CIC Application For Accreditation and Report Format

Electronic CIC Forms: Revised CIC Accreditation Application and Documentary Requirements for SY 2022-2023
Republic of the Philippines

OFFICE OF THE OMBUDSMAN
Agham Road, Diliman, Quezon City
Ann
Annex “K”
Honorable SAMUEL R. MARTIRES

Ombudsman
Re: APPLICATION FOR ACCREDITATION AS CAMPUS INTEGRITY

CRUSADERS (CIC) FOR SY 2022-2023
Dear Ombudsman, Martires:
The applicant, SUPREME STUDENT GOVERNMENT

(Name of student organization),
VICTORIAS NATIONAL HIGHSCHOOL- GASTON EXTENSION

(Name of school/college/university),
City Schools Division of Victorias

DepEd Division / Place of College/University
through its President, JEAN ROSE D. PUNTAL, as duly authorized representative, to this
Honorable Office, respectfully applies for CIC accreditation for School Year 2022-2023 to
implement online CIC Project’s activities promoting integrity and social responsibility using the
online platform, with supporting electronic documentary requirements per Section 4C of
Memorandum Circular No. 04, Series of 2012:
1. Certificate of Recognition of organization issued by the School Principal/Dean of

Student Affairs.
2. List of organization’s officers.
3. Designation of organization’s Adviser by the Principal/Dean of Student Affairs.
4. Project Proposal to implement online activities for the School Year 2022-2023; and
5. Commitment of Support to implement online activities by the School Principal/Dean
of Student Affairs and Designated CIC Adviser
For your Honor’s consideration.
SUPREME STUDENT GOVERNMENT

Name of the Organization
JEAN ROSE D. PUNTAL

President of Organization
(E-Signature over Printed Name)
Noted by:
NIKKI ROSE L. CADIAO

Designated Adviser of Organization
GELEX M. JACOMILLA
School Principal/Dean of Student Affairs
Annex “K-1”
CERTIFICATE OF RECOGNITION
This is to certify that SUPREME STUDENT GOVERNMENT

(Name of organization)
is a duly recognized student organization of VICTORIAS NATIONAL-GASTON EXTENSION
(Name of school/college/university)
Division of /Place of college/university
for School Year (SY) 2022-2023.
This Certification is issued for the above-named organization’s application for

accreditation as Campus Integrity Crusaders (CIC) of the Office of the Ombudsman for SY 2022-
2023.
HIGHSCHOOL
Issued this _05_of December_, 2023.
GELEX M. JACOMILLA
(Signature over Printed Name)
Email address
Annex “K-2”
SUPREME STUDENT GOVERNMENT

(Name of Organization)
VICTORIAS NATIONAL HIGHSCHOOL-GASTON EXTENSION

(Name of School/College/University)

(DepEd Division/Place of College/University)
LIST OF OFFICERS FOR SY 2022- 2023
POSITION NAME EMAIL ADDRESS FB ACCOUNT CP NUMBER

JEAN ROSE D. jeanrosepuntal534@g JEAN ROSE 09633207768
PRESIDENT PUNTAL mail.com DAYANAN
VICE- SAM Lloyd L. osamlloydocup@gma SAM OCUP 09974991175
PRESIDENT OCUP il.com
FRANZEN B. butalonfranzen@gma FRANZ/FRANZEN 09317309562
SECRETARY BUTALON il.com BUTALON
DENVER DEZA Denverdeza14@gmai DENVER DEZA 09633001410
TREASURER l.com
PAUL ANDREI P. perezpaulandrei7@g PAUL PEREZ 09060580516
AUDITOR PEREZ mail.com
PUBLIC MIKAELA JAY jonsonmikaelajay@g MIKAELA KAYLA 09773662171
INFORMATION B. JONSON mail.com JONSON
OFFICER
PROTOCOL ANGELO S. GELO MENDOZA 09562752408
OFFICER MENDOZA
PROTOCOL JIRO L. DELA JIRO DELA CRUZ 09369440548
OFFICER CRUZ
GRADE 11 IVAN JAMES D. ivanjamesmedayo28 IVAN JAMES 09070042576
REPRESENTATIVE MEDAYO @gmail.com MEDAYO INFANTE
GRADE 9 CELINE tarrojaceline@gmail. CELINE NATASHA 09394547680
REPRESENTATIVE NATASHA L. com LUMAWAG
TARROJA TARROJA
GRADE 7 PRINCESS princesscharmelpastr PRINCESS 09954369859
REPRESENTATIVE CHARMEL A. [email protected] CHARMEL ANAS
PASTRANA PASTRANA
GRADE 7 JESSA L. JESSA BOMBIO 09155815248
REPRESENTATIVE BOMBIO
GRADE 7 KIETH F. [email protected] KATE FLORES 09704952211
REPRESENTATIVE SENAYO o SENAYO
GRADE 10 CHLOE MARIE chloem9272140@gm CHLOE MARIE 09055283485
REPRESENTATIVE P. DONASCO ail.com
Submitted by:
JEAN ROSE D. PUNTAL

Noted by:

Adviser of Organization
Email address: [email protected]
FB Account: Nikki Cadiao
CP Number: 09606186188
Annex “K-3”
Honorable SAMUEL R. MARTIRES

Ombudsman
Re: Designation of Student-Organization’s Adviser
Dear Ombudsman Martires:
This is to respectfully indorse Mr./Ms./Mrs. NIKKI ROSE L. CADIAO,
the designated Adviser of SUPREME STUDENT GOVERNMENT

