Republic of the Philippines

Department of Education
Caraga Administrative Region
Division of Butuan City
East Butuan District III
BASAG NATIONAL HIGH SCHOOL
Basag, Butuan City
Date: _________________________
PASS SLIP
The Undersigned request permission to leave the office at ________ o’clock A.M /P.M. to ____________ o’clock A.M.
/P.M. at the ______________________________________________.

For the following reason/s to wit :

1. _____________________________________________
2. _____________________________________________
3. ______________________________________________

Expected time to return: A.M. ________________/P.M. _____________________

Approve : _________
Disapprove: ________
_____________________________________________
Signature of Employee above printed name

School/ Office assigned:___________________________________

Designation: _____________________________________________
Approved:

DANTE P. MORE, DPA

Secondary School Head

Republic of the Philippines

Department of Education
Caraga Administrative Region
Division of Butuan City
East Butuan District III
BASAG NATIONAL HIGH SCHOOL
Basag, Butuan City
Date: _________________________

PASS SLIP
The Undersigned request permission to leave the office at ________ o’clock A.M /P.M. to ____________ o’clock A.M.
/P.M. at the ______________________________________________.

For the following reason/s to wit :

1. _____________________________________________
2. _____________________________________________
3. ______________________________________________

Expected time to return: A.M. ________________/P.M. _____________________

Approve : _________
Disapprove: ________
_____________________________________________
Signature of Employee above printed name

School/ Office assigned:___________________________________

Designation: _____________________________________________
Approved:

DANTE P. MORE, DPA

Secondary School Head