Application For Permission To Teach Outside of Official Time PDF
Application For Permission To Teach Outside of Official Time PDF
Department of Education
Region lll
DIVISION OF CITY SCHOOLS
City of Malolos, Bulacan
TeiJFax No. (044) 3A5-11XfiAS-1521
E-mallAddress:
websife; fittp ://www. m aiolos-d eped. co m/
A-
Position:
Speciaiization.
Appointment Status
Name of School:
Address:
Term (Pls.
c,4eck)--.-1" Semffri_
2,d Semffri
3'c
TriSummer; Academic
Year
Schedule of Classes
SubjecUs
Day
Time
No.of Units
Ceriified Conect:
iSignatureover@
I{OIE: Ieadt'ag had s*an ne ,rartied fo f2 iorns a rreelr ardjn no cce sftdl a gole*ament employee 5e
regndarmr*lng days flfoadays ro fri@] as fs$Sfd Or& fio. 66, s- 2008
B.
adorryad ta
tedt
-@i-
dq
Subjec?s
Day
Tjme
Number of Minutes
Ceftified Correct:
Signafura over
C.
PrinH
MedicalCertificate
lherebycertifythatlhaveexanrined'andfoundhinrihertobephysicallyfitto
cany out additional work beyond the official time of hi$ her regular functions as shown ln the above schedules ei wori<.
Cefiitied Conect;
(Signature over prinied name of Gr:vernment Physician)
Address:
License No.
Daie:
I am
fully responsible and accounfaile on ffie au{fienticiglcanxbress of &e informafron as nenlioned a}oye.
Evaluated by:
Recommencii ng Approval
Administmtire
MELISSA S. SANCHEZ
Officer-in-Charge
Office of the Asst. Superintendent
fficerV
Administrative SeMces
APPROVED:
an