Republic of the Philippines

Department of Education
Region VII
Division of Lapu – Lapu City
Marigondon National High School

PARENT / GUARDIAN CONSENT FORM

Name of student:
Name of Parent / Guardian:
Address:
Mobile:
Family Doctor: Doctor’s tel.No.:
Does your child suffer from any medical conditions / allergies that the teacher / coach should be aware of
(including any current medication)?

Please provide details of medication that must be administered:

Emergency contact details: (If different from above)

Name:
Tel./cel. no.:
Relationship to the child:

CONSENT (please read carefully)

a. I agree with my son/daughter taking part in the Science Investigatory Project in partial fulfillment
of the Research Course Work to develop the independent and critical skills of the students.
b. I confirm to the best of my knowledge that my son/daughter does not suffer from any medical
condition other than those listed above.
c. I fully support the research undertaking of my son/daughter through minimal financial cost and
through my attendance/presence if so desired.
d. I consent to my son/daughter traveling by any form of public transport, minibus or motor vehicle
by land or water in the course of the research experimentation and gathering needed materials. In
addition, I understand that the teacher/school accepts no responsibility for any untoward incident,
damage, or inquiry caused by or during the conduct of the research study.

Signed:
 (Parent/Guardian sign over printed name) Date:
Republic of the Philippines
Department of Education
Region VII
Division of Lapu – Lapu City
Marigondon National High School

INFORMED CONSENT
Please consider this information carefully before deciding whether to participate in this research:

Purpose of the research: To assess the product / invention quality of the research: (title of the
study) based on the following categories:

What you will do in this research: You will be ask for permission to assess the
product/intervention based on the specific categories given by the researchers.

Time required: The survey will take approximately 10-20 minutes.

Participation and withdrawal: Your participation in this study is completely voluntary and
anonymous, and you may refuse to participate or withdraw from the study without penalty or
loss of benefits to which you may otherwise be entitled. You may withdraw by informing the
experimenter/researcher that you no longer wish to participate.

To Contact the Researchers: If you have questions or concerns about this research, please
contact:

Email:
Contact number:

Agreement:
The nature and purpose of this research have been sufficiently explained and I agree to
participate in this study. I understand that I am free to withdraw at any time without incurring
any penalty.

Signature: Date:
Name:
 Republic of the Philippines
Department of Education
Region VII
Division of Lapu – Lapu City
Marigondon National High School

APPROVAL LETTER
Date:
Reyna May E. Dolera
Research 9 Teacher
Marigondon National High School
Marigondon, Lapu – Lapu City, Cebu

Dear Ms. Dolera,

Warm Greetings!

We, the undersigned students from Grade 9 – SSC of Marigondon National High School (MNHS),
Marigondon, Lapu-Lapu City, are asking for your approval of our study with the title:
are currently conducting a quantitative descriptive research study. In accordance with the course
requirements, the undersigned students are now working on their research project titled:
“In-Vitro and In-Silico Analysis of the Cytotoxic and Gas Chromatography Properties of
Talisay (Terminalia Catappa) Ethanolic Leaf Extract Against HCT116 Cells”
This study is experimental research in nature and is categorized in life science.

We are hoping for positive response. Thank you!

Respectfully yours,

Hannah Faith Mariah Julliana Derron Zimon Mark Justin Ragudo Sophia Bianca Abellar
Mahilum Ayuban Catolpos

9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher

Approve by:
REYNA MAY E. DOLERA
Research Adviser
 Republic of the Philippines
Department of Education
Region VII
Division of Lapu – Lapu City
Marigondon National High School

TRANSMITTAL LETTER
Date:

Mr. Garvin Q. Velos

School Principal II

Marugondon National High School

Marigondon, Lapu-Lapu City, Cebu 6015

Dear Mr. Velos,

Warm Greetings!

We, the undersigned students from Grade 9 – SSC of Marigondon National High School (MNHS), Marigondon, Lapu-Lapu
City, are currently conducting a quantitative descriptive research study. In accordance with the course requirements, the
undersigned students are now working on their research project titled:

“In-Vitro and In-Silico Analysis of the Cytotoxic and Gas Chromatography Properties of Talisay (Terminalia Catappa)
Ethanolic Leaf Extract Against HCT116 Cells”

For this reason, the undersigned students are asking your permission and approval to carry out our study outside of school
where we can create set-ups and conduct experimentation. Moreover, we would like to be excused in our classes if the
experimentation falls during our class ours.

Rest assured that the finding of this research will be utilized for the improvement of the community and environment, and we
the researchers will comply the lacking activities that we have missed during the conduct of the research.

We are hoping for positive response. Thank you!

Respectfully yours,
Researchers:

Hannah Faith Mahilum Mariah Julliana Derron Zimon Mark Justin Ragudo Sophia Bianca Abellar
Ayuban Catolpos

9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher

Noted by: Approved by:

REYNA MAY E. DOLERA GARVIN Q. VELOS

Research Adviser School Principal
 Republic of the Philippines
Department of Education
Region VII
Division of Lapu – Lapu City
Marigondon National High School
Date: November 24, 2023

Subject Teachers
Marigondon National High School

Dear Teachers:

Warm Greetings!

We, the undersigned students from Marigondon National High School (MNHS), Marigondon, Lapu-Lapu City, are
currently conducting a quantitative descriptive research study. In accordance with the course requirements, the
undersigned students are now working on their research project titled:
“In-Vitro and In-Silico Analysis of the Cytotoxic and Gas Chromatography Properties of Talisay (Terminalia
Catappa) Ethanolic Leaf Extract Against HCT116 Cells”
For this reason, the undersigned students are asking your permission to be excused in your class during the conduct
of our experimentation if it falls during your class schedule. Rest assured that we will comply with the activities that
we have missed.

