Republic of the Philippines

Department of Education
COLONGULO NATIONAL HIGH SCHOOL
Colongulo, Surallah, South Cotabato

STUDENT AGREEMENT /CONTRACT

Grade _________
Sy. 2016 – 2017

TO WHOM IT MAY CONCERN:

I, ___________________________________________, GRADE _________student of Colongulo National High

School, SY _________ enters into an agreement with my class adviser and Prefect of Discipline stipulating the following:
( ) Tardiness 1ST 2ND 3RD 4TH FINAL
_________ ________ ________ ________ _________
( ) Misbehavior 1 ST
2 ND
3 RD
4 TH
FINAL
_________ ________ ________ ________ _________
( ) incomplete uniform 1 ST
2 ND
3 RD
4 TH
FINAL
_________ ________ ________ ________ _________
( ) cutting classes 1 ST
2 ND
3 RD
4 TH
FINAL
_________ ________ ________ ________ _________
( ) Failing Grades 1ST 2ND 3RD 4TH FINAL
_________ ________ ________ ________ _________
( ) Absences Dated _____________ 1 ST
2 ND
3 RD
4 TH
FINAL
_________ ________ ________ ________ _________
( ) others, specify: ______________ 1 ST
2 ND
3 RD
4 TH
FINAL
_________ ________ ________ ________ _________
Reason/s:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Agreement
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Do hereby promise to:

1. Abide with the school rules and regulations (tardiness, absences, cutting classes, incomplete uniform,
wearing earrings (male) / extra earrings ( girls) and the school rules and policies.
2. Submit myself voluntarily to the school authorities for disciplinary actions in case I show misconduct or
misbehavior/ disrespect to my teacher/s and school authorities.
3. Attend my classes religiously and regularly , submit school requirements on time.
4. Study hard in order to cope up will all requirements that my teachers may require in my subjects
5. To follow rules and regulations of the school.

I accept the sanction/s imposed to my be the school authorities in the event that I violate this covenant /
agreement on school policies, rules and regulations.

That I have committed a major offense and this is my:

1st 2nd 3rd 4th final warning.

Having understood fully the above premises, I am affixing my signature this ____ day of _________, 20____ in
my own freewill.

CONFORME: ______________________________ _____________________________

Parent’s / Guardian Signature Above Printed Name Students Signature Above Printed Name

Signed: ___________________________ _______________________________

NESTOR B. JEREOS
Adviser Prefect of Discipline

____________________________
_______________________________
AURORA F. DERLA MELINDA C. CARNECER
Guidance Councilor Principal