Department of Education

Region IX, Zamboanga Peninsula

Division of City Schools
BALIWASAN SENIOR HIGH SCHOOL STAND-ALONE
San Jose Road, Zamboanga City
Tel No. 957-3739

P A R E N T’S C O N S E N T F O R M
I allow my son/daughter ____________________________, a Grade 11, __________________(Track &
Section) student of this school to gather data for qualitative research at ____________________________________
(Barangay/School where the research is intended to be conducted), Zamboanga City from January 9 – 18, 2020 (open
schedule) as requirement in his/her Practical Research 1 subject. I am giving consent with my full knowledge that data
gathering is held in relation to the subject.

I shall not hold the school, Baliwasan Senior High School,/ Principal/ Coordinators/Supervising Teacher
responsible for the untoward incident that may happen beyond his/her control during the event.

__________ _____________________________________
Date Parent/Guardian’s Signature over printed name

Department of Education
Region IX, Zamboanga Peninsula
Division of City Schools
BALIWASAN SENIOR HIGH SCHOOL STAND-ALONE
San Jose Road, Zamboanga City
Tel No. 957-3739

P A R E N T’S C O N S E N T F O R M
I allow my son/daughter ____________________________, a Grade 11, __________________(Track &
Section) student of this school to gather data for qualitative research at ____________________________________
(Barangay/School where the research is intended to be conducted), Zamboanga City from January 9 – 18, 2020 (open
schedule) as requirement in his/her Practical Research 1 subject. I am giving consent with my full knowledge that data
gathering is held in relation to the subject.

I shall not hold the school, Baliwasan Senior High School,/ Principal/ Coordinators/Supervising Teacher
responsible for the untoward incident that may happen beyond his/her control during the event.

__________ _____________________________________
Date Parent/Guardian’s Signature over printed name

Department of Education
Region IX, Zamboanga Peninsula
Division of City Schools
BALIWASAN SENIOR HIGH SCHOOL STAND-ALONE
San Jose Road, Zamboanga City
Tel No. 957-3739

P A R E N T’S C O N S E N T F O R M
I allow my son/daughter ____________________________, a Grade 11, __________________(Track &
Section) student of this school to gather data for qualitative research at ____________________________________
(Barangay/School where the research is intended to be conducted), Zamboanga City from January 9 – 18, 2020 (open
schedule) as requirement in his/her Practical Research 1 subject. I am giving consent with my full knowledge that data
gathering is held in relation to the subject.

I shall not hold the school, Baliwasan Senior High School,/ Principal/ Coordinators/Supervising Teacher
responsible for the untoward incident that may happen beyond his/her control during the event.

__________ _____________________________________
Date Parent/Guardian’s Signature over printed name