Teacher’s Copy

_________________________
Date
Dear Mr. & Mrs. _____________________________________

With sincere concern over the welfare of your son/daughter _______________________________, we wish to inform you that
he/she

[ ] has not reported to class since ____________________________

[ ] is irregular in attendance
[ ] has failed in ______________________
[ ] quarreled or made trouble in school
[ ] is cutting class frequently
[ ] is often late to his/her subject classes
[ ] has shown disgraceful conduct
[ ] other reason/s (specify) ___________________________________________________________________________

It is earnestly requested that you come for a conference at _______________________________________________________

on _____________________________ at ______________________________.

Your sincere and immediate attention over this matter is highly appreciated.

Very truly yours,

____________________________________ LORENA S. ROMERO

Adviser/Subject Teacher School Guidance Office In-Charge

NOTE: Please sign this slip and return to the Teacher or Guidance Designate/Counselor.

RECEIVED: ________________________________________
Parent/Guardian

----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

Student’s Copy

_________________________
Date
Dear Mr. & Mrs. _____________________________________

With sincere concern over the welfare of your son/daughter _______________________________, we wish to inform you that
he/she

[ ] has not reported to class since ____________________________

[ ] is irregular in attendance
[ ] has failed in ______________________
[ ] quarreled or made trouble in school
[ ] is cutting class frequently
[ ] is often late to his/her subject classes
[ ] has shown disgraceful conduct
[ ] other reason/s (specify) ___________________________________________________________________________

It is earnestly requested that you come for a conference at _______________________________________________________

on _____________________________ at ______________________________.

Your sincere and immediate attention over this matter is highly appreciated.

Very truly yours,

____________________________________ LORENA S. ROMERO

Adviser/Subject Teacher School Guidance Office In-Charge