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Republic of the Philippines

Department of Education
Region VIII-Eastern Visayas
Schools Division of Calbayog City
Calbayog I District
BAGACAY INTEGRATED SCHOOL
Bgy. Bagacay, Calbayog City, W. Samar
School ID: 500807

__________________________
Date
CERTIFICATION
TO WHOM THIS MAY CONCERN:

THIS IS TO CERTIFY that the undersigned have checked, validated and reviewed as to the
accuracy and consistency of data and entries of the School Forms and other Year-End reports of
GRADE ________ SECTION____________________of Bagacay Integrated School, School Year
2018-2019.
This further certifies that we bind ourselves accountable should there be inaccuracies,
inconsistencies and errors in the said documents or records of the school found in the future.
Issued this ________ day of _____________________, 2019.

DISTRICT CHECKING COMMITTEE

Checked in the presence of:

SF 1
___________________________________________

Name and Signature

SF 5
___________________________________________
Name and Signature

SF 9
___________________________________________
Name and Signature

SF 10
JOSEPHINE L. GALLARDO
Name and Signature

Certificates/Diploma (Completer)

___________________________________________

Name and Signature


LEA L. JORDAN
School Principal
Co-Chairman
Republic of the Philippines
Department of Education
Region VIII-Eastern Visayas
Schools Division of Calbayog City
Calbayog II District
BAGACAY INTEGRATED SCHOOL
Bgy. Bagacay, Calbayog City, W. Samar
School ID: 500807

__________________________
Date
CERTIFICATION
TO WHOM THIS MAY CONCERN:

THIS IS TO CERTIFY that the undersigned have checked, validated and reviewed as to the
accuracy and consistency of data and entries of the School Forms and other Year-End reports of
GRADE ________ SECTION____________________of Bagacay Integrated School, School Year
2018-2019.
This further certifies that we bind ourselves accountable should there be inaccuracies,
inconsistencies and errors in the said documents or records of the school found in the future.
Issued this ________ day of _____________________, 2019.

DISTRICT CHECKING COMMITTEE

Checked in the presence of:

___________________________________________
ADVISER

Checked and verified:

LEA L. JORDAN
School Principal II
Co-Chairman

ANABELLE O. YANGZON
PSDS
Chairman

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