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:

Date released: Date submitted:

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

CLEARANCE
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Bread Pasty Production Oral Communication in Context Komunikasyon at Pananaliksik

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Earth and Life Science General Mathematics Physical Health and Education

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EAPP Filipino sa Piling Larang Theology 102

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Practical Research 1

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Canteen Personnel Gatekeeper Guidance Office

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Class Adviser Prefect of Discipline School Registrar

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Christian Formation Senior High School Coordinator Office of Students Affairs

Recommending Approval: Approved by:

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