Republic of the Philippines

Department of
Education REGION VIII
SCHOOLS DIVISION OF LEYTE

APPLICATION FOR PERMISSION TO STUDY

Name of Applicant: Position:

Civil Service Eligibility: Civil Status:
Name of School where employed: Barrio:
Municipality: Perm/Provl:
Distance in Kms between official station and college where enrolled:

(Name and Location of college where applicant wished to enroll)

Course applied for:

Academic Year: Qtr./Sem. Summer:
(1st, 2nd, 3rd, 4th)
Course to be taken this term and the schedule:
COURSE DAYS OF THE WEEK HOURS OF THE WEEK

Credits or units towards - - - BSE MA Ed.D/Ph.D.

Total number of units previously
Number of units to be earned this Qtr./Sem/Summer

I hereby certify that I have carefully read the information on the page of this form, all the provisions
of which I am bound to observe very strictly, I understand that the regulations on the outside study of
teachers are intended to primarily safeguard the health of the teachers as well as of course to maintain their
efficiency in the service. I also understand that if in the opinion of the Division Superintendent of School this
study adversely affects my efficiency as a teacher this permission to study shall be revoked.

(Signature of Applicant)
Date Submitted:
APPROVAL RECOMMENDED:

The undersigned shall require strict compliance by the applicant with all the existing rules and
regulations regarding permission to study and should hold responsible for any undue delay in forwarding the
applicant to the office doing satisfactory work with an efficiency rating of “ABOVE AVERAGE” or higher. The
applicant will be required by me to submit through office, to the Division Superintendent a certified copy of the
report rating obtained in the course which should be attended to his/her outside study not earlier than thirty
minutes after the afternoon session in the public school.

Date Submitted:
District Supervisor/Sec. Sch. Principal
APPROVED:
This permit expires on:
Date:
Permit No.
MARIZA S. MAGAN EdD, CESO V
Schools Division Superintendent

Address: Government Center, Candahug, Palo, Leyte

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Telephone No.: (053) 888-3527
Email Address: [email protected]
Website: https://depedleytedivision.com
APPLICATION FOR PERMISSION:

INSTRUCTIONS
1. Application for permission to study in five (5) copies must reach the office not later
than two (2) months before the start of the actual classes. THE TEACHERS JUST FILE
REQUEST BEFORE ENROLLING FOR THE FIRST TIME IN ANY SCHOOL, COLLEGE or
UNIVERSITY.
2. The teacher applicant must be doing satisfactory work with an efficient rating of
"ABOVE AVERAGE" or higher.
3. The permission is given until the applicant complete the curriculum towards a
degree. He does not need to file a request for permission every semester.
4. A certificate from the head of the school or college where the teacher is enrolled and
the subject to pursued should be attached with the application.
5. Teachers who are about to finish course, or who have started a course as well as the
subject already completed and those still to be taken all to be certified by the
Registrar of the private school concerned.
6. After each semester every teacher granted permission to study should submit to the
Superintendent's Office, through channels, a certified true copy of the report on the
ratings be obtained in the course which he took during the semester including the
number of units earned. In addition, as soon as he/ she finished a specific curricular
towards a degree he/she should submit a complete set of his/her transcript of grades
and special order to the superintendent through his immediate superior for
validation and verification.
7. The Maximum study of nine (9) units per semester or summer should be strictly
observed. Teachers who are candidates for graduation may be allowed to carry from
(1) one to three (3) units more than the nine (9) units authorized provided that those
units are the last units that the teachers need to enable them to graduate. No
exemption will be given to the teachers who do not fall under the above state
condition. Violation of this regulation on the study load shall be sufficient cause for
revocation of the permission to study for administrative action.
8. The college, school or university in which the teacher contemplates enrolling should
be accessible to this official station so that he will not be unduly complied to hurry
there from in order to arrive at his class by time. The teacher should attend to his
outside study not earlier than thirty (30) minutes after the afternoon session in the
public school.
9. The immediate superior or supervisor shall be hold responsible for any undue delay
in forwarding the application to the superintendent, if the application to the
superintendent has been filed on time.

____________________________________________________________________
(Name and location of college where application wishes to enroll)
TO WHOM IT MAY CONCERN:
This is to certify that ____________________________________________ a public school teacher, is
seeking admission in this college to (course) ______________________________ with the
following subject offered this
_____________________________.

COURSE DAYS OF THE WEEK

HOURS OF THE WEEK
_____________________ ___________________
____________________
_____________________ ___________________
____________________
_____________________ ___________________
____________________
_____________________ ___________________
____________________

__________________________ ___________________________
DEAN REGISTRAR
NOTE:
1. Weekdays classes in a semestral terms should not be earlier than 6:00 p.m.
2. Unless suspended by the DECS Ebery term, a 3 unit lecture subject should be taken as
follows:
SUMMER TERM - 1 ½ HOURS DAILY Monday through Saturday.
Maximum load 9 units for all courses, 6 units in Law in prescribed subjects.
SEMESTRAL TERM - A total of three (3) hours a week. Maximum Load: 9 units for
Undergraduate course or 6 units of graduate level course except for enrollees in Special
Saturday Classes for maximum load not more than 6 units.

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