Department of Education

Region X
Division of Bukidnon
District of Maramag III
KUYA NATIONAL HIGH SCHOOL
P1C Kuya, Maramag, Bukidnon

AGREEMENT
S.Y. 2021-2022

Ako si _______________________________ ginikanan ni

____________________________ nga na enrol sa 12-HUMSS, Kuya National High School
boluntaryo nga mutugot sa akong anak nga muapil sa Expanded Face to Face Classes bisan
wala siyay COVID-19 vaccines. Ako dili magabasol ug manangil sa tanang tawo nga
lumilihok sa eskwelahan (maestra, maestro, principal, faculty and staff) kung mataptan o
magsakit akong anak sa COVID-19 virus.

______________________________________ ____________
Name of Student Date of Signature

_______________________________________ ____________________
Guardian/Parent’s Name and Signature Date of Signature

ENGRID VIANICA L. MENDEZ

Class Adviser

JESSIEL V. TAGADIAD
Senior High School Coordinator

VILMA M. BUSTOS, PhD

School Head