Republic of the Philippines

Department of Education
Regional Office No. VIII (Eastern Visayas)
DIVISION OF LEYTE
Government Center, Candahug, Palo, Leyte

APPLICATION FOR PERMISSION TO STUDY

Name of Applicant: PATRICE ANN C. RAMAS Position:Teacher I

Civil Service Eligibility: Civil Status: Single

Name of School where employed: Isabel National Comprehensive School
Barrio: Brgy. Libertad, Isabel, Leyte
Municipality: Isabel, Leyte Perm/Prov’l:
PERMANENT
Distance in kms. between official station and college where enrolled: 200 km

PALOMPON INSTITUTE OF TECHNOLOGY, PALOMPON, LEYTE

(Name and Location of college where applicant wished to enroll)

Course applied for: Master of Arts in Education – ENGLISH

Academic Year: 2022-2023 Qtr./Sem. Summer: 2nd SEMESTER
Course to be taken this term and the schedule:

COURSE/SUBJECT DAYS OF THE WEEK HOURS OF THE WEEK

METHODS OF EDUCATIONAL RESEARCH SATURDAY _______ 7:00 A.M. – 12:00

NN___

Credits or units towards - - - BSE MA Ed. D./Ph.D.

Total number of units previously ________ _____ ___________
Number of units to be earned this Qtr./Sem./Summer ___________ 3___________________

I hereby certify that I have carefully read the information on the next page of this form, all
the provisions of which I am bound to observe very strictly, I understand that the regulations on
the outside study of teachers are intended to primarily safeguard the health of the teachers as
well as of course to maintain their efficiency in the service. I also understand that if in the
opinion of the Division Superintendent of School this study adversely affect my efficiency as a
teacher this permission to study shall be revoked.

PATRICE ANN C. RAMAS

(Signature of Applicant)
Date Submitted: _______________________

APPROVAL RECOMMENDED:

The undersigned shall require strict compliance by the applicant with all the existing rules
and regulations regarding permission to study and should hold responsible for any undue delay
in forwarding the applicant to the office doing satisfactory work with an efficiency rating of
“ABOVE AVERAGE” or higher. The applicant will be required by me to submit through office, to
the Division Superintendent a certified copy of the report rating obtained in the course which
should be attended to his/her outside study not earlier than thirty minutes after the afternoon
session in the public school.

Date Submitted: _______________________ LUCENA L. CUERVO

District Supervisor/Sec.
Sch. Principal
APPROVED:
This permit expires on ______________________
Date: __________________
Permit No. ______________

MARIZA S. MAGAN, CESO V

 Schools Division Superintendent

APPLICATION FOR PERMISSION:

INSTRUCTIONS

1. Application for permission to study in five (5) copies must reach the office not later than two
(2) months before the start of the actual classes. THE TEACHERS JUST FILE REQUEST BEFORE
ENROLLING FOR THE FIRST TIME IN ANY SCHOOL, COLLEGE or UNIVERSITY.
2. The teacher applicant must be doing satisfactory work with an efficient rating of “ABOVE
AVERAGE” or higher.
3. The permission is given until the applicant complete the curriculum towards a degree. He
does not need to 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 to pursue should be attached with the application.
5. Teachers who are about to finish course, or who have started a course as well as the subject
already completed and those still to be taken all to be certified by the Registrar of the private
school concerned.
6. After each semester every teacher granted permission to study should submit to the
Superintendent’s Office, through channels, a certified true copy of the report on the ratings
be 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 degree he/she
should submit a complete set of his/her transcript of grades 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 (1) one to three (3)
units more than the nine (9) units 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 t 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 this official station so that he will not be unduly complied to hurry there from in
order to arrive at his class by time. The teacher should attend to his outside study not earlier
than thirty (30) minutes after the afternoon session in the public school.
9. The immediate superior or supervisor shall be hold responsible for any undue delay in
forwarding the application to the superintendent, if the application to the superintendent has
been filed on time.

PALOMPON INSTITUTE OF TECHNOLOGY, PALOMPON, LEYTE

(Name and location of college where application wishes to enroll)

CERTIFICATION

TO WHOM IT MAY CONCERN:

This is to certify that PATRICE ANN C. RAMAS _____, Teacher I (POSITION), is

seeking admission in this college to (course) ___MAED with Specialization in English with the
following subjects offered this __ 2nd SEMESTER__.

COURSE/SUBJECT DAYS OF THE WEEK HOURS OF THE DAY

METHODS OF EDUCATIONAL RESEARCH ______1_______ 7:00 – 12:00 NN_

JENNIFER A. GORUMBA, Ed. D. _____________________________

DEAN REGISTRAR

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

SUMMER TERM – 1 ½ hours daily Monday through Saturday.

 Maximum load; 9 units for all courses, 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 of graduate level course except for
enrollees in Special Saturday Classes for maximum load not more
than 6 units.