Republic of the Philippines

Department of Education
Region VII, Central Visayas

DIVISION OF CEBU PROVINCE

IPHO Bldg., Sudlon, Lahug, Cebu City

CONSENT FORM

As the representative of the Homeroom Parent Officers to

_________________________(grade level and name of section) under the advisory of
________________(name of adviser) of _________________________________ (school),
(address) with ___________________________________ (principal), I,
________________________(name of parent),(position) of
_______________(district/division) do hereby give the consent to conduct
__________________________(event) on __________________________(proposed date)
at ___________(proposed time) via ____________________ (platform) subject to the
governed rules and regulations of the IATF, under the Republic Act. No. 10173 or Data
Privacy Act of 2012, __________________ (deped order/memo used) and other relative
guidelines stipulated there unto.

This consent is applicable for the confidentiality and privacy protection of all
information gathered by the school, hence, the school is obliged to strictly cooperate and
abide the laws governing this matter with integrity and upmost position.

This consent is applicable only at one time bases and cannot be transferrable.

________________________________

Parent Representative - _____________

Date: __________________

Information Trunk line: (032) 520-3216 – 520-3217; SDS Office: (032) 255-6405; ASDS Apao: (032) 2364628
HR Section: 0933-5196548 / 0906-6886101; Accounting Section: (032) 254-2632; Disbursing Section: (032) 255-4401
www.depedcebuprovince.ph | cebu.province@deped.gov.ph