Republic of the Philippines

Department of Education
Region IV-A CALABARZON

SAN RAFAEL NATIONAL HIGH SCHOOL

Atimonan, Quezon
School Year 2017 – 2018

March 17, 2018

The Registrar
Kapayapaan National High School
Canlubang
Calamba, Laguna

Sir/Madam:

Please furnish us a copy of Form 137-A (Permanent Record)/Certificate of Good Moral Character of the
student/s listed hereunder who is/are temporarily enrolled in this school.

No. Name of Student/s School Year Last Curriculum Adviser

Attended Year
1 CONSTANTINO, Miles L. 2017 – 2018 Grade 8 - Rose Blair R. Gacosta

( ) 1st Request
( ) 2nd Request
( ) 3rd Request
Very truly yours,
( / ) Urgent
( ) Please entrust to the bearer
TEOFILO R. BALAGAT JR.

Class Adviser
Note: Please disregard this request if the same has been complied with

For:
ANTONIO D. REVILLAME
Principal I