Republic of the Philippines

MARIKINA POLYTECHNIC COLLEGE

#2 Mayor Chanyungco St., Sta. Elena, Marikina City
1800 Trunk line: 8569-8531 loc. 102 - Information
mpc09_college@yahoo.com | www.mpc.edu.ph
Future-Ready MPC, United in Purpose

OFFICE OF STUDENT ORGANIZATIONS AND PUBLICATION

PARENT CONSENT

,a student is planning to
(Name of Student) (Section/Course)

join/participate the “TUTORIAL PROGRAM” at “CONCEPTION DOS AND PARANG, MARIKINA CITY” on
APRIL 1 TO MAY 30, 2024.

TRANSPORTATION (MPC-Destination-MPC) COST:

Roadways No Change
Airways A charge of for transportation is neededA
Waterways charge of for admission is nee
N/A

Recommended by: Approved by:

MARIA CRISTINA PUYONG ALMA A. ELEMENTO, LPT, MAT

President, MPC - FTA Adviser, MPC-FTA

PROF. MARLON ALTICHE, LPT, MACT

OIC-Head, Student Organizations and Publication

April 5, 2024
Date: __________

I understand that the college will take every precaution and care to ensure my son’s/daughter’s safety.
Adults who will provide proper supervision and will exercise every precaution to avoid accidents during
the conduct of the activity.

I hereby give my consent to my son/daughter _______________________________ join/participate

the “TUTORIAL PROGRAM” at “CONCEPTION DOS AND PARANG, MARIKINA CITY” on APRIL 1 TO MAY
30, 2024.

_________________________________________
PARENT/GUARDIAN (Signature over printed name)

In case of emergency, please write your contact number: ___________

April 5, 2024

“ No student will be permitted to attend activity/training/seminar unless this form has been filled out in advance by the
Parent or Guardian and returned into the Office of the Student Organizations.”
(All data written above shall be treated as confidential files. No information shall be used in any personal purpose)