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Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IV – A CALABARZON
Division of Rizal
Elementary School
REQUEST FORM

The Principal/Registrar
Dear Sir/Madam:
Kindly furnish this office with certified true copy of the Pupil’s Permanent Record of pupil listed below who are
temporarily enrolled in this school upon presentation of his/her report card.
Name Grade/Section Teacher School Year

Please entrust to the bearer


Request Urgent Very truly yours,

School Record Coordinator Adviser

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