Republic of the Philippines

Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

AGBUYA, ADRIAN DARAS
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

ALNAS, JAKE BRANGAN
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

CODILLA, JHON LYOD -
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

DELA CRUZ, MARK JOHN QUIRONA
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

DELA CRUZ, REX KELLY PASCUA
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

GAVERSA, MARK RAVEN KIEHL DIOLA
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

GUILING, RENZ VINCENT SUDIO
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

LACABA, JEREN JOVITA
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

NISPEROS, MARK JERWIN MANTILEZ
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

PASCUA, CARL ANDREI GUERRERO
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

PASCUA, JOHN CURBY PAZ
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

POQUIZ, ROBERTO JR. SUDIO
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

PRADO JR., FEDERICO ARCANGEL
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

RESUELLO, DUSTIN JOLO PALITEC
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

REYES, JULIUS MARCELLANO
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

SOLIVEN, KIVERD TAMAYO
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

SORIANO, JOHN BILL BUNA CRUZ
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

SUDIO, CHRISTIAN JAY BAUTISTA
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

SUDIO, LLOYD EDZON PADAOANG
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

SUDIO, RICKY BORBON
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

TAMONDONG, GERALD BALDEO
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

ZUÑIGA, VINCENT PRUDENCIO
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

CANCINO, ARIANNAE LOMBOY
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

DORIA, RENELYN PARAGAS
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

MAMAAT, MAY ANN MUÑOZ
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

MENDOZA, JESSA MAE BARLAAN
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

NEPACINA, ANGEL MAY URSUA
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

PASCUA, DONITA ROSE TCRUZ
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

ROSARIO, JOVELYN SERAFICA
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

SUDIO, JAMAICA MENDAROS
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

SUDIO, SARAH JOVES
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph
 Republic of the Philippines
Department of Education
Region I
Schools Division of San Carlos City
Salinap National High School
Salinap, San Carlos City, Pangasinan

PARENTAL CONSENT FORM

Control No.: Date: 5 April 2024

TO WHOM IT MAY CONCERN:

TANDOC, RACHELLE CASIMINA
This is to allow my son/daughter _________________________________________, a student of
Name of Child

Salinap National High School

__________________________________________________________________ to participate in the
Name of School

Joint Delivery Voucher Program

_______________________________________________ April 8 – May 25, 2024
which will be held on _____________________
Name of Activity Date of Activity

Prime Brilliant Minds Academy, Palaris Street, San Carlos City, Pangasinan
at __________________________________________________________________________.
Place of Activity

Knowing that the school will exercise utmost diligence to keep the safety of the participant/s, I will

Salinap National High School

not hold _________________________________________ responsible for any untoward incident beyond
Name of School

normal control that may happen to my son/daughter in connection with the said activity.

5 April 2024

Printed Name of Parent/Guardian Signature Date Contact Number

Address : Salinap, San Carlos City, Pangasinan

Email Address : salinapnhs@gmail.com / 300387@deped.gov.ph