LAMPAYAN NATIONAL HIGH SCHOOL

Lampayan, Matalam, Cotabato

INTERNET FORM
STUDENT NAME: GRADE:

CELLPHONE UNIT & NAME: FACEBOOK/MESSENGER NAME:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

DATE & DAY: DATE & DAY: DATE & DAY:

U.NAME & P.WORD: U.NAME & P.WORD: U.NAME & P.WORD:
REMARKS: REMARKS: REMARKS:

NOTE: Bring this form everytime you'll ask for the voucher and always fill in the needed/required data.

"I _________________________, promise to use my free internet connection in meaningful and fruitful researches and not
to overused it in Facebook or any other social media platforms only."

(Signature over printed name of the student)