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Antipolo National High School

Antipolo Virac Catanduanes

(file in duplicate)

I,________________________________________________ hereby announce my candidacy for SSG

________________________________________ at Antipolo National High School S.Y. ________________________ Election, and after having sworn in
accordance with the Constitution and BY LAWS of the Supreme Students Government of Secondary Schools, hereby states the following:

1. Full Name:_______________________ _________________________ ________________________

(Surname) (First Name) M.I.
2. Nick Name:________________ 3. Sex: _____________ 4. Age:_______
5. Year & Section: ____________________ _______________ 6. Citizenship: ________________________
7. Address: ________________________________________________________________________
8. Name of Parent /Guardian:________________________________________________
9. Present Position:
a.) SSG _____________________ b.) Clubs__________________
c.) Homeroom _______________ d.) Others_________________
10. Academic Standing (General Average for the 3rd Grading Period) _____________________

That I am eligible for the said position, that I have met the qualification stated in Article VII. Section 7 of the SSG Constitution and
By-Laws: That I will support and maintain Allegiance thereto; that I will obey all Rules and Regulations promulgated by the duly
Constituted school authorities; and that facts stated herein are true to the best of my Knowledge.

Signature of Candidate
SUBSCRIBE AND SWORN TO BEFORE ME this ___________________________ day of _____________
At _______________________________________ after presenting to me his/her rating of_____________.

SSG Adviser/Person Authorized
To administer oath

__________________________________ ________________________________
4th Year Representative Grade 9 Representative

__________________________________ ________________________________
Grade 8 Representative Grade 7 Representative