RELATED LEARNING EXPERIENCE – ENDORSEMENT

Area: ________________________________________________
Inclusive Date: ________________________________________
Name of student Remarks No. of extensions
(cleared / absences/ deficiency)
Sample:
CONCHI C. MANHILOT Cleared None
JUAN DE LA CRUZ 1 day absent 1 day extension
MELCHORA TUBA 2 days absent, Still for submission of requirements.; 1day
Lacking requirement, extension
No exam, not attending post con

Name of student Remarks No. of extensions

(cleared / absences/ deficiency)
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Endorsed by:

_______________________________________________________
Name and signature of Clinical Instructor

Endorsed to:

_________________________________
Name of Instructor/ Adviser

NOTE: Copy to be sent to student, adviser, RLE Coordinator