Republic of the Philippines

Department of Education
Caraga Administrative Region
Division of Agusan del Norte
Carmen 2 District
CERVANTINA ELEMENTARY SCHOOL

January 9, 2023

GEMMA J. BAGNOL
Principal II
Consuelo Elementary School
Magsaysay, Misamis Oriental

Sir/Madam:

Please furnish us with certified true copies of (Permanent Record) Form 137 of the
following pupils/students who have been enrolled in our school upon presentation of the
school report card.

Temporary
School Last School Year
Name enrolled in Teacher
Attended Last Attended
Grade
PACUDAN PETCHEJEAN IV Consuelo S.Y 2019-2020 MARITES C. SAHILAN
G. Elementary
School

The bearer of this request is hereby authorized to hand-carry the said form.

1st Request /__________

nd
2 Request_______________
3rd Request_______________

Very truly yours,

MARY GRACE D. SENDREJAS

Adviser