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RF-011

April 17, 2023

CLEARANCE FORM
(Grade 12 Students)

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


LAST NAME FIRST NAME MIDDLE NAME

Section & Track:

Date released: Date submitted:

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

CLEARANCE
________________________ ________________________ ________________________
E-Tech Physical Education and Health CPAR

________________________ ________________________ ________________________


Media and Information Literacy IPHP Practical Research 2

________________________ ________________________ ________________________


Entrepreneurship Theology 103 Cookery NCII Part 1

________________________ ________________________ ________________________


Canteen Personnel Gatekeeper Guidance Office

________________________ ________________________ ________________________


Class Adviser Prefect of Discipline School Registrar

________________________ ________________________ ________________________


Finance Christian Formation Senior High School Coordinator

______________________________
Office of Students Affairs

Recommending Approval: Approved by:

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

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