Republic of the Philippines

Department of Education
Region IV-A CALABARZON
Division of Rizal
KASIGLAHAN VILLAGE NATIONAL HIGH SCHOOL
Rodriguez, Rizal
S.Y 2022– 2023

KASUNDUAN
Petsa:________________________

Ako po si G./Gng./Bb.______________________________________magulang/tagapagalaga

ni_________________________________ng Grade 9 – Santan. Ako po ay nangangakong ibibigay ang

kopya ng kanyang birth certificate sa darating na _____________________________.

Maraming salamat po!

_________________________ __________________________
Pangalan at lagda ng mag aaral Pangalan at Lagda ng Magulang

__________________
Gurong Tagapayo

Contact Number ng magulang: ________________________________

Address:___________________________________________________