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Republic of the Philippines

Department of Education
Region VI - WESTERN VISAYAS
Division of Negros Occidental
LOPEZ JAENA NATIONAL HIGH SCHOOL
Barangay Lopez Jaena, Murcia, Negros Occidental

_____________
Date
The Principal
___________________
___________________

Sir/Madam:

This is to request for the official transcript of records/Form 137-A of the following
student/s who is/are temporarily enrolled in this school upon presentation of Form 138/ Transfer
credentials:
In Our School In Your School
NAME
Year/Grade & Year/Grade &
SCHOOL YEAR SCHOOL YEAR
Section Section

If for any reason the Form 137-A of the aforementioned student/s cannot be released,
please inform us accordingly.
Thank you.
Very truly yours,
BENJIE C. MAGADA
_______ 1st Request Principal III
_______ 2nd Request
_______ 3rd Request
By:
__________________
Adviser

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