Department of Education
Region IV-A
ATIMONAN NATIONAL COMPREHENSIVE HIGH SCHOOL
SENIOR HIGH SCHOOL
Atimonan, Quezon
PARENTAL CONSENT
The Department of Education and Atimonan National Comprehensive High School – Senior
High School is committed and aims to provide its Senior High School students an exposure and
familiarization to a work-related environment related to their field of specialization in order for
them to enhance their learning competence. The Work Immersion subject is a partial realization
of this commitment.
The Senior High School through the Work Immersion Coordinator acting as the teacher-incharge will perform “due diligence of a good father of a family” in supervising our Work
Immersion students. The school, however, shall not be responsible for any untoward incident,
God forbids, which is due to negligence or any deliberate act on the part of the student or third
party, present the teacher’s observance of due diligence.
The Work Immersion Coordinator shall observe due diligence but, at the same time, shall
expect the same observance and responsibility of the student to avoid any untoward incident.
In conformity to this shared responsibility, the parent-guardian and Work Immersion
Coordinator, shall now commit, sign our names, and accept our co-responsibility.
ANCHS-Senior High School, Atimonan Quezon, Philippines.
SIGNED IN THE PRESENCE OF:
_______________________
_______________________
Signature over Printed Name
Signature over Printed Name
Parent / Guardian
Teacher-in-charge
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES)
_________________________)ss.
BEFORE ME this (date), personally appeared to me with
_______________________CTC# __________________ issued on/at _________________
_______________________CTC# __________________ issued on/at _________________
Known to me and to me known to be the same persons who executed the foregoing instrument,
and they acknowledged to me that the same is free and voluntary act and deed, including that of
the entities that they represent.
WITNESS MY HAND AND NOTARIAL SEAL, on the date at the place first written above.
NOTARY PUBLIC
Doc. No. _________
Page No. _________
Book No. _________
Series of __________