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PUNTA MESA ELEMENTARY SCHOOL

Barangay Punta Mesa, Manapla, Negros Occidental


S.Y. 2019-2020
STUDENT CLEARANCE FORM

Name: _____________________________________________ Grade & Section: ____________________

SUBJECT TEACHER SIGNATURE DATE

Filipino
English
Mathematics
Science
Araling Panlipunan
MAPEH
EPP/ TLE
ESP
MTB

This is to certify that I am clear of all financial obligations including borrowed textbooks, materials/equipment at this
school.

TEODORICO J. MALIHOC, JR. KIA JOY F. MALIHOC ______________________________________


SPFC SPG President Class Adviser

Noted: OSCAR J. DOBREA, JR., PhD.


School Principal

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PUNTA MESA ELEMENTARY SCHOOL


Barangay Punta Mesa, Manapla, Negros Occidental
S.Y. 2019-2020

STUDENT CLEARANCE FORM

Name: _____________________________________________ Grade & Section: ____________________

SUBJECT TEACHER SIGNATURE DATE

Filipino
English
Mathematics
Science
Araling Panlipunan
MAPEH
EPP/ TLE
ESP
MTB

This is to certify that I am clear of all financial obligations including borrowed textbooks, materials/equipment at this
school.

TEODORICO J. MALIHOC, JR. KIA JOY F. MALIHOC ______________________________________


SPFC SPG President Class Adviser

Noted: OSCAR J. DOBREA, JR., PhD.


School Principal

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