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Enclosure 6. Election Application Form
ELECTION APPLICATION FORM
‘The Learner Government Program embodies the ideals, principles,
and practices of participatory democracy. It represents and steers the
learner towards the fulfillment of LG Program goals promoting
learners’ rights and welfare. As a learner government leader, this
Election Application Form is a statement of your best knowledge and
understanding of a position you are applying for.
Place your
Instruction: Please supply the information requested in the space | 2X2 Picture Here
provided
1. PROFILE
Learner's Name:
(Surname, Given Name, Middle
Name, & Extension Name e.g., Jr, hI»)
Date of Birth:
___ Mobile N
I. LEARNER'S ACADEMIC AND BEHAVIORAL STATUS
[Le Has no filing grades in all ubject areas Yes | [No
Attested —- —
* | Class Adviser Name & Signature | Date:
[2s of good moral character [_ [ves Wo
[stent | BaP7Guidance Coordinator Name | pa, :
___ & Signature | Pate:
Ti aT Poy a yi Shel For 9 [earne7s Progr Report Card and Cercle of Good Moral
MI, PARENTAL CONSENT
1 - esa parent/guardian of
will support his/her commitment to the Learner
Government to the best of my ability.
Lam allowing him/her to participate in the programs, projects, and activities of the Supreme
Learner Government.
T agree and understand the commitment of my son/daughter and will support his/her
endeavor to the Supreme Learner Government,
Name and Signature of the Parent/Guardian "Contact Number
IV. CERTIFICATION
I am filing this Election Application Form of the Supreme Learner Government for the school
year _.
Thereby certify that the facts stated herein are true and correct to the best of my knowledge.
Signature of Candidate over Printed Name
Verified by: Approved by:
Screening and Validation Commissioner 1G COMEA Chief Commissioner
Date: Date:
