Division of Quezon City Schools
Quezon City 6th District , Metro Manila
                           Placido Del Mundo Elementary School
                                     School District XX
                                                                     _____________________
                                                                             Date
The Schools Division Superintendent
Quezon City, Metro Manila
Sir / Madam :
     I have the honor to request permission to pursue my studies leading to the degree of
__________________________________________________________________ at the
_________________________________________________________________ starting
________________ Semester / Summer______________________________________
       Enclosed herewith is a list of the subjects I intend to take as approved by the
registrar.
       In this connection , I am submitting herewith some additional information.
       Educational Attainment ___________________________________________
       Year/s in College ________________________________________________
       Total units earned ________    Major ___________ Minor ______________
       Teaching Experience in this Division ______________________________
       Latest Performance Rating _______________________________________
       I hereby certify that I am thoroughly acquainted with the regulations under BPS
Circular No. 17 s.1960 amended by Circular No. 3, s. 1972 and further amended by
Circular No. 7 , s. 1973 and will comply with all the rules and regulations contained
therein.
                                                                     Very truly yours,
                                                                 ____________________
                                                                 Signature of Applicant
RECOMMENDING APPROVAL
                                                                    __________________
______________________________                                   Printed Name of Applicant
           Principal IV
 ( Print Name Below Signature)
      ( Inclosures to the Letter of Application for Permit to Study)
College / University : ________________________________________________
         Subjects               Credit         Rating       School        1st / 2nd            With or
      Already taken                                          Year        summer                Without
                                                                                               permit
                        Subjects to be taken                                          Credit
    Subject still to be taken        Credits            Subjects still to be taken         Credits
                                                                    CERTIFIED CORRECT
                                                             ______________________________
                                                                       Dean / Registrar
                                                               ( Print Name below Signature)
NOTE :
      This request should be in the Division Office at least two ( 2 ) months before the
 enrolment period . The regular study load of a teacher is not more that 9 units during
 college term for BSE and 6 units for MA during semestral term and 9 units during
 summer term.