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Dear Ma'am Rodelyn Dela Peña

With due respect, I hereby inform you that I have a scheduled dentist appointment with Dr. Ella
Mae Falcasanatos, and therefore will only attend Class til 4:00 PM and will request to be
allowed to be released from School Grounds on January 24.
This letter shall serve as the form of my absence.

Thank you for your understanding and consideration.

Sincerely Yours

Liana Miel Parcasio


Grade 9 Student of St. Anthony De Padua

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Subject Teacher Signature

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Advisor's Signature

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Guardian's Signature

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