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NATIONAL HIGH SCHOOL

Department of Education
Region IX, Zamboanga Peninsula
DIVISION OF ZAMBOANGA CITY
SOUTHCOM NATIONAL HIGH SCHOOL
Calarian, Zamboanga City

TEACHERS CLEARANCE
THE SCHOOLS DIVISION SUPERINTENDENT
Through the Principal, Southcom National High School
Zamboanga City
Sir:
I have the honor to inform you that I satisfactorily settled and accounted for all the
properties and financial obligations for which I was responsible in this school and reports required
of me both submitted on the date shown below for school year 2015-2016:
Checked by and date
(Signature over printed name)
1. School Form No. 1, 2, 3, 4, 5 ____________
2. Grading Sheets/
Class Records
_____________
Consolidated Grades ______________
3. DepEd Form 137
_____________
4. DepEd Form 138
_____________
5. CS Form 48(DTR)
_____________
6. Updated Form 212 ( PDS) _____________
7. Lesson Plans
Instructional Plans
______________
8. Nutritional Status (Base/End)______________
9. Class /Organizational List _____________
10. List of Retained/
Dropped Out
Transferred In and Out _____________
11.
ITR ( Income Tax Return _____________

12.
13.
14.

15.

16.

17.
18.
19.

Checked by and date


(Signature over printed name)

Library
_____________
Classroom Inventory
(MR Form)
______________
Financial Obligations
Teachers Club
______________
Canteen
______________
Accomplished IPCRF
and Teachers
Accomplishment
Report/ Portfolio
______________
Department
Accomplishment/
Financial Report
______________
NCBTS/TSNA
_____________
201 Documents
_____________
HRPTA Financial Report ____________

In the exigency of service, I am willing to report to work and attend Summer INSET for
Teachers.

Checked and Verified:

_________________________________
Signature over Printed Name

________________________
Department Coordinator
-------------------------------------------------------------------------------------------------------------------------------------------1st Endorsement
Southcom National High School
Zamboanga City, ______________, 20______
RESPECTFULLY FORWARDED to the Schools Division Superintendent, Division of City
Schools, this city, the last day of service of teacher/employee at the Southcom National High
School, Zamboanga City was _________________________, 20___________.
The above statement is correct and a CONDITIONAL CLEARANCE is hereby granted.

APPROVED:

GLORIA P. CARPIO
Secondary School Principal-II
PEDRO MELCHOR M. NATIVIDAD, CSEE
Schools Division Superintendent

Department of Education
Region IX, Zamboanga Peninsula
Division of Zamboaga City
SOUTHCOM NATIONAL HIGH SCHOOL
Calarian, Zamboanga City

SUPPLEMENTARY CLEARANCE
Please accomplish the following documents to be submitted for this school year 2015-2016.
Furthermore, please compile it correctly and efficiently.

I.

Leadership and Governance


A. Lists of Homeroom Officers
B. List of Officers of the Clubs being handled
C. Action Plan of the Organization or clubs handled
D. Minutes of Meetings ( Homeroom PTA with attendance sheet, resolution and
pictures)
E. Compilation of Post- Training Report ( with Certificates)
F. Narrative report of School- Based seminars or trainings

II. Curriculum and Instruction


A. List of Non- Readers by Section
B. List of Frustration by Grade Level
C. List of Instructional by Grade Level
D. List of Independent by Grade level
E. Lesson Plans and Instructional Plans
F. Summative Test ( Sample test papers from 1 st- 4th Grading)
G. Quarter Examination ( 1st 4th Grading Period) with TOS
H. MPS ( 1st 4th Grading and Over- all MPS)
I. Form 138 and 137
J. Class Records and Grade Sheets
K. Portfolio, Quizzes
L. Minutes of Meetings ( Homeroom PTA with attendance sheet, resolution and
pictures)- another copy
M. Attendance during school activities ( by department)
III.Accountability and Continuous Improvement
A. Schedule for NAT Review ( Coordinator)
B. School Reading Action Plan ( Reading Coordinator)
C. Letter of Invitation during the monthly celebration and other activities handled by the
Department
a) Attendance
b) Pictorials
c) Certificate of Appreciation
D. Narrative Report on Accomplishment of the Department ( Coordinator)
E. List of Transferred In ( indicate the school where they came from)
F. List of Transferred Out ( indicate the school where they transfer)
G. List of Students Promoted
H. List of students Retained and with Deficiency
I. NCBTS/TSNA (per teacher)
J. Report on PTA Contributions and Projects/ HRPTA Financial Report
K. Property Inventory ( Department by Coordinator, Classroom by Adviser)
L. Financial Reports ( Coordinator)
M. Nutritional Status
N. Report on Feeding Program with Pictures ( 2 copies) ( Coordinator)
IV. Management and Resources
A. IPCRF attached with evidences
B. Project Proposal ( Coordinator)
Checked and Accepted By:
GLORIA P. CARPIO
Sec. Sch Principal II

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