Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OFFICE OF NUEVA ECIJA
ZARAGOZA NATIONAL HIGH SCHOOL
SAN RAFAEL, ZARAGOZA, NUEVA ECIJA
RELIEVER FORM
(LOCAL SERVICE CREDIT)
Date:
_____________
TEACHER ON LEAVE/OFFICIAL BUSINESS: _______________________________________
DATE OF LEAVE/OFFICIAL BUSINESS: _______________________________________
PURPOSE OF LEAVE/OFFICIAL BUSINESS: _______________________________________
PLACE OF LEAVE/OFFICIAL BUSINESS: ________________________________________
CLASSESS AFFECTED:
TIME SUBJECT GRADE & SECTION SUBSTITUTE SIGNATURE
TEACHER
Requestee:
______________________
Teacher
Checked by: Approved:
CYRUS C. BADUA RODALYN JANE M. ESCAÑO,Ph.D.
MT I, Head Teacher Designate School Principal IV