REPUBLIC OF THE PHILIPPINES)

PROVINCE OF BOHOL)
MUNICIPALITY OF INABANGA ) S.S.
x------------------------------------------------x

SWORN STATEMENT & PARENT’S CONSENT

I, ________________________, Filipino, married, and presently residing in Sto.
Niño, Getafe, Bohol, Philippines, after having been duly sworn to in accordance with law,
depose and state:

1. That I am a 4th year student of Buenavista Community College (BCC) with address at
Cangawa, Buenavista, Bohol taking BEED as confirmed by the Office of the College /
School Registrar.

2. That to complete the requirements of the program / to graduate in this academic year, I
need to enroll, GE Elec 1 – Living in the IT Era, TLE 1 – Edukasyong Pantahanan at
Pangkabuhayan and GE Elec 3 – Indigenous Creative Crafts, however the said subjects
were not offered in A.Y 2023-2024 first semester by the said school since these subjects
are normally offered in the 2nd semester.

3. That I already previously submitted a letter request for that matter and the same was
granted by the school considering that I am willing and shall voluntarily pay the per
units’ rate of the said subject which is 190 pesos per unit that shall be multiplied by the
number of 10 (the number of students required to open the said subject) divided by the
total number of enrollees, that in my case the total amount I shall pay for the
three subjects is Php 7, 980. In GE Elec 1 – Living in the IT Era we are two in the
class, in GE Elec 3 – Indigenous Creative Crafts we are five and in TLE 1 – Edukasyong
Pantahanan at Pangkabuhayan I am the only student.

4. That I will with full consent and understanding willing to pay the corresponding amount
/ rate for the said subject.

5. That I am executing this affidavit of undertaking voluntarily and fully aware of all the
consequences hereof and to attest to the foregoing facts and for any legal purpose it may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this ________________ in

Inabanga, Bohol, Philippines.

________________________
Affiant
Student ID No.______________
Conforme / Parent’s Consent:

I, ____________________, mother of the above-named student, fully read and

understands the content of this instrument and hereby affirm, confirm and consent to the
same.
I consent to my / our child’s statement & attest to the accuracy, correctness, and truthfulness of
all the statement that I/my child stated.
I understand that any misrepresentation or dishonesty in this instrument may result in the
denial of my / our child’s completion of the said subject.

__________________________
Mother

SUBCRIBED AND SWORN TO before me this _______________ in Inabanga,

Bohol, Philippines, affiant exhibiting to me their valid proof of identification.

Doc. No. ____;

Page No. ____;
Book No. 12;
Series of 2023.