Sacred Heart College

1 Merchan St. Lucena City

DATA PROTECTION OFFICE

CONSENT FORM for USE of ONLINE SERVICES

3rd August 2020

Dear SHC Adult Learners:

Greetings of Peace!

In response to the current pandemic situation, Sacred Heart College, as an academic institution that offers quality
education, now provides access to online learning services as recommended by the Department of Education
(DepEd) for IBED and SHS students and the Commission on Higher Education (CHED) for College and Graduate
School Students.

Online services increase the range of teaching tools available to staff and will ensure and enhance continuous
learning opportunities that are available to student-learners.

We are writing to you to seek your approval or consent for you to be given access to these online services. This may
involve the College using your full name, preferred name, course and year level to access your unique online
services account.

The College’s online services currently provide:

a. individual e-mail domain accounts for ALL students and staff;
b. access to the online teaching and learning services such as web-conferencing, digital resources and online
learning activities;
c. access to online file storage and sharing services; and
d. access to Portal services from home if the home computer or electronic device is connected to the Internet.

If you agree to yourself to make use of these online services, please complete the following consent form. You will
also need to ensure that you read and understand the contents of this form. The signed documents should be returned
to the College so that an online services account can be created for you.

Please note that while every reasonable effort is made by the College to prevent student exposure to inappropriate
online content when using the College’s Online Services, it is not possible to completely eliminate the risk of such
exposure.

You should also be aware that general Internet surfing or browsing by student-learners from home or locations other
than the College is not monitored or filtered by the college since it is not conducted via the College’s network and
that you are responsible for the supervision of your use of the Internet from home.

Thank you for your usual support.

Yours sincerely,

(SGD) Yvonne Hitty L. Mier

Data Protection Officer

Noted by:

(SGD) Sr. Maria Luisa B. Javier, D.C.

President, Sacred Heart College
Lucena City
 Permission for student-learners to have an online services account

(Please write the information using one capital letter or number per box)

Student’s last name

A M A N D Y

Student’s first name(s)

M I C H A E L A N G E L O

Student’s preferred name

M I C H A E L

Course/Year Level
B S N 3 A

Student No.
0 8 - 0 1 0 2 3

Adult Learners

Do you give permission for yourself to have an online services account? Yes / No
(underline one)

I agree to and understand the responsibilities that I have in using the online services provided at Sacred Heart
College for educational purposes in accordance with the acceptable usage agreement for school and students.

I also understand that if I break any of the rules in the agreement, the SDO Director may take disciplinary
action as provided in the policies of the College.

Name of adult learner: Michael Angelo S. Amandy

Electronic Signature of adult learner:

Date: 08/5/2020

Note: While every reasonable effort is made by the College to prevent student exposure to inappropriate online
content when using the College’s Online Services, it is not possible to completely eliminate the risk of such
exposure. The College cannot filter Internet content accessed by yourself from home or from other locations
away from school. The College recommends the use of appropriate Internet filtering software and observance of
netiquette.

Office use only: Date processed: / / Processed by (initials):

 CONSENT FORM for ONLINE CLASSES

Dear SHC Adult Learners:

We, at Sacred Heart College, will utilize the Google Suite platform for our online or blended learning for students,
teachers, staff, parents and other stakeholders of SHC during this quarantine period under the “new normal” for the
School Year 2020-2021.

While we feel that there is no real substitute for face-to-face instruction and interaction between teachers and
students, we would like to assure you that we strive to continue to offer quality education by working with our
students and are grateful for the ease this platform brings to that endeavor.

As with anything we do at Sacred Heart College for our student-learners, we believe that a strong partnership with
families is essential to a successful experience with this new normal way of learning. Using this tool will allow us to
stay in touch and to give instruction to you.

Technology use at Sacred Heart College is governed by RA 10173, otherwise known as the Data Privacy Act of
2012:

Data Privacy Act of 2012

DPA 2012 applies to the protection of the collection, use, process and disposal of personal information, personal
sensitive information and privileged information of data subjects, including our students and personnel. For more
information on DPA 2012, please click here: https://www.privacy.gov.ph/data-privacy-act/

Student’s Name
Michael Angelo Sale

First Name/s Last Name

Student’s Birthdate

04 10 2020

MM DD YYYY

Student’s Email
amandy.mas@shc.edu.ph

Please choose one option below 

 YES, I give permission for myself to participate in Google SHC meetings and to use this platform.

 NO, I do not give permission for myself to participate in Google group SHC meetings and to use this platform.

I understand that no obscene, racist or derogatory language or imagery will be allowed by any student,
parent, guardian, SHC staff or stakeholders while participating in SHC online learning. 

 Yes

 No
I understand that some meetings may be recorded for archival and promotional purposes. I give consent for
these recordings of meetings to be utilized for SHC promotional purposes only. 

 Yes

 No

On screen viewing during online classes:

 YES, I give permission for myself to be seen in the monitor during online classes not only by teachers and/or
fellow classmates, but also the possibility of being seen by others, such as tutor of classmates, parents/guardians of
students and other household members of classmates.

 NO, I do not give permission for myself to be seen in the monitor during online classes.

Electronic Signature 
By signing below, I confirm that I have read and understand the following: Under the Data Privacy Act 2012, a
student's education records are protected from disclosure to third parties. I understand that my education
files/records stored at SHC or any information stored in our online Google Drive folders may be accessible to
someone other than myself by virtue of this online environment. My signature below confirms my consent to allow
my education files/records to be stored by SHC and in locked Google Drive folders. SHC will not share your
information with any third party, but you have the right to request access to your records at any time.

Date

08 05 2020

MM DD YYYY