CERTIFICATE OF QUARANTINE

This is to certify that

(Name of Examinee)

with residence at

(Complete address)

has completed the minimum fourteen (14) day strict home quarantine
from to .
(Starting date) (Ending date)

This certificate will be used as a requirement for the

ARCHITECTURE LICENSURE EXAMINATION.

(Profession)

Furthermore, I am issuing this certification to signify that I have personally seen

and monitored the examinee for the duration specified above. In case that there
are concerns regarding this certification, I am allowing the Professional
Regulation Commission CAR, and its authorized representative/s,
to communicate with me before the start of the licensure examinations on
, if the need arises.

ISSUED BY:

SIGNATURE OVER COMPLETE NAME:

DESIGNATION:

PRC LICENSE NUMBER (For PRC Registered Professionals):

CONTACT NUMBER (Mobile Number):

DATE OF CERTIFICATE ISSUED:

Note: This certification can be issued by ANY OF THE FOLLOWING:

1. Private or Government Physician
2. Municipal Health Officer
3. Provincial Health Officer
4. Barangay Health Official