Republic of the Philippines

Department of Education
Region XII
Division of Sarangani
ALABEL NATIONAL SCIENCE HIGH SCHOOL
Regional Science High School
Alabel

OFFICE OF THE SSG COMELEC

FORM 5-A Reference Form ​(Current Teacher)

INSTRUCTIONS. ​Please accomplish this form with the best of your knowledge of the applicant. Return this to the
applicant, sealed in an envelope with signature across the flap, on or before​ February 15, 2019.​ Thank you.

NAME: ____________________________________ NAME OF APPLICANT: ___________________

CONTACT NUMBER: ________________________ EMAIL ADDRESS: _______________________
ADDRESS: _____________________________________ AGE: ____________ SEX: ______________

How long have you known the applicant? __________________________________

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
 Republic of the Philippines
Department of Education
Region XII
Division of Sarangani
ALABEL NATIONAL SCIENCE HIGH SCHOOL
Regional Science High School
Alabel

OFFICE OF THE SSG COMELEC

FORM 5-B Reference Form ​(Fellow Student)

INSTRUCTIONS. ​Please accomplish this form with the best of your knowledge of the applicant. Return this to the
applicant, sealed in an envelope with signature across the flap, on or before​ February 23, 2019.​ Thank you.

NAME: ____________________________________ NAME OF APPLICANT: ___________________

CONTACT NUMBER: ________________________ EMAIL ADDRESS: _______________________
ADDRESS: _____________________________________ AGE: ____________ SEX: ______________

Relationship with the applicant: __________________________________________

How long have you known the applicant? __________________________________

How would you assess the character of the applicant?

__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

What qualities do you know that the applicant possesses that makes him/her a good leader?
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Other remarks:

I hereby certify the truthfulness of the information stated herein.

_____________________________________ Date: ______________________

​Signature over printed name