(Name of organization)
VICTORIAS NATIONAL HIGHSCHOOL-GASTON EXTENSION
(Name of school/college/university),
Division of/Place of college/university City Schools Division of Victorias
The designated Adviser/s will assist the mentioned organization in the implementation of
online activities as reflected in their Project Proposal in line with the extension of their
accreditation as Campus Integrity Crusaders of the Office of the Ombudsman for SY 2022-2023.
For your Honor’s consideration.
Respectfully yours,
GELEX M. JACOMILLA
Annex “K-4”
Name of Organization: SUPREME STUDENT GOVERNMENT

Name of School/College/University: VICTORIAS NATIONAL HIGHSCHOOL-GASTON
EXTENSION
DepEd Division/Place of College/University: City Schools Division of Victorias
CIC ONLINE PROJECT PROPOSAL FOR SCHOOL YEAR 2022-2023
Title of Project Positive approaches to dealing with academic dishonesty

General Objective/s The project highlights the goal of equipping students with
developmental assets and skills consistent with positive youth
development.
Online Activities *Post an announcement
*Create an online advocacy
a. Promoting Positive approaches to dealing with academic dishonesty
Integrity
Description Is to help and stop the dishonesty inside the school.
Specific Objective To stop the dishonesty during academic exams and summative test.
Date and Time of January 13, 2023- onwards until further notice
Conduct 8:00- 9:00 a.m
Online Platform to be Zoom
used
Account Name and VNHS-GASTON EXTENSION SSG
Administrator
b. Promoting Social Serving to all student without asking a change. Serve that full of
Responsibility willingness and honesty.
Description Doing your responsibility with full of honesty and without asking a
change while serving.
Specific Objective To serve to all students.
Date and Time of January 13, 2023
Conduct 1:00-2:00 p.m
Online platform to be Zoom
used
Account Name and VNHS-GASTON EXTENSION SSG
Administrator
In the implementation of our CIC Project’s online activities, we commit to comply with
all the requirements prescribed under Section 6 of Memorandum Circular No.2, Series of 2020
on the prohibition of in-person face-to-face activities, observance of online etiquettes and
submission of report of CIC activities implemented, among others.
Submitted by:
JEAN ROSE D. PUNTAL


Adviser of Organization
Noted by:
GELEX M. JACOMILLA
Annex “K-5”
LETTER OF COMMITMENT
We, GELEX M. JACOMILLA , School Principal/Dean of Student Affairs
of VICTORIAS NATIONAL HIGHSCHOOL- GASTON EXTENSION

(Name of School/College/University)
and NIKKI ROSE L. CADIAO, as Designated Adviser
of SUPREME STUDENT GOVERNMENT

(Name of Organization),
Division of/Place of College/University VICTORIAS CITY, hereby commit to support the

organization’s online activities as reflected in their Project Proposal in line with their
accreditation as Campus Integrity Crusaders of the Office of the Ombudsman for SY 2022-
2023.
5th day of December 2022, Philippines.
NIKKI ROSE L. CADIAO GELEX M. JACOMILLA

Adviser of Organization Principal/Dean of Student Affairs
(E-Signature over Printed Name) (E-Signature over Printed Name)

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Electronic CIC Forms: Revised CIC Accreditation Application and Documentary Requirements for SY 2022-2023

Republic of the Philippines

Honorable SAMUEL R. MARTIRES

Re: APPLICATION FOR ACCREDITATION AS CAMPUS INTEGRITY

Dear Ombudsman, Martires:

The applicant, SUPREME STUDENT GOVERNMENT

VICTORIAS NATIONAL HIGHSCHOOL- GASTON EXTENSION

City Schools Division of Victorias

1. Certificate of Recognition of organization issued by the School Principal/Dean of

For your Honor’s consideration.

SUPREME STUDENT GOVERNMENT

JEAN ROSE D. PUNTAL

NIKKI ROSE L. CADIAO

This is to certify that SUPREME STUDENT GOVERNMENT

This Certification is issued for the above-named organization’s application for

SUPREME STUDENT GOVERNMENT

VICTORIAS NATIONAL HIGHSCHOOL-GASTON EXTENSION

City Schools Division of Victorias

LIST OF OFFICERS FOR SY 2022- 2023

POSITION NAME EMAIL ADDRESS FB ACCOUNT CP NUMBER

JEAN ROSE D. PUNTAL

NIKKI ROSE L. CADIAO

Honorable SAMUEL R. MARTIRES

Re: Designation of Student-Organization’s Adviser

Dear Ombudsman Martires:

This is to respectfully indorse Mr./Ms./Mrs. NIKKI ROSE L. CADIAO,

the designated Adviser of SUPREME STUDENT GOVERNMENT

For your Honor’s consideration.

Name of Organization: SUPREME STUDENT GOVERNMENT

CIC ONLINE PROJECT PROPOSAL FOR SCHOOL YEAR 2022-2023

Title of Project Positive approaches to dealing with academic dishonesty

JEAN ROSE D. PUNTAL

NIKKI ROSE L. CADIAO

We, GELEX M. JACOMILLA , School Principal/Dean of Student Affairs

of VICTORIAS NATIONAL HIGHSCHOOL- GASTON EXTENSION

and NIKKI ROSE L. CADIAO, as Designated Adviser

of SUPREME STUDENT GOVERNMENT

Division of/Place of College/University VICTORIAS CITY, hereby commit to support the

NIKKI ROSE L. CADIAO GELEX M. JACOMILLA

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