDINATOR/COLLEGE SECRETARY DR. JENNIFER NAILES/ JUL-08-20200 ______________________________________ Signature over printed name / Date Noted by: _________________________________________ DEAN PROGRAM COORDINATOR I certify that the student is qualified for oral THESIS WRITING ENROLLMENT STAGE defense of his/her manuscript. Term 1 Term 6 Term 2 Term 7 ________________________________________ Term 3 Term 8 Signature over printed name / Date Term 4 Term 9 Term 5 UNIVERSITY REGISTRAR I certify that the student has completed his/her coursework & can proceed to the Thesis stage. ABIGAIL M. LAUS / JUL-08-2022 ____________________________________________ Signature over printed name / Date ________________________________________ STUDENT Signature over printed name / Date Accomplish this form in four copies, and pay the assessed proposal or final defense fees. Distribution of the copies shall be: Office of the Registrar (1); Graduate School (1): Program Coordinator (1); and the Student (1).
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