RLC/ CWLC total unit/s requested

(1)

UP Form 67-CPL (Project List Form) to be submitted (a) in print together with UP Form C (Revised 28 Jun 2017), and (b) Excel file copy to be emailed to rlc.cwlc@gmail.com

Project Title Project Type Nature of

Involvement

Research/Creative Work Agenda Theme

Start Date (Month/Year)

End Date

(Month/Year) Expected Output Percent of Work Accomplished

Funding Classification

Funding

Institution Total Amount for Project Type:

 Research Program;

 Research Project;

 Creative Work;

 Textbook Writing

I certify that all information/data in this form are true to the best of my knowledge. I understand that a report or proof of output is to be submitted to the OVCRD at the end of the semester or term for which RLC/CWLC is granted and at the end of the project period. I further certify that I have no overdue accountabilities for OVCRD-funded and managed projects.

Name and Signature of Faculty Member RLC/ CWLC total unit/s requested: _______

Date Accomplished: _________________________

Academic Year: _________________________

Semester: _________________________

Please use the following legend:

for Nature of Involvement:

 Program Leader;

 Project Leader;

 Co-project Leader;

 Artist;

 Author;

 others, please specify

for Funding Classification:

 UP Diliman;

 UP System;

 DOST;

 Phil Gov't;

 NGO;

 Private;

 Foreign for Expected Output:

 research project with corresponding technical report;

 creative work with corresponding permanent documentation;

 accepted, peer-reviewed article in a national/ international journal;

 creative output in a national/ international forum or presentation;

 national policy, regulation, bill, or law w/ public acknowledgment;

 new patent claim;