TOMAS CLAUDIO COLLEGES

Morong, Rizal Affix Photo

BASIC EDUCATION DEPARTMENT Here
Senior High School
Passport
School Year 2019 – 2020
Size

CERTIFICATE OF CANDIDACY
INSTRUCTIONS: (Read well before filling up this form)
1.) File this in ONE (1) LEGIBLE copy.
2.) File this certificate of candidacy with all the required information accurately and legally.
3.) No filling fee shall be imposed.
I hereby announce my candidacy for the position of ____________________, ABM Club, in the August 7,
2019 elections; and after having been sworn to in accordance with the law, hereby state the following:
1.) Full Name 3.)Gender 4.) Age

Last Name Male _________

Female
First Name 5.) Date of Birth

Month / Day / Year

Middle Name
6.) Place of Birth
City/Municipality:
2.) I am generally or popularly known by the nickname or stage name
Province:
_______________________

8.) Civil Status

7.) I am officially nominated by
___ Single ____ Married
___ Widow ____ Divorced
(Political Party) Full name of spouse, if
married:

9.) Complete Address: 10.) Contact Details

Tel. No.: _______________

(House no./Street/Subdivision) (Barangay) Cell phone No: __________

_______________________________________________________________ Email Address:

(City/Municipality) (Province)
11.) Parents 14.) I am a student of Tomas
Claudio Colleges.
Mother’s Maiden Name: ______________________________________
Contact Number: __________________ Occupation: _____________ 15.) I am of excellent moral
character.
Father’s Name: _____________________________________________ 16.) I am eligible for the
Contact Number: __________________ Occupation: _____________ office I seek to be elected in.
12.) I will run because 17.) I will support and defend
the Constitution and By-
Laws of the ABM Club of
Tomas Claudio Colleges and
I will maintain true faith and
allegiance thereto. I will
obey the laws, legal orders
13.) Some of my achievements in High School are and decrees promulgated by
the duly constituted
authorities. I impose this
obligation upon myself
voluntarily, without mental
reservation or purpose of
evasion.

I hereby certify that the facts stated herein are true and correct of my own personal knowledge.

____________________________________________
Signature of Candidate Over Printed Name

___________________________________________
Grade / Strand / Section

___________________________________________
Adviser Left thumb mark Right thumb mark

OATH

SUBSCRIBED AND SWORN to before me this _____ day of _____________, 2019, at

_________________________, affiant exhibiting to me his / her nomination kit which contains
the following:

 One (1) Certificate of Candidacy with two (2) recent uniform copies of passport size
pictures signed at the back (in school uniform with white background)
 One (1) photocopy of Birth Certificate
 Two (2) copies of Parental Consent
 One (1) original copy of the Reference Form from a current teacher

Endorsed:

MR. RAFAEL P. AMONOY

Grade 12 ABM-B Adviser

Approved:

MRS. CRISELDA C. PATAG

ABM Coordinator
 TOMAS CLAUDIO COLLEGES
Morong, Rizal
BASIC EDUCATION DEPARTMENT
Senior High School
School Year 2019 – 2020

Reference Form (Current Teacher)

INSTRUCTION. Please accomplish this from with the best of your knowledge of the applicant.

NAME: ____________________________ NAME OF APPLICANT: ____________________

CONTACT NUMBER: _______________ E-MAIL ADDRESS: ________________________
ADDRESS: _____________________________________ SEX: ______ AGE: _______

How long have you known the applicant? _____ years ______ months

How would you assess the academic performance of the applicant?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How would you assess the character of the applicant?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Other remarks:

I hereby certify the truthfulness of the information stated herein.

______________________________________________________ Date:_____________
Signature over Printed Name
 TOMAS CLAUDIO COLLEGES
Morong, Rizal
BASIC EDUCATION DEPARTMENT
Senior High School
School Year 2019 – 2020

PARENTAL CONSENT

I, ____________________________, as a parent / guardian will support my son /

daughter, ____________________________________, to the best of my ability as he / she
commits to the ABM Club.

I am allowing him / her to fulfill the duties and responsibilities of being an ABM Club
officer and to be involved to all its activities, programs and projects.

__________________________________________ ____________
Parent’s / Guardian’s Signature over Printed Name Date

TOMAS CLAUDIO COLLEGES

Morong, Rizal
BASIC EDUCATION DEPARTMENT
Senior High School
School Year 2019 – 2020

PARENTAL CONSENT

I, ____________________________, as a parent / guardian will support my son /

daughter, ____________________________________, to the best of my ability as he / she
commits to the ABM Club.

I am allowing him / her to fulfill the duties and responsibilities of being an ABM Club
officer and to be involved to all its activities, programs and projects.

__________________________________________ ____________
Parent’s / Guardian’s Signature over Printed Name Date