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Division of Pasig City

Rizal High school


SENIOR HIGH SCHOOL
Caniogan St., Pasig City

______________________
Date
GUIDANCE DEPARTMENT
DROP-OUT FORM

Mr. Gilbert O. Inocencio


Principal IV
Rizal High School
Caniogan, Pasig City

Dear Sir,

I would like to formally inform you that ___________________________________________


(Full Name of Student)
of___________________________, _______ Semester, 20______-20______ will no longer go
(Grade/Track/Strand/Section)
to school starting today _____________________________ _________, 20 __________ due to
(Month) (Day) (Year)
Reason for Dropping-Out:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Respectfully yours,
_____________________________________
Signature Over Full Name of Parent/Guardian

Date: ________________________________
Address: ______________________________________________________
Contact No. of Parent/Guardian: ___________________________________

Attested:
\

______________________________ ______________________________
Signature Over Full Name of Adviser Senior High Guidance In-charge

Noted:

Mr. Gilbert O. Inocencio


Principal IV

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