Republic of the Philippines

Department of Education
Regional Office No. VIII
Division of Northern Samar
SAN JOSE ELEMENTARY SCHOOL
Mapanas District

October 7, 2019

The Principal

Gamay Central Elementary School

Gamay, N. Samar

Sir/Madam:

May I have the honor to request for certified copy of FORM 137-E of the following pupil who
is temporarily enrolled in our school upon presenting her credentials.

Name of Pupil Attended your Grade & Section Temporarily Adviser

School Admitted to
CHARICE B. 2018-2019 Three-Melon Grade Four- Cristina R. Gomba
MENDEZ Gumamela

__________ Request

__________ Please entrust to the bearer

Very respectfully yours,

DHARYL L. PIANDIONG
Adviser

NOTED:

ROMER B. LONGCOP
Teacher-In-Charge