CLEARANCE CERTIFICATE

AGENCY: SAN QUINTIN CENTRAL SCHOOL

ADDRESS: CASANTAMARIA-AN, SAN QUINTIN, PANGASINAN

POINT PERSON/DESIGNATION: ROWENA F. PALISOC/PRINCIPAL II

ACTIVITY: VALENTINE FESTIVAL

TARGET NUMBER OF ATTENDEES: _________

DATE OF PROPOSED ACTIVIY: MARCH 6, 2020

S. NO. DEPARTMENT SECTION Remarks

(pls. put SIGNATURE DATE
check)
AGENCY CERTIFYING OFFICER YES NO
1 San Quintin ROWENA F. PALISOC
Central School
2 PTA President JEROME ERVYN D.
RAGA
3 PSDS DR. DOMINGA C.
MERCADO
4 Punong Brgy. ZENAIDA A. LIBERATO
5 Mun. DILG SHIELA E. VELASQUEZ
6 Mun. SB on Health Mun. Coun. ARIEL G.
FERRERIA

Additional Remarks:

_____________________________________________________________________________________

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Recommending Approval:

DR. ROMELA REMEDIOS A. CABANAYAN

Municipal Health Officer

APPROVED:

HON. CLARK CECIL P. TIU

Municipal Mayor