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LUNA ST.

LA PAZ, ILOILO

STUDENT’S CLEARANCE
SY 2018 - 2019

___________________________________
Name
YEAR & SECTION ______________________ MAJOR: ____________________

NAME / ORGANIZATION SIGNATURE OVER PRINTED NAME DATE

SA Student Council ----------------------------------- --------------------------------------


STEPHANIE GASALAO FRANK BEBIT

SA Research (for Grade 10 Only) ----------------------------------- --------------------------------------


SUBMI A. JAMANTOC REX S. PAULINO

SA PTA ------------------------------------------------------
EUNER N. ESTIMADA

SA Records ------------------------------------------------------
MARITES P. HISANCHA

Arts Division Chair (c/o subj chair: ------------------------------------------------------


Creative, dance, media, music, TA, visual)

Class Adviser ------------------------------------------------------

Program Head ------------------------------------------------------


DIARY SARGADO RODRIGUEZ

LUNA ST. LA PAZ, ILOILO

STUDENT’S CLEARANCE
SY 2018 - 2019

___________________________________
Name
YEAR & SECTION ______________________ MAJOR: ____________________

NAME / ORGANIZATION SIGNATURE OVER PRINTED NAME DATE

SA Student Council ----------------------------------- --------------------------------------


STEPHANIE GASALAO FRANK BEBIT

SA Research (for Grade 10 Only) ----------------------------------- --------------------------------------


SUBMI A. JAMANTOC REX S. PAULINO

SA PTA ------------------------------------------------------
EUNER N. ESTIMADA

SA Records ------------------------------------------------------
MARITES P. HISANCHA

Arts Division Chair (c/o subj chair: ------------------------------------------------------


Creative, dance, media, music, TA, visual)

Class Adviser ------------------------------------------------------

Program Head ------------------------------------------------------


DIARY SARGADO RODRIGUEZ

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