RF-011

April 17, 2023

CLEARANCE FORM
(Grade 11 Students)

PERSONAL INFORMATION: (Please sign in Print) School Student ID:

LAST NAME FIRST NAME MIDDLE NAME

Section & Track:

11 HOME ECONOMICS – ST. JAMES

Date released: Date submitted:

JANUARY 11, 2024

______________________________________ _______________________________________
Parent’s/Guardian’s Signature over printed name Student’s Signature

CLEARANCE
Mr. Jayson G. Billones Mr. Normandy D. Balasa Mrs. Elvie B. Arcega
Bread Pasty Production Oral Communication in Context Komunikasyon at Pananaliksik

Mr. Selwyn B. Villarezco Mr. Khrysmund A. Posaran Mr. Ronel D. Alagon

Earth and Life Science EAPP Physical Health and Education

Mr. Jason G. Binondo Mr. John Ashley Ocaso Ms. May B. Bonita

General Mathematics Filipino sa Piling Larang Practical Research 1

Sr. Lee J. Pamisal, sdP Mr. Rommel Delandao Mr. Jay Trinidad
Theo 101 Finance Registrar

Mr.________________ Ms. Lorna Fuentes Ms. Nea Dumali

Gate Keeper Canteen Personnel Class President

Sr. Lee J. Pamisal, sdP Mr. Jayson G. Billones Sr. Lee J. Pamisal, sdP
Class Adviser Prefect of Discipline Guidance and Counselling

Sr. Lee J. Pamisal, sdP Mr. Jason G. Binondo Mrs. Ronalyn Barruela
Christian Formation Office of Students Affairs Senior High School Coordinator

Recommending Approval: Approved by:

Ms. Loriene Y. Garra Rev. Fr. Gybyyn G. Gumban

School Principal School Director
Original copy of form must be submitted to the office of the School Registrar.