Republic of the Philippines

CEBU TECHNOLOGICAL UNIVERSITY

DAANBANTAYAN CAMPUS
Agujo, Daanbantayan, Cebu, Philippines
Website: http://www.ctu.edu.ph E-mail: info-daanbantayan@ctu.edu.ph
Phone: +6332 239 6549 loc. 113

COLLEGE OF EDUCATION
ST Form 7
October 2012
Revision: 0
LABORATORY SCHOOL CLEARANCE

This is to certify that __________________________________, _____________________

Name Yr., Sec., & Curr.

a Student Teacher of the Cebu Technological University, ___________________Campus,

undertaking the practicum at _________________________________________________

from _________________to __________________________, has been cleared of money,

property and all other responsibilities.

Effective this ________day of _____________________, 20_______

Student Teaching Mentor/s:

______________________
1st Shift Mentor

______________________
2nd Shift Mentor

Conforme:

__________________________
Principal

_______________________________
Student Teaching Chairman/Supervisor