Republic of the Philippines

DAVAO DE ORO STATE COLLEGE

Compostela, Davao de Oro
academic.division@ddosc.edu.ph

REPUBLIC OF THE PHILIPPINES)

COMPOSTELA DAVAO DE ORO) S.S.
X----------------------------------------X

CONSENT FORM

I, ______________________ of legal age being ______ years old, Filipino/

(nationality), single/married and the resident of ____________________, Philippines, after
having been duly sworn to in accordance with law, do hereby depose and say:

1. THAT, I am the same person as above described;

2. THAT, I am a ________________________ student of Davao de Oro State College

(Year/Course/Section)
of Davao de Oro.

3. THAT, I am giving my express consent to take part of the limited face-to-face -

class of Davao de Oro at the following institutions for the period reflected therein:

NAME OF SCHOOL/INSTITUTION PERIOD OF FACE-TO-FACE CLASS

a. DAVAO DE ORO STATE COLLEGE
b. OFF-SEMESTER (JUNE-JULY)

4. THAT, my parents/guardians and I are fully aware that the said limited face-to-face class
is NOT MANDATORY but an option that each student must choose to complete the
course;

5. THAT, my consent to this also means that I have to comply with the requirements
provided by DDOSC;

6. THAT, I am executing this Consent Form voluntarily without coercion and fully informed
of the rights, obligations, and risks involved.

IT WITNESS WHEREOF, I have hereunto set my hand this ____________at

_____________________________.

_______________________________
Student
School ID No._____________

With conformity of:

_______________________________
(Name of Parent /Guardian)
Gov’t ID No._________

EXCELLENCE | INTEGRITY| SOLIDARITY

 Republic of the Philippines
DAVAO DE ORO STATE COLLEGE
Compostela, Davao de Oro
academic.division@ddosc.edu.ph

SUBSCRIBED AND SWORN to before me this __________, 2022 at Davao de

Oro, Philippines to affiant exhibited to their Competent Evidence of Identity written below their
names.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2022

REPUBLIC OF THE PHILIPPINES)

COMPOSTELA DAVAO DE ORO ) S.S
X--------------------------------------------X

EXCELLENCE | INTEGRITY| SOLIDARITY