Permission to Conduct Needs Assessment Survey (Principal)

KCD Technical Institute Inc.

National Highway, Brgy. II, Poblacion
Alaminos, Laguna
Date

Anicia R. Ciabal
Principal
KCD Technical Institute Inc.

Ma’am/ Sir:
Greetings of peace!
One of the goals of the K-12 Basic Education Curriculum is holistic human development. The
Grade 12 Students of KCD Technical Institute Inc. under the HUMSS Strand is taking up Community
Engagement, Solidarity and Citizenship.

It focuses on the application of initiatives such as Community Engagement, Solidarity, and Citizenship as
guided by the core values of Human Rights, Social Justice, Empowerment and Advocacy, Gender
Equality, and Participatory Development.

Hence, this letter intends to ask the permission of your good office to please allow us to conduct needs
assessment survey at _______________________ (name of barangay) on ____________ (date). The
goals of the said activity are to identify the needs of the barangay, to enhance students’ sense of shared
identity and willingness to contribute to the pursuit of the common good of the community and to enable
them to integrate applied social sciences into community-action initiatives.

While waiting for your approval, allow me express my sentiments of high regards and prayerful best
wishes to you and your institution.

Sincerely Yours,

____________________
Class President

Approved:
____________________
SHS Head Teacher

____________________
Teacher
 Permission to Conduct Needs Assessment Survey (School Administrator)

KCD Technical Institute Inc.

National Highway, Brgy. II, Poblacion
Alaminos, Laguna
Date

Dennis B. De Torres
School Administrator
KCD Technical Institute Inc.

Ma’am/ Sir:
Greetings of peace!
One of the goals of the K-12 Basic Education Curriculum is holistic human development. The
Grade 12 Students of KCD Technical Institute Inc. under the HUMSS Strand is taking up Community
Engagement, Solidarity and Citizenship.

It focuses on the application of initiatives such as Community Engagement, Solidarity, and Citizenship as
guided by the core values of Human Rights, Social Justice, Empowerment and Advocacy, Gender
Equality, and Participatory Development.

Hence, this letter intends to ask the permission of your good office to please allow us to conduct needs
assessment survey at _______________________ (name of barangay) on ____________ (date). The
goals of the said activity are to identify the needs of the barangay, to enhance students’ sense of shared
identity and willingness to contribute to the pursuit of the common good of the community and to enable
them to integrate applied social sciences into community-action initiatives.

While waiting for your approval, allow me express my sentiments of high regards and prayerful best
wishes to you and your institution.

Sincerely Yours,

____________________
Class President

Approved:
____________________
School Administrator

____________________
Teacher
 Parental Consent (Conduct Needs Assessment Survey)

KCD Technical Institute Inc.

National Highway, Brgy. II, Poblacion
Alaminos, Laguna

PARENTAL/ GUARDIAN CONSENT

Date:______________

TO WHOM IT MAY CONCERN:

This is to certify that I allowed my son/ daughter to participate in the conduct of Needs
Assessment Survey as requirement in Community Engagement, Solidarity, and Citizenship (CESC).

Name of Son/Daughter
Name of Activity
Inclusive Date/s
Place(s) to Visit

Thank you very much!

_____________________________
Parent/ Guardian
(Signature over printed name)
 Waiver (Conduct Needs Assessment Survey)

KCD Technical Institute Inc.

National Highway, Brgy. II, Poblacion
Alaminos, Laguna

STUDENT WAIVER

I, ___________________ presently enrolled in ____________________ (Track/Strand) present myself to

participate in the Community Engagement as part of our school activity and do hereby pledge that:

1. I will obey and abide the rules and regulations promulgated, enforced by the school, carried by
the teacher-in-charge for the protection and safety of all;

2. I hereby waive and renounce my rights to all damages, hospitalization, and the like. I will not
hold the school, staff and the teacher concerned responsible for any misfortune, injury, or accident be
slight or serious, that may happen in connection with the activities or requirements. The cause of which
will be attributable to my acts of disobedience, negligence, and the offense of my heading to advice,
warning, precaution, and safety rules that were discussed to me the subject-teacher in charge before the
start of the activity.

The content of this waiver was read and explained to me before I affix my name and signature this
_____th day of _____________, 20___ freely and voluntarily.

Thank you very much!

Yours truly,
_____________________________ _____________________________
Name of Student Name of Parent/Guardian
(Signature over Printed Name) (Signature over Printed Name)
 Permission Letter to Conduct the Activity (Barangay Captain)

KCD Technical Institute Inc.

National Highway, Brgy. II, Poblacion
Alaminos, Laguna

Date:

Kapitan Jeffrey
Barangay Captain
Barangay II, Poblacion

Ma’am/ Sir:
Greetings of peace!

One of the goals of the K-12 Basic Education Curriculum is holistic human development. The
Grade 12 Students of KCD Technical Institute Inc. under the HUMSS Strand is taking up Community
Engagement, Solidarity and Citizenship.

It focuses on the application of initiatives such as Community Engagement, Solidarity, and Citizenship as
guided by the core values of Human Rights, Social Justice, Empowerment and Advocacy, Gender
Equality, and Participatory Development.

Hence, this letter intends to ask the permission of your good office to please allow us to conduct needs
assessment survey at _______________________ (name of barangay) on ____________ (date). The
goals of the said activity are to identify the needs of the barangay, to enhance students’ sense of shared
identity and willingness to contribute to the pursuit of the common good of the community and to enable
them to integrate applied social sciences into community-action initiatives.

While waiting for your approval, allow me express my sentiments of high regards and prayerful best
wishes to you and your institution.

Sincerely Yours,
Approved:
____________________
Class President School Administrator

Approved: Approved:
____________________
SHS Head Teacher Barangay Captain

____________________
Teacher