Republic of the Philippines

Department of Education
National Capital Region
Schools Division Office of Makati City
San Antonio National High School
Mayapis St., San Antonio Village, Makati City

ANNEX “A”

CONSENT FORM

Name of Student:

Grade Level:

Name of Parent/Guardian:

I hereby give my consent to SAN ANTONIO NATIONAL HIGH SCHOOL and the designated teachers of
my child/ward to:

1. Conduct online interaction through whatever social media platforms with my child/ ward for any
distance learning activities;

2. To keep a record of online interaction with my child/ward whenever recording is made;

3. To take snapshots/images/videos which may include my child’s/ward’s image for documentation and
other lawful purposes;

4. To post in the Official social media page/web page/private social media group; the image, name and
section of my child/ward as well as any acknowledgement/awards that he/she is entitled;

5. Other similar processing of information of my child/ ward for any activities sanctioned by DepED.

___________________________ __________________
Signature over Printed Name Date Signed

8-897-5160

305408@deped.gov.ph
 Republic of the Philippines
Department of Education
National Capital Region
Schools Division Office of Makati City
San Antonio National High School
Mayapis St., San Antonio Village, Makati City

8-897-5160

305408@deped.gov.ph