APPOINTMENT DATE: Dec 20, 2019 (02:00 PM TO 03:00 PM) - PRC Cebu - Main Office (Initial Registration, PIC

Renewal, Certifications)
REFERENCE NO: INW5EPNF8SNJ | OR: - | AMOUNT: PHP -

NOT FOR SALE (REPRODUCTION IS ALLOWED)

Republic of the Philippines

Professional Regulation Commission
Manila Paste here
your recent
PASSPORT SIZE
colored picture in
white background
PANUNUMPA NG PROPESYONAL with complete
name tag

MAE DIANE TEJAMO BRAGAT

Ako, si ______________________________________________________________________, ng
_____________________________________________________________________________________
TUBURAN, CEBU
(Pook na Sinilangan, Bayan/Lungsod, Probinsya)
ay taimtim na nanunumpa na itataguyod ko at ipagtatanggol ang Saligang Batas ng Pilipinas, na ako ay
tunay na mananalig at tatalima rito; na susundin ko ang mga batas, mga utos na legal, at mga atas na
ipinahayag ng mga sadyang itinakdang may kapangyarihan ng Republika ng Pilipinas; at kusa kong
babalikatin ang pananagutang ito, na walang ano mang pasubali o hangaring umiwas.

Taimtim pa rin akong manunumpa na sa lahat ng panahon at pook na kinaroroonan ay mahigpit

akong manghahawakan sa mga etikal at tuntuning propesyonal ng mga
PROFESSIONAL TEACHER
____________________________ sa Pilipinas, at marapat kong gagampanan ng buong husay sa abot ng
(Propesyon)
aking makakaya ang mga tungkulin at pananagutang iniatang sa isang itinakdang
PROFESSIONAL TEACHER
________________________.
(Propesyon)

Kasihan Nawa ako ng Diyos.

______________________________________
( Lagda)
28534209
A - ____________________________ PUTAT, TUBURAN, CEBU
_______________________ Jul 18, 2019
_________________________
(Blg. Ng Sedula) (Kinuha sa) (Petsa)

Nilagdaan at Pinanumpaan sa harap ko ngayong ika-____________ ng ________________________

taon ng ating Panginoon _____________________ sa ___________________________, Pilipinas.

FOR PRC PROCESSING

-
OK to Pay: __________________________________ __________________________________
Selyo -
OR No.: _____________________________________ (Pinunong Tagapanumpa)
Dokumentaryo -
Date Paid: ___________________________________
PROFESSIONAL TEACHER
Profession: __________________________________ __________________________________
Registration No.: ______________________________ (Katungkulang Opisyal)
Registration Date: _____________________________

PERSONAL DATA
Telephone/Contact Number: 09553301715 Date of Examination: Sep 01, 2019
Citizenship: FILIPINO Date of Birth: Sep 25, 1997
Civil Status: MARRIED Sex: FEMALE Spouse’s Name/Citizenship: TADEO CORNELIO M. BRAGAT II / FILIPINO
Father’s Name/Citizenship: EMIE C. TEJAMO / FILIPINO Mother’s Name/Citizenship: GLENDA Y. TEJAMO / FILIPINO

PLEASE FILL OUT THIS CLAIM SLIP

CLAIM SLIP

MAE DIANE TEJAMO BRAGAT

NAME: _______________________________________ PROFESSIONAL TEACHER
PROFESSION: _________________________________
REGISTRATION NO. ____________________________ REGISTRATION DATE: __________________________
Please present this slip at Issuance Window ____________________ to claim your professional identification card on
________________________.
(NOTE: REPRESENTATIVE WITH PROPER IDENTIFICATION SHOULD PRESENT SPECIAL POWER OF ATTORNEY/ AUTHORIZATION
LETTER FROM THE REGISTERED PROFESSIONAL). FOR CONFIRMATION PLEASE CALL UP (02) 736-22-48.

____________________________________________
(Registration Officer)

REG- 01
Rev. 00
February 25, 2015
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