Valenzuela City | Quezon City | Antipolo City | San Fernando City | Cabanatuan City | Santa Rosa City

COLLEGE OF MEDICAL LABORATORY SCIENCE

COLLEGE OF BUSINESS AND ACCOUNTANCY

STUDENT & PARENT’S CONSENT FORM

PARTICIPATION IN THE LIMITED FACE-TO-FACE EXAM

Name: Gelyn Cimanes

Current Address: 130 Osaka Lambakin,Marilao,Bulacan
Email Address: gcimanes4343val@student.fatima.edu.ph
Mobile Number: 09750183412
Campus: Valenzuela

As a 2nd year student of Our Lady of Fatima University - College of Business and
Accountancy, I have been oriented and duly informed about the guidelines, requirements, and
protocols of the University for the face-to-face final pre-board examinations.

Furthermore, I was allowed by my parent/guardian to join the limited face-to-face activities. We

shall abide by all the health protocols and comply with the requirements which the University
and the local government unit set for the safety of all.

I fully understand that this consent form has been executed for the purpose of my attendance
in the limited face-to-face activities in the campus.

October 28,2022

Student’s Signature over Printed Name Date

October 28,2022

Parent’s Signature over Printed Name Date