Selg Form - Sanjose
Selg Form - Sanjose
Selg Form - Sanjose
DEPARTMENT OF EDUCATION
Bureau of Learner Support Services
Youth Formation Division
To run for a position in the SSG/SPG office, each candidate should submit a completed signed application
with the following attachments:
Certificate of Candidacy
Parental Consent
Two (2) pcs. of 2x2 photograph
An official copy of the Report Card for the present Academic Year
General Plan of Actions
Two (2) recommendation letters from two (2) individuals whom the candidate has worked with in a co-
curricular and extra-curricular activity.
RECOMMENDATION LETTERS:
Please secure and submit two (2) recommendation letters (in a signed/sealed envelope) from two (2) individuals that
the candidate has worked with in a co-curricular and extra-curricular activity. The recommendations shall include the
following:
Description of the activity wherein the candidate and the author of the recommendation letter worked
together
Detailed-description of how the candidate the principles of teamwork, collective decision-making, and good
work ethic in the said activity.
The author of the recommendation letters should not be related by affinity or consanguinity to the candidate.
The two (2) recommendation letters should each come from a fellow student that he/she worked with in an activity
and from the teacher that served as an adviser of the same activity.
The authors of the recommendation letters should not be related to the candidate by affinity or second degree
consanguinity. If needed, the COMELEC has the authority to validate the recommendation letters with its signatories.
Enclosure No. 2: Parental Consent for SPG Candidates
Parental Consent
_________________________________________________ ___________________
Parent's/ Guardian's Signature over Printed Name Date
Enclosure No. 3: Parental Consent for SSG Candidates
Parental Consent
_________________________________________________ ___________________
Parent's/ Guardian's Signature over Printed Name Date
Enclosure No. 4: Certificate of Candidacy for the SPG
An officer of the Supreme Pupil Government lives the ideals, principles, and practices OF participatory democracy. He/She
represents the student body, and must be fully committed to lead and serve the student body towards the fulfillment of the goals of
the Student Government. He/ She must uphold the core values and thrusts of the Department of Education and serve as a role model
of school and community in words and in deeds.
Student’s Name: ________________________________________________________ Current Grade Level: _________
PERSONAL DETAILS:
Gender: _______ Age: _______ Date of Birth: ________
E-mail Address: ____________________________________ Mobile No: _____________ Landline: ____________
Home Address: __________________________________________________________________________________
COMPETENCIES OF CANDIDATES IN RELATION TO THE DESIRED POSITION
Name of activities participated related to the desired position Specific role in the activity
ELECTORAL INFORMATION:
Party Name: ______________________________________________ Position in the Party: _________________________
I certify that I am a bona fide student of this school.
I, whose name and other persona] details are herein stated, do hereby file this Certificate of Candidacy for the Supreme Pupil
Government COMELEC in the election for school year 2020-2021.
I do hereby declare my intention and desire to be nominated for the particular position of ______________________.
I further state that I am bona fide student of this school with good moral character and academic standing, and I will abide with the
election rules and guidelines of the Supreme Pupil Government.
I hereby certify that the facts stated herein are true and correct to the best of my knowledge.
_________________________________________
Signature of Candidate over Printed Name
SUBSCRIBED AND SWORN to before me this _______ day of __________, 2020, at ____________, affiant exhibiting to me
his/her nomination kit which contains his/her COC, photograph, academic records, and parental consent.
___________________________________
________
SPG COMELEC REPRESENTATIVE
An officer of the Supreme Student Government lives the ideals, principles, and practices OF participatory democracy. He/She
represents the student body, and must be fully committed to lead and serve the student body towards the fulfillment of the goals of
the Student Government. He/ She must uphold the core values and thrusts of the Department of Education and serve as a role model
of school and community in words and in deeds.
Student’s Name: ________________________________________________________ Current Grade Level: _________
PERSONAL DETAILS:
Gender: _______ Age: _______ Date of Birth: ________
E-mail Address: ____________________________________ Mobile No: _____________ Landline: ____________
Home Address: __________________________________________________________________________________
COMPETENCIES OF CANDIDATES IN RELATION TO THE DESIRED POSITION
Name of activities participated related to the desired position Specific role in the activity
ELECTORAL INFORMATION:
Party Name: ______________________________________________ Position in the Party: _________________________
I certify that I am a bona fide student of this school.
