Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
Division of Laguna
Santa Cruz

APPLICATION FOR PERMISSION TO STUDY

Name of Teacher:

_________________________________________________________________
SARA
ANDRES KALIKASAN
SAN PEDRO
(Surname)
(First Name)
(Middle Name)

School where applicant plans to study: ____________________________________________________

UNIVERSITY OF THE PHILIPPINES LOS BAOS
LOS BAOS, LAGUNA
(School)
MPAf Ed. Mgt
Course to be pursued: _________________

(Place)

Starting 1st, 2nd Semester/Summer: __________

LIST OF SUBJECTS TO BE TAKEN

SUBJECTS
DAYS
TIME
NO. OF UNITS
_____________________________________________________________________________________
Educational Leadership
_____________________________________________________________________________________
1:00- 4:00
3
_____________________________________________________________________________________
_____________________________________________________________________________________
LIST OF SUBJECTS COMPLETED (if any)
_____________________________________________________________________________________
PAf 201 Political Economics in Public Affairs
_____________________________________________________________________________________
PAf 203 Data Analysis and Modelling in Public Affairs
_____________________________________________________________________________________
PAf 204 Ethics in Public Affairs
_____________________________________________________________________________________
DM 224
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
LIST OF REMAINING SUBJECTS TO BE TAKEN
_____________________________________________________________________________________
_____________________________________________________________________________________
__________________________________________________________________________________
CERTIFIED CORRECT:
______________________
(Registrar)
End of the afternoon session:

___________
4:00

Latest Performance Rating:

___________

Teaching Experience:

____________

________________________________
ANDRES KALIKASAN S. SARA
(Signature of Applicant)
RECOMMENDING APPROVAL:
____________________________
JOEL J. VALENZUELA
Principal II
APPROVED:
________________________________
MARITES A. IBAEZ
Schools Division Superintendent