________________________________

Name of School

CERTIFICATION
TO WHOM IT MAY CONCERN:

This is to certify that __________________________________ is officially

enrolled as Grade ___ student at
________________________________ School, DepED–La Carlota City for School
Year 201__ – 201__.

This is to certify further that he/she is a student of good moral

character.
This certification is issued to the above–named student for the purpose
of ________________________.

Signed this ___ day of _________ 201__ in La Carlota City, Negros

Occidental, Philippines.

_________________________________________
Name & Signature of Guidance Teacher /
Counselor

_________________________________
Name & Signature of School
Head

CC – School File