I, whose name and other persona] details are herein stated, do hereby file this Certificate of Candidacy for the Supreme Student
Government COMELEC in the election for school year 2020-2021.
I do hereby declare my intention and desire to be nominated for the particular position of ______________________.
I further state that I am bona fide student of this school with good moral character and academic standing, and I will abide with the
election rules and guidelines of the Supreme Student Government.
I hereby certify that the facts stated herein are true and correct to the best of my knowledge.
_________________________________________
Signature of Candidate over Printed Name
SUBSCRIBED AND SWORN to before me this _______ day of __________, 2020, at ____________, affiant exhibiting to me
his/her nomination kit which contains his/her COC, photograph, academic records, and parental consent.
___________________________________
________
SSG COMELEC REPRESENTATIVE
Enclosure 6: General Plan of Action
STUDENT GOVERNMENT
GENERAL ASSEMBLY
Grade Level Section Homeroom Class President Sex (M/F) Age Signature
Republic of the Philippines
Department of Education Republic of the Philippines
CARAGA REGION
DIVISION OF AGUSAN DEL SUR Department of Education
Sta. Josefa District CARAGA REGION
SAN JOSE ELEMENTARY SCHOOL DIVISION OF AGUSAN DEL SUR
OFFICIAL BALLOT
Sta. Josefa District
SAN JOSE ELEMENTARY SCHOOL
OFFICIAL BALLOT
Voting Instructions:
1. Shade the box properly using the marker provided. Do not write anything
Voting Instructions:
else on the ballot.
1. Shade the box properly using the marker provided. Do not write anything
2. Vote for only one (1) candidate per position by shading the box next to else on the ballot.
your choice.
2. Vote for only one (1) candidate per position by shading the box next to
3. Once done with voting, affix your thumbmark and signature on the box
your choice.
provided.
3. Once done with voting, affix your thumbmark and signature on the box
4. Fold the ballot, then place it in the ballot box.
provided.
5. Further instructions will be provided by the elections officer whenever
4. Fold the ballot, then place it in the ballot box.
necessary.
5. Further instructions will be provided by the elections officer whenever
necessary.
Student Government Candidates
President (vote for 1) Student Government Candidates
Prince Vincent L. Lapidez (WORKER party) President (vote for 1)
Mary Pauline G. Lopez (FEARLESS party) Prince Vincent L. Lapidez (WORKER party)
Vice-President (vote for 1) Mary Pauline G. Lopez (FEARLESS party)
Allah James S. Duno (FEARLESS party) Vice-President (vote for 1)
Jeniel Danica G. Vito (WORKER party) Allah James S. Duno (FEARLESS party)
Secretary (vote for 1) Jeniel Danica G. Vito (WORKER party)
Rachelle Claire F. Maitem (WORKER party) Secretary (vote for 1)
Kezziah Angelei L. Talha (FEARLESS party) Rachelle Claire F. Maitem (WORKER party)
Treasurer (vote for 1) Kezziah Angelei L. Talha (FEARLESS party)
Farah Cassandra O. Dagaang (FEARLESS party) Treasurer (vote for 1)
