NORTHERN ZAMBALES COLLEGE, INC.

Inhobol, Masinloc, Zambales | (047) 821-1575

Basic Education Department
END OF SCHOOL YEAR (S.Y. 2022-2023) TEACHER’S CLEARANCE
INSTRUCTION TO TEACHER:
This form must be signed and returned to the School Principal.
COMPLETE THE SECTION BELOW
Last name: Given name: Middle Name:
Advisory Class: (Grade / Strand / Section)                                                                                                                          
Complete Home Address:

Phone Number :                                             E-Mail Address:                                                     

DEPARTMENT SIGNATORY SIGNATURE

SHS
ACADEMIC PROGRAMS
School Register- daily used in manual checking of attendance (with advisory class only). Ariel E. Ebbay, Principal

SF1 School Register LIS Generated (for Kinder to Grade 10 Advisers Only) Leonard Amores, Elem - JHS LIS Coord
SF1 School Register LIS Generated (for SHS Advisers Only) Ramil Ebelte, SHS LIS Coord.
SF2 Learner Daily Attendance Report Blesel B. Ebalan, Asst.Principal

Books Issued and Returned Charrie A. Basarte , Librarian

SF4 Monthly Learner Movement and Attendance Report (for SHS) Blesel B. Ebalan, Asst.Principal

SF5A End of Semester & SY Learner Status (1 & 2

st nd
Semester / SHS with advisory class only) Blesel B. Ebalan, Asst.Principal

SF5B List of Learners with Complete SHS Requirements (G-12 advisers only) Blesel B. Ebalan, Asst.Principal

SF7 School Personnel Assignment List and Basic Profile Ariel E. Ebbay, Principal
SF9 Learner’s Progress Report Card (with advisory class only). Blesel B. Ebalan, Asst.Principal

SHS-SF10 Learner’s Permanent Academic Record with the ff. attachment

(copy of PSA Birth Cert., JHS F137, NCAE Result, Cert of Completion and QVR cert. if the
student is from private sch.) Note: for teacher with advisory class only. Duly checked and signed Blesel B. Ebalan, Asst.Principal
by the ff: Class Adviser, Subject Group Head and
Academic Coordinator.
SHS-ICT Required Document/s (Soft Copies of SF5B for G 12 only, SF5A and SF10) Maricel Eclarinal, APOLS/Registrar
Curriculum Map Subject Group Head/Subj. Head

Curriculum Guide SHS Blesel B. Ebalan, Asst.Principal

Lesson Plan SHS Blesel B. Ebalan, Asst.Principal

NLIS/ Transferred Out student's documents Maricel Eclarinal, APOLS/Registrar

Class Record Blesel B. Ebalan, Asst.Principal

Summary of Grades Final (with advisory class only) Blesel B. Ebalan, Asst.Principal

Test questions with answer keys and TOS Blesel B. Ebalan, Asst.Principal
Other required document/s for ESC (Grade 7 Advisers) / TSS (Recipient only) Leonard Amores, JHS LIS Coord

PROPERTY MANAGEMENT
Instructor / Teacher Regalia (Toga) Mario Manangan, Property Custodian BE

Barrowed materials/ equipment Mario Manangan, Property Custodian BE

Classroom inventory (with advisory class only). Mario Manangan, Property Custodian BE

Quarterly procurement Mario Manangan, Property Custodian BE

Computer / ICT Laboratory Mario Manangan, Property Custodian BE

Faculty Club Clive Justine Elamparo, SHS Faculty Club Pres.

STATEMENT OF CLEARANCE
This is to certify that I have satisfactorily complied with all academic requirements and returned all equipment, tools and other tangible properties of Northern
Zambales College, Inc. for the School Year 2022-2023.

Teacher’s Signature: Date:

Recommending Approval : BLESEL B. EBALAN

SHS Assistant Principal
Appro ARIEL E. EBBAY
ved : Principal

Copy Furnished :
Office of the Principal