Republic of the Philippines

DEPARTMENT OF EDUCATION
XII
(Region)
SOUTH COTABATO
(Division)
TUPI NATIONAL HIGH SCHOOL
(School)
TUPI, SOUTH COTABATO
(School Address)

_________________________
Date

PARENT’S CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter ______________________________ in the Graduation
Pictorials at Tupi National High School dated May 16 - 18, 2022 and agreed
to pay the one hundred eighty pesos (P180.00) as payment.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned student in accordance with the Data Privacy Act of 2012.

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Signature of Guardian over Printed Name

(Relationship with the Student)

STEPHEN S. SALAZAR
Adviser School Head
(Signature Over Printed Name) (Signature Over Printed Name)

Note:
If No Parent/s, submit Affidavit of Guardianship duly verified by the adviser.
If parents are abroad, Special Power of Attorney (SPA) is needed.
 Republic of the Philippines
DEPARTMENT OF EDUCATION
XII
(Region)
SOUTH COTABATO
(Division)
TUPI NATIONAL HIGH SCHOOL
(School)
TUPI, SOUTH COTABATO
(School Address)

_________________________
Date

PARENT’S CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter ____________ in attending In School
Work Immersion to be held at Tupi National High School on May 16-20, 2022.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned student in accordance with the Data Privacy Act of 2012.

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Signature of Guardian over Printed Name

(Relationship with the Student)

STEPHEN S. SALAZAR
Adviser School Head
(Signature Over Printed Name) (Signature Over Printed Name)

Note:
If No Parent/s, submit Affidavit of Guardianship duly verified by the adviser.
If parents are abroad, Special Power of Attorney (SPA) is needed.