REPUBLIC OF THE PHILIPPINES
Third Judicial Region
REGIONAL TRIAL COURT
Office of the Executive Judge
City of San Fernando, Pampanga
IN RE: Application for Level 1 Certification,
STUDENT’S NAME, Application No.___________
Applicant.
x-----------------------------------------------------------x
APPLICATION
I, STUDENT’S NAME, of legal age and a resident of
ADDRESS, state under oath that:
1. I am currently enrolled at the Don Honorio Ventura
State University School of Law at Bacolor, Pampanga;
2. I have satisfactorily and successfully completed all
of
my first year courses;
3. I will enroll in the school’s clinical legal education
program for the first semester of academic year 2024 –
2025;
4. I am aware of and will abide by the limitations
under
Sections 4, and the duties and obligations under Section 6
– 8 of Rule 138-A of the Rules of Court;
5. I have paid the necessary fees under Section
21(1) of
1
Rule 141 of the Rules of Court for the issuance of the Level
1 Certification. Attached herein is a copy of the official
receipt as proof of payment;
WHEREFORE, it is respectfully prayed that this
application be approved, and the Level 1 Certification be
issued.
City of San Fernando, Pampanga, Date.
NAME OF THE STUDENT
Applicant
SUBSCRIBED AND SWORN TO before me, a notary
public for City of San Fernando, Pampanga, Philippines, this
_____ day of September 2024, applicant personally
appeared and exhibited to me his
issued by valid until
as competent evidence of identity.
NOTARY PUBLIC
Doc. No. ____
Page No. ____
Book No. ____
Series of 2024.