Glaiza Faith L. Faulve (WORKER party) Farah Cassandra O. Dagaang (FEARLESS party)
Auditor (vote for 1) Glaiza Faith L. Faulve (WORKER party)
Jeon P. Gumtang (FEARLESS party) Auditor (vote for 1)
Joshen Luke E. Igar (WORKER party) Jeon P. Gumtang (FEARLESS party)
Public Information Officer (PIO) (vote for 2) Joshen Luke E. Igar (WORKER party)
Jannie S. Anticamara (FEARLESS party) Public Information Officer (PIO) (vote for 2)
Reyver N. Asesor (WORKER party) Jannie S. Anticamara (FEARLESS party)
Joshua L. Castillo (WORKER party) Reyver N. Asesor (WORKER party)
Jillian S. Rosales (FEARLESS party) Joshua L. Castillo (WORKER party)
Business Managers (vote for 2) Jillian S. Rosales (FEARLESS party)
Dave Hurt E. Ayala (FEARLESS party) Business Managers (vote for 2)
Gil Anthonette C. Jordan (WORKER party) Dave Hurt E. Ayala (FEARLESS party)
Cloue M. Moncatar (FEARLESS party) Gil Anthonette C. Jordan (WORKER party)
Christina Rhea M. Plaza (WORKER party) Cloue M. Moncatar (FEARLESS party)
Sgt. At Arms/Peace Officer (vote for 2) Christina Rhea M. Plaza (WORKER party)
AJ P. Balacanta (WORKER party) Sgt. At Arms/Peace Officer (vote for 2)
Rain Rafael L. Gregory (FEARLESS party) AJ P. Balacanta (WORKER party)
John Carlo O. Honorio (WORKER party) Rain Rafael L. Gregory (FEARLESS party)
Cedric Ivan D. Lopez (FEARLESS party) John Carlo O. Honorio (WORKER party)
Grade 3 Representative (vote for 1) Cedric Ivan D. Lopez (FEARLESS party)
Janica L. Marmito (FEARLESS party) Grade 3 Representative (vote for 1)
Blessey G. Ticquian (WORKER party) Janica L. Marmito (FEARLESS party)
Grade 4 Representative (vote for 1) Blessey G. Ticquian (WORKER party)
Mekyla Grace I. Cahiles (WORKER party) Grade 4 Representative (vote for 1)
Jannia Ellaine C. Labita (FEARLESS party) Mekyla Grace I. Cahiles (WORKER party)
Grade 5 Representative (vote for 1) Jannia Ellaine C. Labita (FEARLESS party)
Anzia Mae S. Navarro (FEARLESS party) Grade 5 Representative (vote for 1)
Richel A. Salmorin (WORKER party) Anzia Mae S. Navarro (FEARLESS party)
Grade 6 Representative (vote for 1) Richel A. Salmorin (WORKER party)
Meljun C. Balatongle (WORKER party) Grade 6 Representative (vote for 1)
Fhymae Grace O. Dagaang (FEARLESS party) Meljun C. Balatongle (WORKER party)
Voter’s Thumbmark: Voter’s Signature: Fhymae Grace O. Dagaang (FEARLESS party)
Voter’s Thumbmark: Voter’s Signature:
________________________
________________________
Voting Instructions:
1. Write the name of your chosen candidate. Do not
Student Government Candidates write anything else on the ballot.
President (vote for 1) 2. Vote for only one (1) candidate per position.
Prince Vincent L. Lapidez (WORKER party) 3. Once done with voting, affix your thumbmark and
Mary Pauline G. Lopez (FEARLESS party) signature on the box provided.
Vice-President (vote for 1) 4. Fold the ballot, then place it in the ballot box.
Jeniel Danica G. Vito (WORKER party) 5. Further instructions will be provided by the elections
Allah James S. Duno (FEARLESS party) officer whenever necessary.
