Republic of the Philippines

Department of Education
Region I
Schools Division Office II of Pangasinan
DISTRICT
NAME OF SCHOOL

May 5, 2021

DANILO C. SISON, EdD., CESO V

Schools Division Superintendent

Sir:

I would like to request permission to conduct a (e.g. School-based/District-based Training Program / LAC Session) entitled,
_____________________________________ on ________________________ to be held at
____________________________________.

Participants in this training are ___________________ with an expected number of _____ attendees via ______ ( e.g. Zoom/MS
Teams/Google Meet / face to face). The amount of expenses is P_____ charged to (fund source).

The objectives of this training/activity are:

1.
2.
3.

In view of the Covid-19 situation, we will observe the guidelines pursuant to DepEd Memorandum No. 052, s. 2020 consistent
with the policies set forth by the Inter-Agency Task force for the Management Emerging Infectious Diseases (AITF) and the Civil
Service Commission (CSC).

Attached is the INSET/LAC Proposal for your perusal.

I hope for your favorable action and approval on my request. Thank you very much.

Sincerely yours,
_________________________________
Name and Signature of Proponent

Noted:

________________________ _____________________________
School Head PSDS

Checked and Recorded:

NOTE: Signatories for Approving Authority
MARA LUISA C. CATALAN, PhD
Senior Education Program Specialist - HRD For Elementary:
WILFREDO E. SINDAYEN, EdD
RECOMMENDING APPROVAL: Assistant Schools Division Superintendent
_____________________________
For Secondary:
Chief Education Supervisor In-Charge
ARLENE B. CASIPIT, EdD
APPROVED FOR THE SCHOOLS DIVISION SUPERINTENDENT: Assistant Schools Division Superintendent
_______________________________________
Assistant Schools Division Superintendent