Republic of the Philippines

Department of Education
Region IV-A(CALABARZON)
Division of Lipa City
BULACNIN INTEGRATED NATIONAL HIGH SCHOOL
Bulacnin, Lipa City

Request for Minor Repair of Classroom

(Please check the appropriate item)

Needed Item/ Description Number of pieces

Steel window glass

Jalousie glass blade

Jalousie aluminum frame

faucet

Others: (please specify)

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Requested by: ________________________

Year/ Section: ________________________