Secretary (vote for 1)
Rachelle Claire F. Maitem (WORKER party) Student Government Candidates
Kezziah Angelei L. Talha (FEARLESS party) President
Treasurer (vote for 1)
Name: ___________________________________________
Glaiza Faith L. Faulve (WORKER party)
Vice-President
Farah Cassandra O. Dagaang (FEARLESS party)
Auditor (vote for 1) Name: ___________________________________________
Joshen Luke E. Igar (WORKER party) Secretary
Jeon P. Gumtang (FEARLESS party)
Public Information Officer (PIO) (vote for 2) Name: ___________________________________________
Joshua L. Castillo (WORKER party) Treasurer
Reyver N. Asesor (WORKER party) Name: ___________________________________________
Jillian S. Rosales (FEARLESS party) Auditor
Jannie S. Anticamara (FEARLESS party)
Business Managers (vote for 2) Name: ___________________________________________
Gil Anthonette C. Jordan (WORKER party) Public Information Officer
Rain Rafael L. Gregory (WORKER party)
Name: ___________________________________________
Dave Hurt E. Ayala (FEARLESS party)
Peace Officer
Cloue M. Moncatar (FEARLESS party)
Sgt. At Arms/Peace Officer (vote for 1) Name: ___________________________________________
John Carlo Honorio (WORKER party) Grade 7 Representative
Cedric Ivan D. Lopez (FEARLESS party)
Grade 3 Representative (vote for 1) Name: ___________________________________________
Blessey G. Ticquian (WORKER party) Grade 8 Representative
Janica L. Marmito (FEARLESS party) Name: ___________________________________________
Grade 4 Representative (vote for 1) Grade 9 Representative
Mekyla Grace I. Cahiles (WORKER party)
Jannia Ellaine C. Labita (FEARLESS party) Name: ___________________________________________
Grade 5 Representative (vote for 1) Grade 10 Representative
Richel A. Salmorin (WORKER party)
Name: ___________________________________________
Anzia Mae S. Navarro (FEARLESS party)
Grade 11 Representative
Grade 6 Representative (vote for 1)
Meljun C. Balatongle (WORKER party) Name: ___________________________________________
Fhymae Grace O. Dagaang (FEARLESS party) Grade 12 Representative
________________________
District: _______________________________________
School: _________________________________________
OFFICIAL BALLOT
Republic of the Philippines
Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF NEGROS ORIENTAL
District: _______________________________________
School: _________________________________________
OFFICIAL BALLOT
Voting Instructions:
1. Write the name of your chosen candidate. Do not
write anything else on the ballot.
2. Vote for only one (1) candidate per position.
3. Once done with voting, affix your thumbmark and
signature on the box provided.
4. Fold the ballot, then place it in the ballot box.
5. Further instructions will be provided by the elections
officer whenever necessary.
________________________
Republic of the Philippines
Department of Education Republic of the Philippines
CARAGA REGION
DIVISION OF AGUSAN DEL SUR Department of Education
Sta. Josefa District CARAGA REGION
SAN JOSE ELEMENTARY SCHOOL DIVISION OF AGUSAN DEL SUR
OFFICIAL BALLOT
Sta. Josefa District
SAN JOSE ELEMENTARY SCHOOL
OFFICIAL BALLOT
Voting Instructions:
1. Shade the box properly using the marker provided. Do not write anything
Voting Instructions:
else on the ballot.
1. Shade the box properly using the marker provided. Do not write anything
2. Vote for only one (1) candidate per position by shading the box next to else on the ballot.
your choice.
2. Vote for only one (1) candidate per position by shading the box next to
3. Once done with voting, affix your thumbmark and signature on the box
your choice.
provided.
3. Once done with voting, affix your thumbmark and signature on the box
4. Fold the ballot, then place it in the ballot box.
provided.
5. Further instructions will be provided by the elections officer whenever
4. Fold the ballot, then place it in the ballot box.
