AGUSAN DEL SUR STATE COLLEGE OF AGRICULTURE AND TECHNOLOGY

P-1, San Teodoro, Bunawan, Agusan del Sur 8506

website: www.asscat.edu.ph
e-mail address: op@asscat.edu.ph
mobile no: +639483679266

PARENTAL CONSENT

Date: ___________________
To: Parents and/or Legal Guardian

You are notified that your son/daughter ANGELO DOLDOLEA has been recommended by the school,
Agusan del Sur State College of Agriculture and Technology, to represent the school and undergo
Teaching Internship to be held in Datu Lipus Makapandong National High School on February
2024.

The said activity is designed as reinforcement of the formative education of your child.

EGAN C. TRABADO, PhD

Coordinator, Internship Program

Permission
I/we ARLENE G. DOLDOLEA the parent/ guardian of ANGELO DOLDOLEA allowed our
son/daughter to attend on the abovementioned activity; the following condition that:

a. The school/direct in charge shall not be liable to any unexpected events outside/not connected
with the abovementioned activity.

I/We declared having read and understood the above Parental Consent Agreement in its entirely and
hereby consent to allow Mr./Ms. ANGELO DOLDOLEA to participate, acknowledging all of the
foregoing.

ARLENE G DOLDOLEA Date:____________________

Signature over printed Name of Parent / Guardian
__________________________________________________________________________________
___Republic of the Philippines...)
Province of Agusan del SurMunicipality ____________________
X…………………………………………X

SUBSCRIBED AND SWORN TO before me this ___ day of _______, _______, with Residence No.
__________________ issued on ___________________________ at ________________________________.

Doc. No __________;
Page No __________;
Book No __________;
Series of __________;
AGUSAN DEL SUR STATE COLLEGE OF AGRICULTURE AND TECHNOLOGY
P-1, San Teodoro, Bunawan, Agusan del Sur 8506
website: www.asscat.edu.ph
e-mail address: op@asscat.edu.ph
mobile no: +639483679266