Study Permit 2

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Republic of the PhiliPPines

DEPARTMEilT OF EDUCATIOT{
Region X-No[hern Mindanao
DIVISION OF CAMIGUIN
Mambajao

APPLICATIO]T FOR PERMISSION TO STUDY

Name of Applicant: Position:


Civil,Service Eligibility: Civil Status:
Name of School where employed: Barris:
Municipality: PermlProv'l;
Distance in Kms between official station and college where enrolled:

(Name and Location of college where applicant wished to enroll)

Course applied for:


Academic Year: Qtr,/Sem. Summer:

{lt, 2nd, 3rd, 4*)


Course to be taken this term and the schedule:

COURSE DAYS OT THE WEEK ffi

Credits or units towards - D5tr


h^-
MA Ed. D./Ph.D.
Total number of units previously
Number of units to be earned this Qtr./Sem./Summer

I herby certify that I have carefully read the information on the next page of this form, all the provisions
of which I arn bound to cbserve very stridly, I understand that the regulations cn 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 ihis study adversely
affect my efficiency as a teacher this permission to study shall be revoked.

(Signature of Applicant)
Date Submitted:

APPROVAL RECOM Fl EN DED :

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 aoplicant to
the office doing satisfactory work with an efficienry rating of "ABOVE AVERAGE" or higher. The applicant will be
required by me to submit through office, ta the Division Superintendent a certified copy of the report rating
obtained in the course which should be attended to hislher outside study not earlier than thifi minutes after
the afternoon session in the public sehool.

Date Submitted:
School Principal
APPROVED:
This permit expires on
Date:
Permit No.

REYNALDO E, MANUEL JR., ph.D., CESE


Assistant Schocls Division Superintendent
Sfficer In-Charge
lrlffira nf tha Cnlrn*lc l.lirrioinn Cr rnorintanl{ant
I

APPtICATlOil FgR PER}4ISSIOIT:


INSTRU.CTIONS
1, Application for permission to study in five {5) copies must reach the office not later
than two (2} months
ENR0LLING FoR THE
before the start sf the aetuat ctasses. THE TiACHERS IUST FILE REQUEST BFFORT
FIRST TIME IN ANY SCHOOL, COLLEGE OT UNIVERSITY. *ABCVE AVERAGE" or
?. The teacher applicant must'be doing satisfactoyr+ork with an efficient rating of
higher.
3. The permission is given until the applicant complete the curriculum towards a degree. He does not need to
file a request for permission every semester.
4. A certificate from the head of the school or college where the teacher is enrolled and the subject to pursued
should be attached with the application'
5. Teachers who are about to finish course, or who have started a course as well as the subject already
completed and thase still to be taken all to be ce*ified by the Registrar of the pi"ivate schoo! concerned.
6. After each semester every teacher granted permission to study should submit to the Superintendentt Office,
through channels, a ce*iiied true iopy of tire report on the ratings be obtained in the course which he took
during the seme#r including the number of units earned. In addition, as soon as he/she finished a specific
curricular towards a degree fre/she should submit a complete set of his/her transcript of grades and special
order to the superintendent through his immediate superior for validation and verification.
Z. The Maximum study of nine (g) units per semester or summer should be strictly observed. Teachers who
are candidates foi'graduation rnay be allowed to carry fram {1) one to three (3) units more than the ni*e
(g) units authorizeJ provided that those units are the last unib that the teacherc *eed to enable them to
graCuate. No exemption will be given to the teachers who do not fall under the above state condition.
*iohtion of this regulation on the study load shall be sufficient cause for revocatisn of the permission to
study for administrative action.
8. The college, sehool or university in which the teacher contemplates enrolling should be accessible to this
official station so that he will nat be unduly complied to hurry there from in order to arrive at his class by
time, The ieacher should atiend to his ouiside study not earlier than thifi {30} minutes aftei'the afternoon
session in the public school.
9. The immediate superior or superuisor shall be hold responsible for any undue delay in forwarding the
application to the superintendent if the application to the superintendent has been filed on time.

(Name and location of college where application wishes to enroll)

CERTIFICATION
TO WHOM iT MAY CONCERN:

This is to certifu that a public schoolteacher, is seeking


admission in this college to (course) with the following subjects offered
this

COURSE DAYS OF THE WEEK HOURS OF THE DAY

DEAN REGISTRAR

NOTE:
1_ Weekdays classes in a semestral terms should not be earlier than 6:00 p-m-
2" Unless superseded by the DECS Every term, a 3 unit leeture subject should be taken as follows:

SUIVIMER TERM * t yz hours daily Manday thraugh Saiurday,


Maximum load; 9 units for all ceurses, 6 unib in Law in prescribed subjects.
SEi4ESTRAL TIRM - A total af three (3) hours a week, Maximum Load: 9 units for
Undergraduate course sr 6 units of graduate level course except for enrollees
in Special Saturday Classes fcr maximum load not more than 6 units.

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