Republic of the Philippines

orth Eastern Mindanao State University

Formerly Surigao del Sur State University
Rosario, Tandag City, Surigao del Sur 8300
Telefax No. 086-214-4221
Website: www.sdssu.edu.ph

N S T P
A.Y. 2021-2022

PARENT/ GUARDIAN CONSENT

I, , the parent/ legal guardian of

Name of parent or guardian.
hereby expressly state that I agree to the following:
Name of student.

1. To allow my son/daughter, take his/her Community Service Training for a total of

50-90 hours.

2. I have read the rules and regulations set by Host Barangay that my son/daughter

will abide by the said rules and regulations.

3. I fully and voluntarily waive my right to hold NEMSU and/or any of its officers,

employees, or representatives responsible for any case of untoward incident that

may happen to my son/daughter during the duration of his/her training.

Signature over Printed Name of Date signed

Parent or Guardian