January 15, 2019

JIMMICIO S. DAOATEN
Provincial Director
TESDA, Negros Occidental Provincial Office
Talisay City, Negros Occidental

Sir,
Greetings!
We would like to request your good office to grant authority to JONELL M. VIZCAYA as
representative of La Granja National High School to claim the National Certificate in behalf of
our students who had taken the assessment in Organic Agriculture Production NC II at RMD
Agri-Tourism Industries and Training Center Inc. at Brgy. Maao, Bago City last November
2018.
We are hoping for your positive response.

Very truly yours,

BERNADETTE B. DORONILA
Principal II
 REGISTRATION FORM
NAME OF INSTITUTION La Granja National High School

COMPLETE ADDRESS Brgy. La Granja, La Carlota City

CONTACT NUMBER 09275197945/09491453380

EMAIL ADDRESS lagranja.highschool@deped.gov.ph

LIAISON OFFICER JONELL M. VIZCAYA

Signature Over Printed Name

AUTHORIZED SIGNATORY/IES
NAME Bernadette B. Signature 1
Doronila
Signature 2
TITLE/ School Head
DESIGNATION Signature 3

NAME Jonell M. Vizcaya Signature 1

TITLE/ Teacher I/TVL Agri- Signature 2

DESIGNATION Fishery Arts Teacher
Signature 3

SUBMITTED BY: DATE SUBMITTED:

JONELL M. VIZCAYA JANUARY 16, 2019