Republic of the Philippines

DEPARTMENT OF EDUCATION
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN
Urbiztondo
BAYAOAS INTEGRATED SCHOOL

ADVISER’
S.Y. 2021 – 2022
S
CLEARAN PROMOTED: M: ____ F: ____ T: _____
NAME OF ADVISER: _____________________________________ GRADE AND SECTION: ____________________

NO. OF STUDENTS: M: ____ F: ____ T: _____

CE FORM NLPS: M: ____ F: ____ T: _____
RETAINED: M: ____ F: ____ T: _____

SF1: _____ SF5: _____

NAME SF10 SF
BIRTH CERTIFICATE HGP
(Last Name, Middle Name, First 9
NO
Name) Barangay Baptismal Local NSO PS SF10 SF 10 for SF 10
.
Certificate A Elem. Transfere Latest
e
 Prepared by:
SHERYL M. LAYOSO
ADVISER 10 - A

Respectfully forwarded to the next adviser/records in charge, with the information/data that the
foregoing forms are correct, and a complete clearance is hereby granted.

Checked and Reviewed:

JOJO L. TAMONDONG ANALYN A. VALERIO, EdD. MARJORIE D. FERRER

ICT Coordinator Master Teacher I Master Teacher I

EHLEN B. MENDOZA LIGEA L. ARAMBULO, EdD.

Head Teacher III Head Teacher III

Approved:

MARIBEL S. TAMONDONG, EdD.

Principal II
SCHOOL SEAL
Receiver: Date:

Signature Over Printed Name