Clearance Request Form
Please fill-up this form for your request concerning processing of library clearance online.
Privacy Notice:
By voluntarily signing this form, clients consent to the collection of the following information: Name, Position, College, contact number, and email address. The collected personal information will be used solely in this request. It will be used within the University Library and will not be shared with any other outside institutions. You have the right to ask for a copy of any personal information we hold about you, as well as to ask for it to be corrected if you think it is wrong. (This google form will automatically send a copy of your responses to the email you have provided.)

To do so, contact Ms. Amelia C. Cendana at

***Note: only the data collector (University Library) can see the data/information collected unless stated otherwise.
Personal info
Name (Last name, First name, Middle initial) *
ID Number *
Email address *
Contact Number *
College *
User Group *
Other details of the request
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