REQUEST FOR INCENTIVE OF RESEARCH OUTPUT
THE UNDERSIGNED HEREBY REQUEST FOR INCENTIVE BE APPLIED. / (The following is to be filled in by the University Research Office)Application No.:TSU-URO-SF-04
Filing Date:
Date of Receipt:
(1) APPLICANT’S INFORMATION
Full Name:
Department/Office/College:
Office Contact Number:
Contact Number:
E-mail Address:
(2) KIND OF RESEARCH OUTPUT (PLEASE CHECK ✓)
International Publication National Publication
International Oral Presentation National Oral Presentation
Terminal Incentives Citations
Winners in Research Competitions Cash Prizes for Oral Presentation in the UniversityIn-House
Review of Researches
NOTE:
- For PUBLICATION, proceed to 3A
- For PRESENTATION, proceed to 3B
- For TERMINAL INCENTIVE, proceed to 3C
- For CITATION, proceed to 3D
- For WINNERS IN COMPETITIONS and CASH PRIZE for ORAL PRESENTATION IN THE UNIVERSITY
(3) DETAILS OF RESEARCH OUTPUT
- RESEARCH PUBLICATION
Name of Journal
ISSN/Volume/Number
Date of Publication
Editor
Publisher/Address
Number of Pages
Indexing Agency
Amount of Incentive / ₧ ______
(Attach copy of journal or the article including cover page, copyright page, editorial board and table of contents of the journal)
- RESEARCH PRESENTATION
Title of Conference/ Seminar
Sponsoring Agency
Date
Place
Amount of Incentive / ₧ ______
(Attach copy of the paper, invitation to the presentation, program of the conference, certificate of appearance, certificate of recognition/participation and travel order)
- TERMINAL INCENTIVES
Name of Authors and co-Authors:
Date of Completion
Final Evaluation Rating:
(to be filled by URO)
Amount of Incentive / ₧ ______
(Attach copy of the revised paper and college level evaluation)
- CITATION
Title of the Citing Article/Book
Author/s of the Article/Book
Citing Journal/Book
ISSN/Volume/Number
Date of Publication
Editor
Category of the Citing Journal/Books / SCOPUS, Thomson Reuters (ISI, ISSI), Proquest, Elsevier
and CHED Accredited Journals Category A and B
Book by International Authors (does not include self-citation)
Google Scholar Indexing and all other International Refereed Journals
Amount of Incentive / ₧______
(Attach copy of the Citing Article)
- WINNERS IN RESEARCH COMPETITION/ORAL PRESENTATION IN THE UNIVERSITY IN-HOUSE REVIEW
Research Competition / In-House Review
Name of Competition / Category / Science, Technology, Engineering and Mathematics
Social Science and Education
Competition Level / International National Regional / Place / First
Second
Third
Place / First Third
Second Best Paper
Amount of Incentive / ₧ ______
(Attach copy of the paper, invitation to the presentation, program of the event, certificate of appearance, certificate of recognition and travel order if applicable)
(4) CERTIFICATION
I hereby certify that the information given are true and correct.
_ _______ ____________
Signature over Printed Name of the Applicant Date
(5)ENDORSEMENT (to be accomplished by URO)
______
Director, URO Date
(6) RECOMMENDING APPROVAL(to be accomplishedby theoffices of VP RES and VP Finance & Administration)
______Vice President, RES Date Vice President, Admin. & Finance Date
(7) AVAILABILITY OF FUNDS (to be accomplishedby the Budget Management Office)
____________
Budget Officer Date
(8) APPROVED (to be accomplished by the Office of the President)
____________
President Date
Received approved request:
______
Signature over Printed Name of URO Representative Position/Designation Date
Form No.: TSU-URO-SF-04 | Revision No.: 00 | Effective Date: June 28, 2016 / Page 1 of 2