Thank you!

Respectfully yours,

Hannah Faith Mariah Julliana Derron Zimon Mark Justin Ragudo Sophia Bianca
Mahilum Ayuban Catolpos Abellar

9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher

Subject Teachers:

Daria Nimenzo Brayan Cai Igot Allana Catubay

MAPEH Teacher Science Teacher Filipino Teacher/Adviser

Ana Fe Capampangan Maria Norma Denuyo Helen Ariza Aranas

AP Teacher Math Teacher ESP Teacher

Gladys Mae Buenaagua Rolie Ongo

English Teacher CT Teacher

Noted by: Approved by:

REYNA MAY E. DOLERA GARVIN Q. VELOS

 Research Adviser School Principal
Republic of the Philippines
Department of Education
Region VII
Division of Lapu – Lapu City
Marigondon National High School

Date: November 24, 2023

Angel C. Enriquez
Regional Executive Director, Da- Regional Field Office VII
Department of Agriculture
DA-RF07 Complex, Highway Maguikay, Mandaue City, 6014 Cebu City

Madame,

Greetings!

We, Grade 9 SSC students of Marigondon National High School, are conducting a research study titled
"In-Vitro and In-Silico Analysis of the Cytotoxic and Gas Chromatography Properties of Talisay
(Terminalia catappa) Ethanolic Leaf Extract Against HCT116 Cells." As part of our study, we
require certification to ensure that the leaves we are using are indeed Talisay (Terminalia catappa)
leaves.

For this reason, we would like to seek your permission to submit our collected Talisay leaves for
verification and certification under your professional care. Your assistance in confirming the authenticity
of the leaves will be invaluable to the integrity and success of our research.

We hope this will merit a favorable response. Thank you, Sir / Madame, and good day!

Sincerely,

Hannah Faith Mariah Julliana Derron Zimon Mark Justin Sophia Bianca
Mahilum Ayuban Catolpos Ragudo Abellar

9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher

Noted by:

REYNA MAY E. DOLERA

Research Adviser
Marigondon National High School – Junior High School Department
Contact Numbers: 09324417865 / [email protected]
 TALISAY PROFILE

Life Science Title : "In-Vitro and In-Silico Analysis of the Cytotoxic and Gas
Chromatography Properties of Talisay (Terminalia catappa) Ethanolic Leaf Extract
Against HCT116 Cells."

Name: Talisay (Terminalia catappa)

Description: Talisay is a large, deciduous tree, reaching a height of 20 to 25 meters,
smooth or nearly so. Branches are horizontally whorled. Leaves are shiny, obovate, 10
to 25 centimeters long, tapering below to a narrow and heart-shaped base with a
expanded rounded apex. Leaf stalks are short and stout. Flowers are white, small, and
borne on spikes in the axils of the leaves, 6 to 18 centimeters long. Fruit is smooth and
ellipsoid, 3 to 6 centimeters long, and prominently bi-ridged or keeled down to the sides.
Pericarp is fibrous and fleshy, the endocarp hard.
 Republic of the Philippines
Department of Education
Region VII
Division of Lapu – Lapu City
Marigondon National High School

Date: November 24, 2023

Jonie C. Yee
Biology Department Chairman, Assisstant Professor
University of San Carlos, Talamban

Sir,
Greetings!

We, Grade 9 SSC students of the Marigondon National High School are conducting a research entitled:

"In-Vitro and In-Silico Analysis of the Cytotoxic and Gas Chromatography Properties of Talisay (Terminalia
catappa) Ethanolic Leaf Extract Against HCT116 Cells"

However, the project requires certain equipment which are not available in our school laboratory.

For this reason, we would like to ask for you permission for us to be able to hand over our raw materials for the
research to you for professionally-monitored processing. We request to be able to visit and observe the processing of
our raw materials on the scheduled date.

We hope this will merit a favorable response. Thank you, Sir / Madame, and good day!

Sincerely,

Hannah Faith Mariah Julliana Derron Zimon Mark Justin Ragudo Sophia Bianca
Mahilum Ayuban Catolpos Abellar

9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher 9-SSC Researcher

Noted by:

REYNA MAY E. DOLERA

Research Adviser
Marigondon National High School – Junior High School Department
Contact Numbers: 09324417865 / [email protected]
 MARIGONDON NATIONAL HIGH SCHOOL
Marigondon, Lapu-Lapu City

JUNIOR HIGH SCHOOL DEPARTMENT

CHECKLIST FOR RESEARCH PAPER

Parts Checklist Remarks
1. Research Plan
2. ISEF Forms
3. Title Page
4. Table of Contents
5. Abstract
6. Background of the study / Rationale
7. Statement of the Problem
8. Hypothesis
9. Significance of the Study
10. Scope and Limitation
11. Conceptual Framework
12. Definition of terms
13. Review of Related Literature and Studies
14. Research Design
15. Research Environment
16. Research Participants/Subjects
17. Research Materials
18. Research Procedures
19. Data gathered/ Test Parameters
20. Statistical tool
21. Ethical considerations
22. Results and Discussion, Data analysis
23. Summary, Conclusion, Recommendations
24. References/Bibliography
25. Acknowledgement
26. Appendix 1 – Documentations, Profiles
27. Appendix 2 – Transmittal Letter
28. Appendix 3 – Informed Consent
29. Appendix 4 – Parental Consent
30. Appendix 5 – Work Plan Schedule
31. Appendix 6 – Research budget
32. Appendix 7 – Scanned Research Journal
33. Appendix 8 – Researcher’s Curriculum vitae

Prepared by: Group 1 Date: _____________________

Group Name/Number or Leader

Checked and Reviewed by: Reyna May Dolera

RESEARCH TEACHER
APPROVED: ____________ CONSIDER REVISING: __________________