ANNEX D

CAV FORM 4- CERTIFICATION OF ENROLMENT / COMPLETION / GRADUATION

Republic of the Philippines

Department of Education
Region XI
Division of Tagum City
Mangga Elementary School

CERTIFICATION OF ENROLMENT

TO WHOM IT MAY CONCERN:

This is to certify that, based on the available records in this

school, the following information pertaining to _________________with

Learner Reference Number ________________________appear:

(  ) enrolled in _____________ during the School Year ___________.

( ) completed Grade ____ during the School Year ______________.

( ) satisfactorily graduated from Elementary Course for the School

Year __________________ as prescribed by the Department of Education.

This certification is issued on _________ upon the request of

_____________________in connection with his application for

Certification, Authentication and Verification.

___________________
PRINCIPAL -IV

“If graduated from secondary course in private school, indicate

Special Order Number and date”