Date:

Name of addressee with title (if applicable)

Position of addressee

Company of Addressee

Dear Mr/Ms.________

(Introduction Greeting)

I, the undersigned, am a senior nursing student from the Lyceum of the Philippines University College of Nursing who is currently developing an undergraduate research study entitled as a partial requirement for the Bachelor of Science in Nursing degree. This study aims to (Write your objectives here in declarative sentences. Avoid using the same words used in your title.)

In line with this, I would like to request permission to conduct the said study in your institution. The study would involve gathering data from (Write the characteristics of your respondents and their inclusion criteria). The study would (explain your study methodology and data gathering procedure). Adherence to full disclosure of information to the participants and confidentiality of data gathered from them will be strictly maintained. All information gathered will only be used for academic purposes

The perceived benefits of this study are (write the significance of your study in relation to the benefits that can be achieved by the institution and its participants).

Attached herewith is a copy of the research instrument that will be utilized for the study.

For any queries, regarding this study, I may contacted through cellphone at ____________ or via email at _______________

Thank you.

Sincerely,

Sesha Neheru C. Antonio

Student Researcher

LPU College of Nursing

Noted by:

Kenn Everard D. Lachenal, MSN RNLeonora N. Reyes, MN RN

Research ProfessorDean

LPU College of NursingLPU College of Nursing