National Capital Region

Division of City Schools

M. B. ASISTIO SR. HIGH SCHOOL UNIT
Pla-pla Street, Kaunlaran Village
Caloocan City

Advocating the noble mission of education, the learners in a child-friendly, inclusive and
equitable learning environment.

CERTIFICATION

This is to certify that__________________________________________________

of Grade/Track/Strand___________________________________ a nominee for an award as a
_________________________________________________.

CRITERIA
SKILL IN OUTPUT (5)
DISCIPLINE MEMBERSHIP (5)
CLASS/SCHOOL PRESENTAION (10)
WINNING & AWARDS (20)
SUBTOTAL
ATTITUDE TOWARD PEER EVALUATION (8)
THE DISCIPLINE COMMENDATION FROM
COACH/ADVISER (12)
SUBTOTAL
CONTRIBUTION TO TUTORIAL/COACHING (12)
THE SCHOOL PERFORMANCE IN SCHOOL’S VARIOUS
RELATED TO THE FUNCTIONS AND EVENTS (5)
DISCIPLINE PRODUCTS (8)
PROJECTS (3)
VOLUNTEER WORKS (3)
SUBTOTAL
GRAND TOTAL
RANK

Certified by:

__________________________________
(Signature of teacher over printed name)

MBASHS-Unit 1: EXCELLENCE, COMMITMENT, and ALTRUISM for school, community and

nation building.
Pla-Pla St. , Kaunlaran Village, Caloocan City Telephone No. 287-09-52
Email address: mbashsunit1@yahoo.com Fax. No. 287-09-52