Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
Division of Rizal

JOSE F. DIAZ MEMORIAL NATIONAL HIGH SCHOOL

San Mateo, Rizal

28 February 2019

DR. MARITES A. IBANEZ, CESO V

Schools Division Superintendent
Talking, Taytay, Rizal

ATTENTION: AMELIA R. DEAN

Administrative Officer V

Madam:
Please let this letter serve as a notification that I will be returning to my position
as Teacher I at Jose F. Diaz Memorial National High School today, February 28, 2019. As you
know from my maternity leave, I began my leave last January 27, 2019 and should end March
27, 2019. Instead, I decided to return to work earlier as per advised by my medical health
provider and I know that I am capable enough to work again in this institution.

In consideration of being allowed to work, I acknowledge and agree that:

1. I knowingly and freely assume all responsibility for any risk of health problems that may be
sustained by me or others as a result of my action.
2. I further agree to release and hold harmless the Jose F Diaz Memorial National High School
from all claims and liabilities of any type whatsoever with regards to medical issues which may
result from my decision in returning at Jose F. Diaz Memorial National High school.
3. I acknowledge that I am in good physical condition and do not know of any condition or
reason that I should not participate at Jose F. Diaz Memorial National High School.
4. I understand that a medical examination to assure myself of physical fitness is desirable, that
obtaining such an examination is my own responsibility.

Attached here is my medical certificate for your record.

Sincerely,

Jennylyn H. Mendoza

Noted:

ZENAIDA S. PALILEO

Principal I