Name of Applicant: ___________

Eligibility:
Address: ____________________________________________
Name of School where employed
Distance in Kms. between official station

________________________________________________
Course applied for:

Academic Year: ____________

Course to be taken this term and the schedule:

SUBJECT





Credits or units towards
Total number of units previously
Number of units to be earned this Sem

I hereby certify that I have carefully read the information on the next page
understood all the provisions of which
regulations on the outside study of teachers are intended to pr
teachers, as well as, of course
opinion of the Schools Division Superin
this permit to study shall be revoked.


Date Submitted: ___________________

APPROVAL RECOMMENDED:
The undersigned shall require strict compliance by the app
regulations regarding the permi
the application to the office
through my office, to the Divi
obtained in the semester/course
Average in his/her assigned task.

Date Submitted: _____________________

__________________________________________________________________________________________________________
APPROVED:
This permit expires on

Date : _______________________
Permit No.: _________________





Department of Education, Culture and Sports
Region III
DIVISION OF CITY SCHOOLS
Olongapo City

APPLICATION FOR PERMISSION TO STUDY

___________ Position:
Civil Status
____________________________________________Status of Appointment:
of School where employed: ________________________________
etween official station and college where enrolled:
_________________________________________
(Name of college where applicant wished to enroll)
________________________________________________
(Location of college where applicant wished to enroll)
___________________________________________________

(Write in Full)
____________ Semester/ Summer: _____________________________
(1
st
, 2nd, 3
rd
)
n this term and the schedule:
SUBJECT DAY(S) OF THE WEEK





Credits or units towards BSE
Total number of units previously earned :
Number of units to be earned this Semester/Summer :
I hereby certify that I have carefully read the information on the next page
all the provisions of which I am bound to observe very strictly
regulations on the outside study of teachers are intended to primarily safeguard the health of the
of course, to maintain their efficiency in the service
Division Superintendent the study would adversely affect my effici
to study shall be revoked.
___________________

___________________
APPROVAL RECOMMENDED:
The undersigned shall require strict compliance by the applicant with all the existin
permit to study, and should hold responsible for any undue delay in forwarding
to the office of the Superintendent. The applicant will be required by me to submit
vision Superintendent a certified copy of the
/course. The undersigned certifies that the applicant is performing Above
Average in his/her assigned task.
_____________________ __________________________________

___________________________________________________________________________________
This permit expires on _________________________________.
_______________________
_______________________
JESSIE D. FERRER, CESO IV
Schools Division Superintendent


Department of Education, Culture and Sports
ERMISSION TO STUDY
Position: __ _
Status: _______ _
Status of Appointment: _____________
_________________________________
__ _______
_________________________________________
where applicant wished to enroll)
________________________________________________
of college where applicant wished to enroll)

___________________________________________________

____________________________
(Inclusive date)
DAY(S) OF THE WEEK HOUR(S) OF THE WEEK





BSE
MA
Doctoral






I hereby certify that I have carefully read the information on the next page of this form and
very strictly. I understand that the
imarily safeguard the health of the
in the service. I also understand that if in the
adversely affect my efficiency as a teacher
_______________________________
Signature of Applicant
licant with all the existing rules and
to study, and should hold responsible for any undue delay in forwarding
The applicant will be required by me to submit,
sion Superintendent a certified copy of the report of the ratings of the units
The undersigned certifies that the applicant is performing Above
_________________________________
School Principal
___________________________________________________________________________________
_________.
JESSIE D. FERRER, CESO IV
Schools Division Superintendent
Due at the Division Office
Two Months Before the start
of the actual classes.
RULES AND REGULATIONS FOR THE APPLICATION OF PERMIT TO STUDY
1. Application for permission to study in five (5) copies must be submitted to the office not later than (2)
months before the start of the actual classes. TEACHERS MUST FILE REQUEST BEFORE ENROLLING IN ANY
SCHOOL, COLLEGE or UNIVERSITY. In case of late filling, applicant must attach his/her letter of explanation
as to the delay in filling said application. He/she must also attach certificate of registration/enrollment
(original and one (1) photocopy).
2. The teacher applicant must be doing satisfactory work with an efficient rating of ABOVE AVERAGE or
higher
3. The permision is given until the applicant complete the subject of the degree. He/she must file a request for
permission every semester.
4. A certificate from the head of the school or college where the teacher is enrolled and the subject taken
should be attached with the application.
5. Teachers who are about to finish a course, or who have completed the academic of a course must submit a
transcript of records certified by the Registrar of the private school concerned.
6. After each semester, every teacher, granted permission to study should submit to the Superintendents
Office, through channels, a certified true copy of the report of the ratings obtained in the course which he
took during the semester including the number of units earned, in addition, as soon as he/she finished a
specific curricular towards a degreee he/she should submit a complete transcript of records, and special
order to the superintendent through his immediate superior for validation and verification.
7. The maximum study of nine (9) units per semester or summer should be strictly observed. Teachers who are
candidates for graduation may be allowed to carry from one (1) to three (3) unit, more than the nine (9)
authorized, provided, that those units are the last units that the teachers need to enable them to graduate.
No exemption will be given to the teachers who do not fall under the above state condition. Violation of this
regulation on the study load shall be sufficient cause for revocation of the permission to study for
administrative action.
8. The college, school or university in which the teacher contemplates enrolling should be accessible to his/her
official station so that he/she will not be unduly complied to hurry there from, in order to arrive at his/her
class by time. The teacher should attend to his/her outside study not earlier than thrity (30) minutes after
the afternoon session in the public school.
9. The immediate superior or supervisor shall be held responsible for any undue delay in forwarding the
application to the superintendent, if the application to the superintendent has been filed on time.

C E R T I F I C A T I O N
TO WHOM IT MAY CONCERN:
This is to certify that ______________________________________ a public school teacher is
seeking admission in this ___________________________________________________________________
(Name of college where applicant on wishes to enroll)
for the ________________________________________________________ with the following subjects

(COURSE)
offered this _____________ for ___________________:

(SEMESTER)

(ACADEMIC YEAR)

SUBJECT DAY(S) OF THE WEEK HOUR(S) OF THE WEEK






_______________________________ _________________________________
DEAN OF THE GRADUATE SCHOOL REGISTRAR


NOTE:
1. Weekdays classes in a semestral terms should not be earlier that 6:00 p.m.
2. Unless superseded by the DepEd every term, a 3 unit lecture subject should be taken as follows:

SUMMER TERM : 1 hours daily Monday through Saturday. Maximum load: 9 units for all course, 6 units
in law in prescribed subjects.

SEMESTRAL TERM : A total of three (3) hours a week. Maximum load: 9 units for Undergraduate course or 6
units for graduate level course except for enrollees in Special Saturday Classes for
maximum load not more than 6 units.