REPUBLIC OF THE PHILIPPINES)

City of Kidapawan)

PARENT’S CONSENT
FORM
I, (name of parent/guardian);, of legal age, Filipino,
(please check) □single or □
married to _______________ ___________,and a
resident of _______________________ , after having been duly sworn to in accordance with
law, hereby depose and say:

1. I am the (please check)

□ Parent □ Legal Guardian based on the records of the college of

____________________________________________ (Name of Student);

2. My child/ward is presently enrolled at the CENTRAL MINDANAO COLLEGES this

SECOND SEMESTER ACADEMIC YEAR 2023-2024

3. In the course of his/her stay at the CENTRAL MINDANAO COLLEGES he/she will undergo
________________________________ at _______________________________.

4. In compliance with CHED Memorandum Nos . 4 and 6, S.-2022, I hereby declare that I am
allowing him/her to attend such activity provided that the same is sanctioned by the CENTRAL
MINDANAO COLLEGES and provided further that this form will be used as parent’s consent
for any subsequent activities.

5. I am executing this affidavit to attest to the veracity of the foregoing facts, in compliance with
the requirements of the Commission on Higher Education, and for whatever legal purpose this
may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this at

, Philippines.

Parent’s Signature over

Printed Name ID

Witnesses

NAME AND SIGNATURE MR. EROLLE LINUS T. MIRANDA

College Dean/Principal/Head of Office Director for Student Affairs and Services

SUBSCRIBED AND SWORN to before me this , at

, Philippines, by the affiant who exhibited to me his/her competent proof
of identity as shown above.

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