Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IVA- CALABARZON
SCHOOLS DIVISION OFFICE OF LAGUNA
Provincial Capitol Compound
Santa Cruz

________________________
(Date)

CERTIFICATION
(G. L. No. 129, September 16, 1974)

This is to certify that _________________________________________ will be

(Name)
assigned to _______________________________________________________ with the least
(Name and Address of School)
the minimum number of teachers prescribed for the position, and that there is no
other Principal / Head Teacher in this school where proposed appointee will be
assigned.

Below are pertinent data about the school:

1. Number of classes ------------------------------ _______________________

2. Number of Teachers ------------------------------ _______________________

3. Enrolment by grade:

I. ____________________
II. ____________________
III. ____________________
IV. ____________________
V. ____________________
VI. ____________________

TOTAL ENROLMENT ____________________

____________________________
District Supervisor

__________________
Date

_______________________________
Schools Division Superintendent

__________________
Date
(Inclosure to General Letter No. 129, dated September 16, 1974)

INFORMATION SHEET ON TEACHERS IN EACH SCHOOL

DIVISION OF LAGUNA
SY______________

Name of School: ________________________________ District: __________________

Municipality :____________________________________ Barangay: _______________
Sitio: _____________________

NAME OF INCUMBET TEACHERS EXACT DATE OF INDICATE THE NAME

ITEM NO. (If unfilled, write the word “vacant”) ASSIGNMENT IN THE OF PERSON IN-
SCHOOL CHARGE

Prepared by:

__________________________
Date: ____________________

Certified Correct:

__________________________
Date: ____________________
APPROVED:

______________________________
Schools Division Superintendent