Notification Consent Form
Notification Consent Form
Notification Consent Form
SCHOOL: ________________________
Date: ____________________________
Students Name: ____________________
Students Address: ___________________
Name of Parents/Guardian: ____________
Dear Parent/Guardian:
The Local Government Unit (LGU) of Kumalarang , ZDS in partnership with the Social Paraclete
Association Incorporated , thru the Asisi Foundation will conduct a Supplemental Feeding for 120 days in
our school which aims to help improve the health and well-being of our learners thru the provision of
proper nutrients to grow and develop properly.
This Notification is being issued to you as information of the activity that will be conducted on
SY: 2023-2024. Should you have further questions/clarifications on this matter, please get in touch with
the Principal/School Head.
Thank you.
__________________________
Name of Principal/School Head
This is to acknowledge receipt of the Notification Letter regarding the conduct of the
Supplemental Feeding Program in _____________________.
I have read and understood the information regarding the services to be given to my child.
(Please check in the box provided)
Yes, I will allow my child to participate in the Supplemental Feeding Program of the LGU, Kumalarang
No, I will not allow my child to participate in the Supplemental Feeding Program of the LGU,
Kumalarang. Reason
________________________________
Name and Signature of Parent/Guardian