Acknowlegement Statement

Name :_________________________

Date :__________________

Here I acknowledge receiving from Miss Lamia Khalifa the following items:
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------I am personnally accountable for the above mentioned items .
In case of breakage or the item being lost , I am to replace the item from my own account .
The following items are to be renew on a regular basis without any charrges .
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Green Land count on your cooperation and good jugement to use all school supplies
adequately.
- On the 1st of June you are requested to give back all of your school supplies to Ms Lamia
Khalifa .
- A letter of will be handed to you at that moment .
Thanks for your collaboration ,
Signature :___________________

Title:________________________

Class: _________________

Department :____________________

Signature of G.S.V:__________________

Date:___________________