HINUNANGAN CAMPUS

Ambacon, Hinunangan, Southern Leyte

Contact No: 09285521758
Email: cd_hn@southernleytestateu.edu.ph
Website: www.southernleytestateu.edu.ph
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OFFICE OF THE STUDENT TEACHING SUPERVISOR

DEPARTMENT OF SECONDARY EDUCATON

PARENTS’ CONSENT

I/We, Mr. _________________________ and Mrs. _______________________ parents of

_________________________________________, a prospective Pre-Service Teacher of the Southern Leyte
State University- Hinunangan have hereunto grant permission for him / her to undergo 600
hours of the Teaching Internship in ________________________ (school) which is a requirement for
graduation.

That we made it known our continued financial and moral support to him/ her during the
internship. That we shall adhere to any disciplinary action of the school, such as dropping him/
her from the rolls of trainers and/or barring him/ her from graduation should it be found that
he/she is a frequent absentee and/or notoriously undesirable trainee.

It is fully known that we have read and understood all the contents of the parents’ consent
and have signed with our voluntary act and deed.

Signed this___________ day of ______________ 20_____ in _______________, Philippines.

__________________________________ ________________________________
Signature of Parent/Guardian Signature of Student Teacher

WITNESSES:

MONDANI R. MANUN-OG
Student Teaching Supervisor

NOTED BY: CONFORME:

MARY BETH T. SALUDSOD, Ed.D. _______________________________________________________

Department Head, Education Signature over Printed Name of Student Teacher

SUBSCRIBED AND SWORN TO before me this ________ day of ________________, 20_____________

at __________________________ , Philippines

____________________________
Notary Public

Doc. Code: SLSU-QF-IN07 FOLLOW US HERE:

Revision: 01 https://www.facebook.com/southernleytestateu/
https://www.youtube.com/c/SouthernLeyteStateUniversity
Date: 30 January 2019