Republic of the Philippines

DEPARTMENT OF EDUCATION
Region I
SCHOOLS DIVISION OFFICE URDANETA CITY
Urdaneta City
Cluster 9
DON AMADEO PEREZ, SR.MEMORIAL CENTRAL SCHOOL-MAIN

June 21, 2017

The Principal
DON AMADEO PEREZ SR. MECS-WEST
Brgy. San Vicente West, Urdaneta City, Pangasinan
City School Division of Urdaneta City
Region I

Sir/Madam:

Please furnish us as soon as possible a certified true copy of Form 137-E

of the following pupil(s) who are temporarily enrolled in our school on the basis
of the credentials submitted. Also, please confirm her in your LIS Toggle List
for formal transfer of record once it is available.

Name of Pupils Attended Your School School Year

JEFFREY T. REGONAN, JR. Grade 3-A S.Y. 2016-2017

LRN: 102295130020

Thank you very much for your kind and immediate attention regarding
the above request.

Very truly yours,

EMMA R. CAMPILLA
Principal IV

√
___ __ 1st request
_______ 2nd request
_______ urgent

___________________________________________________________________________________________________________________________

San Vicente Central, Urdaneta City, Pangasinan

Contact Number: 09272002182
Email: emma.campilla@deped.gov.ph