2x2

CERTIFICATE OF CANDIDACY FOR ESC (Eugenio M. Lopez Center for Latest

Media Arts SHS Student Council) Photo

An officer in the ESC lives the ideals, principles, and values of the Department of Education. They
are the representative of the student body and must always be prepared to lead the student body and to
protect their rights and welfare. As mature, principled, and enthusiastic leaders, they must always serve as
role models for their fellow students.

Student Name: ____________________________________________ Current Grade Level: _________

PERSONAL DETAILS
Gender: _____________ Age: ____________ Date of Birth: __________ Email Address: ___________
Mobile Number: ______________________________ Landline: _________________________________
Address: _____________________________________________________________________________

AFFILIATIONS: CLUBS AND ORGANIZATIONS (INSIDE AND OUTSIDE THE SCHOOL)

Club/Organization Year/s of Membership Position

ELECTORAL INFORMATION

Party Name: ______________________________ Position in the Party: __________________________

I, whose name, and other personal details are herein stated, do hereby file this Certificate of
Candidacy for the Eugenio M. Lopez Jr. Center for Media Arts Senior High School Student Council
Elections (ESC) this School Year _____________, and I do hereby declare my intention and desire to be
nominated for the position of

___________________________________

And I further state that:

I am a bonafide student at this school with good moral character and academic standing, and I will
abide by the election rules and guidelines of the Eugenio M. Lopez Jr. Center for Media Arts Senior High
School Student Commission on Elections (ECE).

I hereby certify that the facts stated herein are true and correct to the best of my knowledge.

__________________________________
Signature of Candidate

SUBSCRIBED AND SWORN to me before this ________ day of __________ year _______, at ________,
with the affiant exhibiting to me his/her nomination kit which contains his/her C.O.C, photograph,
academic records, parental consent, general plan of action, essay, and references.
 ______________________________
ELJSHS COMELEC Representative

PARENT'S CONSENT FORM

I, ________________________ as a parent/guardian will support my son/daughter

_____________________ to the best of my ability as he/she commits to the Student Council. I am allowing
him/her to fulfill the duties and responsibilities of a Eugenio Student Council Officer and to be involved in
all its activities, programs, and projects.

Parent’s/Guardian’s Signature over Printed Name Date