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Permission to Study Application Form

This document is an application for permission to study from the Department of Education Region X - Northern Mindanao. It contains information about the applicant such as name, position, civil status, and employer. It also lists the college/university, course, academic year, and schedule that the applicant wishes to enroll in. The principal and division superintendent must recommend and approve the application. The applicant agrees to observe all regulations and understands the permission can be revoked if it affects work efficiency.

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Hendrix Antonni Amante
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537 views2 pages

Permission to Study Application Form

This document is an application for permission to study from the Department of Education Region X - Northern Mindanao. It contains information about the applicant such as name, position, civil status, and employer. It also lists the college/university, course, academic year, and schedule that the applicant wishes to enroll in. The principal and division superintendent must recommend and approve the application. The applicant agrees to observe all regulations and understands the permission can be revoked if it affects work efficiency.

Uploaded by

Hendrix Antonni Amante
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Education Region


X - Northern Mindanao
DIVISION OF LANAO DEL NORTE
Gov. A. Quibranza Prov’l. Gov’t. Compound
Pigcarangan, Tubod Lanao del Norte
(063)227 - 6633, (063)341 - 5109
lanao.norte@deped.gov.ph
Application for Permission to Study

Name of Applicant: ______________________________ Position: _________________


CS Eligibility: ___________________________________ Civil Status: ______________
Name of School where employed: ___________________ Barangay: ________________
Municipality: ____________________________________ Perm/Prov’l: ______________
________________________________________________________________
(Name and Location of College/University where applicant wished to enroll)

Course applied for: ____________________________________________


Academic Year: _______________ Qtr./Sem./Summer: __________

Course to be taken this term and the schedule:


COURSE DAYS OF THE WEEK HOURS OF THE WEEK
________________________ ________________________ ________________________
________________________ ________________________ ________________________
________________________ ________________________ ________________________
________________________ ________________________ ________________________
Credits or units towards BSE MA Ed.D./Ph.D.
Total number of units previously ____________ ____________ ____________
Number of units to be earned this Qtr./Sem./Summer: _________________________________

I hereby certify that I have full knowledge with all the provisions of which I am bound to strictly
observe. I understand that the regulations on the outside study are intended to primary safeguard the
health and to maintain the efficiency of the service. I also understand that if found that this permit
adversely affects the efficiency of the service, this permission to study shall be revoked.

_____________________________
(Signature of Applicant)
Date Submitted:____________________

APPROVAL RECOMMENDED:
The undersigned shall require strict compliance by the applicant with all the existing rules and
regulations regarding permission to study and should hold responsible for any undue delay in forwarding
the applicant to the office by doing satisfactory work with an efficiency rating of “ABOVE AVERAGE” or
higher. The applicant will be required by me to submit through office, to the Division Superintendent a
certified copy of the report rating obtained in the course which should be attended to his/her outside
study not earlier than thirty minutes after the afternoon session in the public school.

Date Submitted:_________________ ________________________________


School Principal

RECOMMENDING APPROVAL:

MARIA CARMELA T. ABLIN, Ed.D.


Chief, School Governance and Operation Division

APPROVED:

EDILBERTO L. OPLENARIA, CESO VI


Schools Division Superintendent

#GO100

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