Attendance Agreement Form

Learner’s name: _____________________________

LRN: ___________________________
School: Unson Elementary School
Grade and Section: ___________________________
Class Adviser: ___________________________

For the reason that the learner has been absent for days, this is an agreement that he/she will (no longer attend
school/attend school again). The learner will (no longer attend/ be going back to) school from ___________________.

*Reasons: (ref. DepEd School Form 2)

 Domestic-Related Factors
______-had to take care of siblings
______-early marriage/pregnancy
______-parents’ attitude toward schooling
______-family problems
 Geographical/Environmental
______-distance between home and school
______-armed conflict (including tribal wars and clan fueds)
______-calamities/disasters

 Individual -Related Factors  Financial-Related

______-illness ______-child labor, work
______-overage
______-death
______-drug abuse
______-poor academic performance
______-lack of interest/distractions
______-hunger/malnutrition

 School-Related Factors  Others (Please specify)

______-teacher factor __________________________________________________________
______-physical condition of classroom __________________________________________________________
______-peer influence ____________

This is to certify that this agreement regarding the learner’s attendance is upon the knowledge and
consent of his or her guardian/s.

_______________________________________________________ ________________________________________
Signature over printed name of the parent/guardian Classroom Adviser