Drop Out Form

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Republic of the Philippines

Department of Education
REGION III
SCHOOLS DIVISION OF PAMPANGA
LANANG HIGH SCHOOL
Lanang, Candaba, Pampanga

DROP OUT FORM

Name of Student: ______________________________________ Date: ______________


Grade & Section: ______________________________________

This is to certify that the name mentioned above has dropped out his/her enrollment in
the school year _______________, due to ________________________________________.
The last class attended was on __________________.
Thus, the parents/guardians have been notified by the class adviser through the means
of follow-up letter or home visitation.

Parents’/Guardians’ Feedback:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

________________________ _____________________________
Adviser Parent/Guardians’ Name and Signature

MELINDA S. DAYAO
HTIII-OIC

Address: Lanang High School, Lanang Candaba, Pampanga


Email Address: [email protected]
Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF PAMPANGA
LANANG HIGH SCHOOL
Lanang, Candaba, Pampanga

Address: Lanang High School, Lanang Candaba, Pampanga


Email Address: [email protected]

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