Republic of the Philippines Republic of the Philippines

Department of Education Department of Education

Division of Agusan del Sur Division of Agusan del Sur
GUADALUPE NATIONAL HIGH SCHOOL GUADALUPE NATIONAL HIGH SCHOOL

INDIVIDUAL PASS SLIP INDIVIDUAL PASS SLIP

FOR PERSONAL BUSINESS FOR PERSONAL BUSINESS

Date: __________________________ Date: __________________________

________________________________ ________________________________
Printed Name & Signature of Employee Printed Name & Signature of Employee

Permission is hereby requested to: Permission is hereby requested to:

Leave the office premise during office hours Leave the office premise during office hours

From: ______________________ (Time of departure) From: ______________________ (Time of departure)

To: ________________________ ( Time of arrival) To: ________________________ ( Time of arrival)

Deviation from fixed time of arrival Deviation from fixed time of arrival

From________________ to _____________________ From________________ to _____________________

Purpose: ____________________________________ Purpose: ____________________________________

____________________________________________ ____________________________________________

____________________________________________ ____________________________________________

Approved by: Approved by:

MELCHOR C. PATRICIO MELCHOR C. PATRICIO

School Principal I School Principal I

Actual time of departure: _______________________ Actual time of departure: _______________________

Guard on Duty: _______________________________ Guard on Duty: _______________________________