Tle Membership Form

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HOLY CHILD’S ACADEMY OF PAGADIAN, INC.

Student Servant Leader


San Jose District Pagadian City

TLE CLUB
School Year 2023 - 2024
MEMBERSHIP FORM

I. General Information
Last name First Name Middle Name Nick Name

Home Address

Contact Number/s Email Address

Sex Citizenship Age Date of Birth Place of Birth

Father’s Name / Guardian’s Name Contact Number/s

Mother’s Name / Guardian’s Name Contact Number/s

II. Educational Attainment


Grade / Year Level Section Class Adviser

Membership in Other School Organization/s or Club/s Position/s Held School Year

Other Co-Curricular Activities Available Time Schedule for TLE Club Special Skills/Talents

PARENTS/GUARDIANS PERMIT

I/We hereby permit my son/daughter to join the TLE Club. We also

promise to support him/her, morally & financially or otherwise, in all undertakings related to the Club’s mandated

programs, projects and activities.

PARENT/GUARDIAN
Signature over Printed Name
Do not fill-up below this line

---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(To be filled-up by the TLE Club Adviser Only)

Recommending Approval: Approved by:

EPIFANIA L. DUHAYLUNGSOD, MA

TLE Club Adviser School Principal

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