SPECIAL POWER OF ATTORNEY

KNOW ALL MEN BY THESE PRESENTS:

That I, __________________________________________________, of legal age, Filipino, single /

married / widow / widower, with permanent address at _______________________________________,
Philippines and presently residing in UAE, with postal address at _______________________________,
do hereby name, appoint and constitute Mr./Ms. _______________________________________, likewise
of legal age, single/married/widowed and presently residing at
______________________________________________, Philippines as my true and lawful attorney, for
me and in my name, place and stead for my own use and benefit, to do any or all of the following acts and
things to wit:

1. To apply for the issuance of my Diploma, Transcript of Records, and other pertinent documents
from __________________________________________________________;
2. To cause the process the authentication of my said academic records with the proper government
agencies but not limited to Ched, DepEd (complete name of agencies);
3. To sign, execute and deliver any document necessary for the said application;
4. To demand, claim and receive the requested documents; and
5. To do all acts necessary to give effect to the foregoing authority.

Whereby giving and granting unto said attorney, full power and authority to perform each and every act and
thing whatsoever requisite or necessary to be done in and about the premises, as fully to all intents and
purposes as I might or could do if personally present and acting, and hereby ratifying and confirming all that
my said attorney shall lawfully do or cause to be done and virtue of these presents.

IN WITNESS WHEREOF, I have hereunto set my hand this ______ day of _______________________
20____ in ________________.

__________________________________
Signature of Principal

SIGNED IN THE PRESENCE OF: __________________________________

Doc. no. : __________

Service no. : __________
Series of : __________
O.R. no. : __________
Date : __________