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    Consent Bago

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    Consent Bago

    Uploaded by

    forj72885
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    consent bago

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    18 views1 page

    Consent Bago

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    © All Rights Reserved
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    of 1

    Republic of the Philippines

    CENTRAL LUZON STATE UNIVERSITY


    Science City of Muñoz, Nueva Ecija

    OFFICE OF THE VICE PRESIDENT FOR ACADEMIC AFFAIRS

    LOCAL OFF-CAMPUS ACTIVITIES


    PARENT’S/GUARDIAN’S CONSENT
    ______________
    (Date)
    Dear Parent/Guardian,

    This is to inform you that your son/daughter _____________________________________________ who is


    (Name)
    Choose the most appropriate situation:

    AGRIC 3400 - Apprenticeship


     enrolled in the subject _______________ (________________________________________________________)
    (Cat. No.) (Descriptive Title)
     student from the _____________________________________________________________________________
    (Name of College)
     member of the organization/council ______________________________________________________________
    (Name of Student Organization/Student Council)

    2023-2024 Midyear Apprenticeship program


    is encouraged to join the __________________________________________________________________________
    (Name of Activity)
    June 18, 2024
    on _________________________ at ________________________________________________________________.
    ****put the location here based on your final designation
    (Date) (Place)

    Please be informed further that each student shall contribute _____________________________________


    (Amount in Words)
    (P________________) which shall be used to defray the following expenses: _______________, _______________,
    (Amount in Pesos)
    _____________, _____________, _____________ and _____________ (indicate the appropriate items).

    The other pertinent information regarding the activity are:


    Personel-in-charge: ____________________________________
    SETH VINCENT VALDEZ / JOSEPH MENDOZA Contact number: ____________________________
    09226170068 / 09171338103
    to expose students to actual industry farm animal operations
    Objective/s of the activity: _________________________________________________________________________
    ______________________________________________________________ Number of participating students: _____
    Vehicle to be used: ______________ Owner: _______________ Accommodation venue (if applicable): ___________
    Security measures: ______________________________________________________________________________.

    In case you are interested to clarify something regarding the activity, please contact
    __________________________________
    SETH VINCENT VALDEZ / JOSEPH MENDOZA 09226170068 / 09171338103
    through the telephone/mobile number ___________________________.

    Be assured that the safety of your son/daughter shall be our primary concern.

    Very truly yours,

    ___________________________________
    Name and Signature of Personnel-in-charge
    -----------------------------------------------------------------------------------------------------------------------------------------------
    To whom it may concern:

    This is to certify that I have read the above letter and that I am allowing my son/daughter/ward
    __________________________________ to join the ___________________________________________________,
    (Name of Student) (Name of Activity)
    June 18, 2024
    which is scheduled to be on ______________________________ at ______________________________________.
    ****put the location here based on your final designation
    (Date/s) (Destination/s and/or Venue/s)

    I release and discharge the Central Luzon State University from any liability of whatever nature.

    _______________________________________
    Printed Name and Signature of Parent/Guardian
    Please provide the following information:
    Contact number: ___________________________________ E-mail address: ______________________________
    Home/Mailing address: ____________________________________________________________________________

    SUBSCRIBED AND SWORN to before me, this ______________________________, by ______________________ who exhibited to me (his/her)
    competent proof of identification____________________________________ issued at ____________________________________________,
    Philippines on _________________________________.

    Notary Public
    Doc. No. ______;
    Page No. ______;
    Book No. ______;
    Series of ______. (Please accomplish in triplicate)

    ACA.XXX.YYY.F.010 (Revision No. 1; September 22, 2017)

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