You are on page 1of 2

Republika ng Pilipinas

Kagawaran ng Edukasyon
REHIYON V
SANGAY NG MGA PAARALAN NG LUNGSOD NAGA
SAN ISIDRO NATIONAL HIGH SCHOOL
ZONE 5 SAN ISIDRO LUNGSOD NAGA

STUDENTS OFFENSE REPORT FORM

Date and Time: _______________________


Full Name: _________________________________________________________ Grade & Section: ______________________
Last Name First Name M.I.
Adviser: _______________________________________________Concerned Personnel: ______________________________

Description of Offense: ☐ 1st ☐ 2nd ☐ 3rd ☐ 4th


☐ Tardiness ☐ Cutting Class ☐ Not wearing ID ☐ Not wearing proper uniform
☐ Using of phone during class hours ☐ Wearing of earrings (M) ☐ Using hat inside the classroom ☐ Bullying
☐ Others/Please specify: __________________________________________________________________________________

Disciplinary Action: ______________________________________________________________________________________


_______________________________________________________________________________________

Remarks: _______________________________________________________________________________________________

RENZ ALDRIN T. PAGLINAWAN ELLA LANE C. GARCHITORENA


Disciplinary Prefect Guidance Designate
Address: Zone 5 San Isidro, Naga City
Email Address: 305876@deped.gov.ph
FB Page: www.facebook.com/SINHS2020

Republika ng Pilipinas
Kagawaran ng Edukasyon
REHIYON V
SANGAY NG MGA PAARALAN NG LUNGSOD NAGA
SAN ISIDRO NATIONAL HIGH SCHOOL
ZONE 5 SAN ISIDRO LUNGSOD NAGA

STUDENTS OFFENSE REPORT FORM

Date and Time: _______________________


Full Name: _________________________________________________________ Grade & Section: ______________________
Last Name First Name M.I.
Adviser: _______________________________________________Concerned Personnel: ______________________________

Description of Offense: ☐ 1st ☐ 2nd ☐ 3rd ☐ 4th


☐ Tardiness ☐ Cutting Class ☐ Not wearing ID ☐ Not wearing proper uniform
☐ Using of phone during class hours ☐ Wearing of earrings (M) ☐ Using hat inside the classroom ☐ Bullying
☐ Others/Please specify: __________________________________________________________________________________

Disciplinary Action: ______________________________________________________________________________________


_______________________________________________________________________________________

Remarks: _______________________________________________________________________________________________

RENZ ALDRIN T. PAGLINAWAN ELLA LANE C. GARCHITORENA


Disciplinary Prefect Guidance Designate
Address: Zone 5 San Isidro, Naga City
Email Address: 305876@deped.gov.ph
FB Page: www.facebook.com/SINHS2020

You might also like