Student Quarantine Pass

Please fill in the necessary information to request for a Student Quarantine Pass.
You will be notified via Text or Email once the quarantine pass is ready.
Bring a valid ID, School ID or School Admission slip to claim your Student Quarantine Pass.

NOTE:

All data collected will be used ONLY for contact tracing purposes and will be shared ONLY to the relevant department.

Student’s Name: (First M.I Last) *

Student Status *

Purok *

Barangay *

Complete address for Non-resident

Student's Contact No. (Guardian if none) *

Level *

Grade (For Secondary & SHS)

School Name *

School Address *

Parent/Guardian's Name *

Guardians Contact Number *

Would you like it laminated? (Just pay P10.00 on your claim date) *

Terms & Conditions: I certify that the information provided are true and I agree that the information provided will be used for contact tracing purposes and will be shared to the relevant department only. *

Student Quarantine Pass

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