Republic of the Philippines
Department of Education
REGION IX_
DIVISION OF ZAMBOANGA SIBUGAY
___________ __ SCHOOL DIVISION OF ZAMBOANGA SIBUGAY___________________________
“Annex B”
APPLICATION FOR PERMISSION TO STUDY
Name of Applicant: ELONA JANE L. CAPANGPANGAN Position: TEACHER I
Civil Service Eligibility: LET Civil Status: SINGLE
Name of School where employed: VILLACASTOR ELEMENTARY SCHOOL Barrio: __________________________
Municipality: BUUG Perm/Prov’l: PERMANENT
Distance in Kms between official station and college where enrolled: 67.1 kms
SOUTHERN MINDANAO COLLEGES-PAGADIAN CITY
(Name and Location of college where applicant wished to enroll)
Course applied for: Ph.D
Academic Year: 2024-2025 Qtr./Sem. Summer: SUMMER
(1st,2nd ,3rd ,4th)
Course to be taken this term and the schedule:
COURSE DAYS OF THE WEEK HOURS OF THE WEEK
_______________________________ ____________________________ ____________3_______________
_______________________________ ____________________________ ____________3_______________
_______________________________ ____________________________ ____________3_______________
Credits or Units towards - - - BSE MA Ed. D/Ph.D.
Total number of units previously _________ _________ _____6_____
Number of units to be earned this tr./ Sem./ Summer _______9_______________________________________________
I now certify that I have carefully read the information on the next page of this form, all the provisions of which I am
bound to observe very strictly, I understand that the regulations on the outside study of teachers are intended to primarily
safeguard the health of the teachers as well as of course to maintain their efficiency in the service. I also understand that if
in the opinion of the Division Superintendent of School, this study adversely affects my efficiency as a teacher this
permission to study shall be revoked.
___________________________________
(Signature of Applicant)
Date Submitted: JUNE 20, 2024
APPROVAL RECOMMENDED:
The undersigned shall require strict compliance by the applicant with all the existing rules and regulations regarding
permission to study and should be held responsible for any undue delay in forwarding the applicant to the office doing
satisfactory work with an efficiency rating ID “ABOVE AVERAGE” or higher. The applicant will be required to submit
through the 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: JUNE 20, 2024 SILVERIA P. PAGAYON
District Supervisor/ Sec. Sch. Principal
APPROVED:
This permit expires on ____________________________
Date: ____________________
Permit No.: _______________
___________________________________
ROSMINDO L. ANCHETA, JR.
Education Program Supervisor
SGOD
Republic of the Philippines
Department of Education
REGION IX_
DIVISION OF ZAMBOANGA SIBUGAY
___________ __ SCHOOL DIVISION OF ZAMBOANGA SIBUGAY___________________________
“Annex B”
APPLICATION FOR PERMISSION TO STUDY
Name of Applicant: ALVE JEAN P. PETALLAR Position: TEACHER I
Civil Service Eligibility: LET Civil Status: MARRIED
Name of School where employed: TALAMIMI ELEMENTARY SCHOOL Barrio: __________________________
Municipality: BUUG Perm/Prov’l: PERMANENT
Distance in Kms between official station and college where enrolled: _____km
SOUTHERN MINDANAO COLLEGES-PAGADIAN CITY
(Name and Location of college where applicant wished to enroll)
Course applied for: Ph.D
Academic Year: 2024-2025 Qtr./Sem. Summer: SUMMER
st nd rd th
(1 ,2 ,3 ,4 )
Course to be taken this term and the schedule:
COURSE DAYS OF THE WEEK HOURS OF THE WEEK
_______________________________ ____________________________ ____________3_______________
_______________________________ ____________________________ ____________3_______________
_______________________________ ____________________________ ____________3_______________
Credits or Units towards - - - BSE MA Ed. D/Ph.D.
Total number of units previously _________ _________ _____6_____
Number of units to be earned this tr./ Sem./ Summer _______9_______________________________________________
I now certify that I have carefully read the information on the next page of this form, all the provisions of which I am
bound to observe very strictly, I understand that the regulations on the outside study of teachers are intended to primarily
safeguard the health of the teachers as well as of course to maintain their efficiency in the service. I also understand that if
in the opinion of the Division Superintendent of School, this study adversely affects my efficiency as a teacher this
permission to study shall be revoked.
___________________________________
(Signature of Applicant)
Date Submitted: JUNE 20, 2024
APPROVAL RECOMMENDED:
The undersigned shall require strict compliance by the applicant with all the existing rules and regulations regarding
permission to study and should be held responsible for any undue delay in forwarding the applicant to the office doing
satisfactory work with an efficiency rating ID “ABOVE AVERAGE” or higher. The applicant will be required to submit
through the 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: JUNE 20, 2024 SILVERIA P. PAGAYON
District Supervisor/ Sec. Sch. Principal
APPROVED:
This permit expires on ____________________________
Date: ____________________
Permit No.: _______________
___________________________________
ROSMINDO L. ANCHETA, JR.
Education Program Supervisor
SGOD
