Republic of the Philippines Department of Education Region IV-A

CERTIFICATION FOR TRANSFER

Learners Information
First Name:
RODELYN
Middle Name:
DAVID
Last Name:
ARDALES
Birthday:
MAY 5, 1998
Gender:
FEMALE
LRN Number:
Current Grade/ Year Level: GRADE 10
Section:
HGT
First Day of Attendance in this school:
JUNE 15, 2015
Last Day of Attendance in this school:
___________________
4Ps Recipient for public school student/s
Yes ( )
No ( / )
GASTPE Recipient for private school student/s Yes ( )
No ( / )
Schools Information
School Name:
DR. ARSENIO C. NICOLAS NATIONAL HIGH SCHOOL
School Address:
BRGY. PANDANAN, CALAUAG, QUEZON
School ID No.
308021
Name of Adviser:
HAZALE G. TRAPANE
Advisers Contact No.: 09472971119
Name of School Head: JOEL LIM GEROLIA
School Heads Contact No: 09989899768
I hereby certify that the above information is true and correct to the best of my
knowledge and belief.
Given this ______ of ________, 20____ for LIS/EBEIS purpose/s.
HAZALE G. TRAPANE
Adviser
(Signature over Printed Name)

JOEL LIM GEROLIA

School Head
(Signature over Printed Name)
Attached: Copy of Available Grades/ Records during his/her attendance in this school
Note: This certification is for SDO Quezon LIS/EBEIS purpose/s only.

RE: COPY OF ADVISER