necessary.
5. Further instructions will be provided by the elections officer whenever
necessary.
Student Government Candidates
President (vote for 1)
Prince Vincent L. Lapidez (FLEXIBLE party)
Mary Pauline G. Lopez (FEARLESS party)
Vice-President (vote for 1)
Allah James S. Duno (FEARLESS party)
Jeniel Danica G. Vito (FLEXIBLE party)
Secretary (vote for 1)
Rachelle Claire F. Maitem (FLEXIBLE party)
Kezziah Angelei L. Talha (FEARLESS party)
Treasurer (vote for 1)
Farah Cassandra O. Dagaang (FEARLESS party)
Glaiza Faith L. Faulve (FLEXIBLE party)
Auditor (vote for 1)
Jeon P. Gumtang (FEARLESS party)
Joshen Luke E. Igar (FLEXIBLE party)
Public Information Officer (PIO) (vote for 2)
Jannie S. Anticamara (FEARLESS party)
Reyver N. Asesor (FLEXIBLE party)
Joshua L. Castillo (FLEXIBLE party)
Jillian S. Rosales (FEARLESS party)
Business Managers (vote for 2)
Dave Hurt E. Ayala (FEARLESS party)
Gil Anthonette C. Jordan (FLEXIBLE party)
Cloue M. Moncatar (FEARLESS party)
Christina Rhea M. Plaza (FLEXIBLE party)
Sgt. At Arms/Peace Officer (vote for 2)
AJ P. Balacanta (FLEXIBLE party)
Rain Rafael L. Gregory (FEARLESS party)
John Carlo O. Honorio (FLEXIBLE party)
Cedric Ivan D. Lopez (FEARLESS party)
Grade 3 Representative (vote for 1)
Janica L. Marmito (FEARLESS party)
Blessey G. Ticquian (FLEXIBLE party)
Grade 4 Representative (vote for 1)
Mekyla Grace I. Cahiles (FLEXIBLE party)
Jannia Ellaine C. Labita (FEARLESS party)
Grade 5 Representative (vote for 1)
Anzia Mae S. Navarro (FEARLESS party)
Richel A. Salmorin (FLEXIBLE party)
Grade 6 Representative (vote for 1)
Meljun C. Balatongle (FLEXIBLE party)
Fhymae Grace O. Dagaang (FEARLESS party)
Voter’s Thumbmark: Voter’s Signature:
________________________
Student Government Candidates
President (vote for 1)
Prince Vincent L. Lapidez (FLEXIBLE party)
Mary Pauline G. Lopez (FEARLESS party)
Vice-President (vote for 1)
Allah James S. Duno (FEARLESS party)
Jeniel Danica G. Vito (FLEXIBLE party)
Secretary (vote for 1)
Rachelle Claire F. Maitem (FLEXIBLE party)
Kezziah Angelei L. Talha (FEARLESS party)
Treasurer (vote for 1)
Farah Cassandra O. Dagaang (FEARLESS party)
Glaiza Faith L. Faulve (FLEXIBLE party)
Auditor (vote for 1)
Jeon P. Gumtang (FEARLESS party)
Joshen Luke E. Igar (FLEXIBLE party)
Public Information Officer (PIO) (vote for 2)
Jannie S. Anticamara (FEARLESS party)
Reyver N. Asesor (FLEXIBLE party)
Joshua L. Castillo (FLEXIBLE party)
Jillian S. Rosales (FEARLESS party)
Business Managers (vote for 2)
Dave Hurt E. Ayala (FEARLESS party)
Gil Anthonette C. Jordan (FLEXIBLE party)
Cloue M. Moncatar (FEARLESS party)
Christina Rhea M. Plaza (FLEXIBLE party)
Sgt. At Arms/Peace Officer (vote for 2)
AJ P. Balacanta (FLEXIBLE party)
Rain Rafael L. Gregory (FEARLESS party)
John Carlo O. Honorio (FLEXIBLE party)
Cedric Ivan D. Lopez (FEARLESS party)
Grade 3 Representative (vote for 1)
Janica L. Marmito (FEARLESS party)
Blessey G. Ticquian (FLEXIBLE party)
Grade 4 Representative (vote for 1)
Mekyla Grace I. Cahiles (FLEXIBLE party)
Jannia Ellaine C. Labita (FEARLESS party)
Grade 5 Representative (vote for 1)
Anzia Mae S. Navarro (FEARLESS party)
Richel A. Salmorin (FLEXIBLE party)
Grade 6 Representative (vote for 1)
Meljun C. Balatongle (FLEXIBLE party)
Fhymae Grace O. Dagaang (FEARLESS party)
Voter’s Thumbmark: Voter’s Signature:
________________________
Republic of the Philippines
Department of Education
CARAGA REGION
DIVISION OF AGUSAN DEL SUR
Sta. Josefa District
SAN JOSE ELEMENTARY SCHOOL
2. CASTILLO, JOSHUA L.
Business Managers
1. BALACANTA, AJ P.
1. TICQUIAN, BLESSEY G.
Grade 4 Representative
1. SALMORIN, RICHEL A.
Grade 6 Representative
1. BALATONGLE, MELJUN C.
SELG ADVISER:
Vice-President
1.
Secretary
1.
Treasurer
1.
Auditor
1.
2.
Business Managers
1.
2.
1.
2.
Grade 3 Representative
1.
Grade 4 Representative
1.
Grade 5 Representative
1.
Grade 6 Representative
1.
SELG ADVISER: