Annex A.
Template for Expression of Intent as a Volunteer Teacher
Expression of Intent
I, Francisco C. Yap hereby express my intent to be a Learning Camp
(Complete Name)
Volunteer in Lual National High School, Brgy. Lual, Casiguran, Aurora
(Name of School) (Address of the School)
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 hiring of learning camp volunteers in the Department.
Personal Information
Age: 32
Sex: Male
Complete Residential Address: 140 Calangcuasan, Casiguran, Aurora
Mobile/Telephone Number: 09510007937
Academic and Employment Details
Bachelor’s Degree & Specialization: BSN, BSED
Master’s Degree & Specialization (if any):
Present Employment (if any): Lual National High School
Present Position (if any): JHS Teacher 1
Grade Level Assignment (if any): 7,9,11
Length of Service as a Teacher (if any): 5 years
laws, rules, and regulations being implemented by the Civil Service Commission
___________________________
Signature Over Printed Name
Date Signed: 02/04/2024
Annex D. Registry of Learning Camp Volunteers
Annex 1: The Learning Camp Registration Template
Name: _______________________________________
Grade Level: _______________________
Section: ____________________
Age: _________________
Residential Address: ________________________
Parent/Guardian:
Name: _________________________________
Contact Number: ________________________
______________________________________________
To be filled out by the Teacher Adviser:
Most Recent Grade in:
English: _____________
Science: _____________
Mathematics: ________
Teacher Adviser in the currently enrolled Grade Level:
Name: _____________________________
Contact Number: ______________________
School: _____________________________________
School ID: ________________________
District: ________________________________
Division: ______________________________
Annex 2. Parent/Legal Guardian Consent Form
Republic of the Philippines
DEPARTMENT OF EDUCATION
________________________
(Region)
______________________________
(Division)
______________________________
(School)
______________________________
(School Address)
___________
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.
