Expression of Intent
during the implementation of the National Learning Camp for 2024 EOSY break, scheduled
this July 1 to July 19, 2024. I am willing to attend an orientation activity on the program
implementation.
Furthermore, I hereby grant the Department of Education the right to collect and
process my personal information and profile as provided below, for purposes relevant to the
Personal Information
Age:
Sex:
Complete Residential Address:
Mobile/Telephone Number:
laws, rules, and regulations being implemented by the Civil Service Commission
___________________________
Signature Over Printed Name
Date Signed: ___________
Name: _______________________________________
Section: ____________________
Age: _________________
Parent/Guardian:
Name: _________________________________
______________________________________________
English: _____________
Science: _____________
Mathematics: ________
Name: _____________________________
Contact Number: ______________________
School: _____________________________________
District: ________________________________
Division: ______________________________
Annex 2. Parent/Legal Guardian Consent Form
___________
Date
PARENTAL CONSENT
I/We hereby willingly and voluntarily give consent to the participation of my/our
son/daughter ____________(name of learner)_______________ in the Learning Camp from
___________(dates of attendance)___________.
I have considered the benefits that my son/daughter will get from his/her participation in
this activity provided that due care and precaution will be observed to ensure the comfort and
safety of my son/daughter and that DepEd employees and personnel may not be held
responsible for any untoward incident that may happen beyond their control.
______________________ _____________________
Signature of Father over Signature of Mother over
Printed Name/Date Printed Name/Date
__________________________
Signature of Guardian over
Printed Name/Date
________________________________
Relationship with the Learner
Verified By:
________________________________________ Date: ___________
Teacher
Note: If No Parent/s, submit an Affidavit of Guardianship duly verified by the teacher. If parents
are abroad, Special Power of Attorney (SPA) is needed.