Republic of the Philippines

Department of Education
Region IV B MIMAROPA
Schools Division of Palawan
DISTRICT OF CUYO
Cuyo, Palawan
_______________________
Date
The Schools Division Superintendent
Division of Palawan
Puerto Princesa City
(Thru Channel)
Sir:
I have the honor to apply for reinstatement as classroom teacher in the
Division of Palawan effective ___________________ 2015. I was on __________ ______
leave of absence from _____________________, 2015 to __________________, 2015.
Attached herewith is/are the pertinent paper(s) that I am physically fit to
return to duty.
( ) C.S. Form 211 (Medical Certificate)
( ) Certificate of Live Birth of my child
( ) _____________________________
Hoping for your favorable consideration.
Very truly yours,
_________________________
Teacher
1st Indorsement
DISTRICT OF CUYO
Cuyo, Palawan_________________, 2015
Respectfully forwarded to the Schools Division Superintendent, Puerto
Princesa
City, recommending
approval
the
reinstatement
of
Mr./
Mrs.
_______________________________, effective ___________________, 2015.
His/her substitute Mr./Mrs./Miss ________________ who served from
________________, 2015 to _______________________, 2015 is dropped from the roll
effective _________________, 2015.

ESTELITA D. PALAY
Principal III
OIC, Cuyo District
Approved:
SERVILLANO A. ARZAGA, CESO V
Schools Division Superintendent