Clearance VCS

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VICTORIOUS CHRISTIAN SCHOOL

Butuay, Jimenez, Misamis Occidental


Cell. # (0920)9888-928
V.C.S. Form 3

STUDENT’S CLEARANCE FORM

Name of the Student: ________________________________________


Last Name First Name Middle Name Reason for Clearance:
ID Number: ________________________________________
a. Enrolling
Contact Number: ________________________________________
b. Graduating
Strand (For SHS Only): ________________________________________
c. Transferring
Grade / Year: ________________________________________
d. Others
Academic Year: ________________________________________
__________________
First Sem. Second Sem. Returnee (Year): _______

NO DEPARTMENT CLEARING OFFICER SIGNATURE DATE REMARKS


.
1 LABORATORY/SHOP/DRUMCORP
2 LIBRARY
3 CASHIER

4 STUDENT SUPREME ___________________ _____________


GOVERNMENT SSG President
_____________
___________________
SSG Adviser
5 CLASS ADVISER
6 PRINCIPAL

_____________________________________
STUDENT’S SIGNATURE OVER PRINTED NAME

(In accomplishing the clearance, please be guided by the instructions at the back.)
VICTORIOUS CHRISTIAN SCHOOL
Butuay, Jimenez, Misamis Occidental
Cell. # (0920)9888-928
V.C.S. Form 3

Subject Subject Fines/ Signature Date


Teacher Requirements for
compliance

INTSRUCTIONS:
1. Secure Student’s Clearance Form at the Registrar’s Office.
2. Laboratory/Shop/Drum Corps in-charge clears the student of accountabilities in
terms of utilization of equipment/tools. The laboratory/shop pertained to here are
the following: Computer, SMAW Welding Lab, School Uniform, Drum Corps, etc.
3. Librarian clears the student of accountabilities in terms of book/s or any other
library’s information material/s.
4. Cashier clears the student of any financial obligation.
5. Student Supreme Government clears the student of accountabilities in terms of
their fines and penalties for not following the rules in school.
6. Class Adviser clears the student of accountabilities concerning classroom
maintenance; the class adviser coordinates with the different subject instructors if
there are other concerns that need to be settled.
7. Principal checks the form for complete clearance by other relevant department.
8. This clearance shall be presented to the enrolling officer during enrolment or when
claiming for transfer credential, Transcript of Records (TOR), diploma and other
certification.

Note: The student needs first to write in full the names of their respective class
adviser, program head, and college dean before requesting for their signatures.

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