Republic of the Philippines
Department of Education
REGION II – CAGAYAN VALLEY
SCHOOLS DIVISION OF QUIRINO
VILLAMOR ELEMENTARY SCHOOL
VILLAMOR, CABARROGUIS, QUIRINO
______________________________________________________________________
PARENTAL CONSENT FORM SUMMER CLASS
I, ________________________________ hereby state that I am the ____________________
(Name of Parent/Guardian) (Relationship to the learner)
of_______________________________ with LRN # _________________ who is presently in
(Name of the learner)
_________________ do hereby signify my consent for my child to be enrolled in the Summer
(Grade Level)
Academic Program this EOSY 2025 from May 13 to June 06, 2025 at Villamor Elementary
School – Villamor, Cabarroguis, Quirino.
______________________________
(Name and signature of Parent/Guardian)
_____________________
(Date)
___________________________________________________________________________________________________________________________
Address: Purok 3, Villamor, Cabarroguis, 3400, Quirino, Philippines
Cellphone Number: 0917-758-3326/ 0908-874-077
Email Address: 104272@deped.gov.ph