ST.

BERNADETTE DIVINE ACADEMY

Brgy. Makinabang, Baliuag, Bulacan

Students of TODAY, LEADERS of Tomorrow!

FACULTY CLEARANCE FORM

Name:__________________________________________ Date Submitted: __________

Advisory Class Handled: ___________________________
School Year: ____________

Cross box check box signature

with deficiency if cleared

Accounting _______
Canteen _______
Room assigned (Inventory) _______
Faculty Room _______
Science. Lab. _______
Computer Lab. _______
Audio Visual Rm. _______
Visual Aids/Instructional _______
Materials Borrowed
Faculty I.D. _______
Books Borrowed _______
(examination copy, manuals,
teacher’s guide, references, etc.)
Library _______
PSEP Materials _______
(CD’s , player & Drill masters)

Reports:
Form 137 (new) _______
Form 138(R.C.) _______
Form 1 _______
Form 9 (Grade 10.) _______
Class Registration _______
Lesson Plan _______ _______
Activity Plan _______
SF Forms _______
(ALL MUST BE IN HARDCOPY)

Other Reports/Documents:
(from 1st grading to 4th grading)

****(duplicate)Report Card _______

****Grading Sheets _______
****Master Sheets _______
****Honor Sheets _______
**** Char. Traits _______
(****Mean Reports) _______
**** Co-Curricular _______
**** Rubrics _______
Anecdotal Notebook _______ _______
Attendance Notebook _______
Report on Bullying _______
Incident Report _______
Home Visitation Report _______

****submit accordingly (placed in separate folder with labels) BE ORGANIZED!!!

Others(pls. specify) ______________________________________

YOLANDA T. REYES REYLANDER T. REYES

Directress Vice-President for Academic Affairs