TriColl Form- D.

02

Date: ____________________

The Chairperson
Tri-College (Ph.D. Philippine Studies Program)
University of the Philippines Diliman

Thru: The College Secretary

Dear Sir/Madam:

I would like to manifest my intent to present and defend my dissertation proposal entitled
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_____________________ on ______________________ at ______________.
(date) (time)

Thank you.

Signature: __________________________ Student No.: _______________________

Name of Student:________________________ Email Address: _______________________
Date: ____________________________ Contact No.: _______________________

Endorsed by:

Signature: __________________________
Name of Adviser: __________________________
Date: __________________________

Note to the Student:

 Accomplish this form, in consultation with your dissertation committee and duly endorsed by the
dissertation adviser, and submit to the Office of the College Secretary at least 3 weeks prior to the proposed
date of dissertation proposal defense.
 Furnish the committee members with a copy of your dissertation proposal at least 2 weeks prior to the
defense.