VISITORS PASS/ PERMIT

Name of Visitor: _____________________________ contact number: ________________

Address: _________________________________________________________________

Time-in: ______________Time-out: _______________ Date: _______________________

ID Presented: _____________________________________________________________

Person/office to Visit Pls Check (/)

___ Student ___ Guidance Counselor ___ Principal
___ Teacher ___ Department Head ___ others pls specify.

Person to visit (name):________________________________

Section: ___________________________________________

Purpose of visit:
_________________________________________________________________________
_________________________________________________________________________
_______________________________________________________________________________

AGREEMENT
I, ________________________________ (name of visitor) will follow and respect the rules and
regulations of the school during the time of my visit. I will not do anything that will harm the school
and its students.

_____________________
Signature over printed name

Guard’s Signature: