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CLEARANCE SLIP

To whom it may concern:

This is to certify that Febie Gae C. Segovia is cleared of all the authorized collections
and any accountability in school for the whole year.

_______________ GRADING PERIOD


SY 2011-2012
PTA An dues. (P30.00) ______________ Projects per subjects: Teacher:
Signature
Sec Guard (P70.00)
______________ Char Ed (P40.00) __________________ __________
School Paper (P60.00) ______________ English (40.00) __________________ __________
PAAF (P20.00)
______________ Science (40.00) __________________ __________
BSP/GSP (P60.00)
______________ Filipino (P40.00) __________________ __________
School Centrum (P10.00) _____________ Math (P40.00) __________________ __________
STEP (P25.00)
______________ HEKASI (P40.00) __________________ __________
Forms Photocopy (P20.00) ____________ MSEP (P40.00) __________________ ___________
H.E Facilities (P20.00) _____________ EPP (P40.00)
__________________ ___________
HRPTA Projects (P120.00)____________ Class treasurer __________________ ___________
Floor wax (4 boxes) __________ * Note: For transferee only---P30.00-PTA membership fee*
Detergent (1/2 bar) __________

_____________________________
Pupil

ENRIQUETA S. LIBANTE
Class Adviser

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