Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
SCHOOLS DIVISION OFFICE OF QUEZON CITY
LAGRO HIGH SCHOOL
DISTRICT V, QUEZON CITY, METRO MANILA

CONSENT FORM

DON CELSO JESUS P EFONDO

Name of Pupil/Student:

VII NEWTON
Grade Level:

EMILY P EFONDO
Name of Parent/Guardian:

I hereby give my consent to LAGRO 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 school 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.

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CONSENT FORM REPLY SLIP

PARA SA MGA MAGULANG/GUARDIAN: (Pakisulat ang bahaging ito sa malinis na papel, kuhaan ng
litrato at i-send ng mag-aaral sa messenger ng guro. Ang bahaging ito ay pagpapatunay na natanggao ninyo
ang liham na ito.)

MAG-AARAL: _______________________________________________________PETSA:
______________________

BAITANG/SEKSYON: _______________________________________________ADVISER: ____________________

____________________________________
Pangalan at Pirma ng Magulang

Address: Misa de Gallo St., cor. Ascension Ave., LagroSubd., Brgy. Greater Lagro,
Novaliches, Quezon City, Metro Manila
Telephone No.: (02) 8693-73-31
(02) 8939-90-26