Republic of the Philippines

SAMAR STATE UNIVERSITY

Student Teaching Office |
College of Education

PARENT’S / GUARDIAN PERMIT

TO WHOM IT MAY CONCERN:
I HEREBY CERTIFY to have granted my son/daughter/ward
_________________
Permission to join and participate in the ____________________________________
on
____________________________ at _____________________________________.
It is understood that the school officials concerned will take all the necessary
precautionary measures within their capacity to ensure the health and safety of the
above-named student during the entire duration of the activity.

_______________________________ _____________________________________
Signature over printed name of student Signature over printed name of Parent/Guardian

______________________
Course & Year

Arteche Blvd., Guindapunan Catbalogan City, 6700 Samar Philippines | Telephone No. (055) 251 – 2139 | Fax: (055) 543 - 8394 | Website:
www.ssu.edu.ph
 Republic of the Philippines
SAMAR STATE UNIVERSITY
Student Teaching Office |
College of Education

Arteche Blvd., Guindapunan Catbalogan City, 6700 Samar Philippines | Telephone No. (055) 251 – 2139 | Fax: (055) 543 - 8394 | Website:
www.ssu.edu.ph