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Conalum Elementary School

Inopacan , Leyte

SUPREME PUPIL GOVERNMENT TO THE STUDENTS: Print legibly all information
CERTIFICATE OF CANDIDACY required. Only complete and accomplished certificate of
candidacy will be processed.

PERSONAL INFORMATION
Name : Age:
Address :
Sex :
Birth Date: Birth Place:
Religion : Nationality:

CONTACT INFORMATION

Cell Phone Number: Landline:

E-mail Address :


FAMILY BACKGROUND
Father: Occupation:
Educational Attainment:
Mother: Occupation:
Educational Attainment:
SIBLING (S): BROTHER (S) SISTER (S)
NAME AGE YEAR/COURSE SCHOOL/WORKPLACE






Major Language Spoken at Home:






AFFILIATIONS: CLUBS AND ORGANIZATIONS (INSIDE AND OUTSIDE THE SCHOOL)

CLUBS/ORGANIZATIONS POSITIONS LOCATION PERSON IN-CHARGE










EDUCATIONAL ATTAINMENT: PREPARATORY, ELEMENTARY AND SECONDARY

GRADUATED LEVEL SCHOOL YEAR SCHOOL ATTENDED
Preparatory (Nursery to Kinder)
Elementary (Grade Six)
Secondary (Present Year)

RECORD OF TRANSFER: IF YOURE A TRANSFEREE TO ASSUMPTA SCHOOL

GRADE / YEAR SCHOOL ATTENDED





ELECTORAL INFORMATION

PARTY NAME:

Position in the Party:


LETTER OF CANDIDACY

I, whose name appears above, as a Bonifide pupil of CONALUM ELEMENTARY SCHOOL, of good academic and good

moral character hereby run for the position of
.
It is that I pledge not to clench for the power but for the service to cater the common good. I run for this position, unstrained but
Voluntarily and whole-heartedly. Ill play fairly and promise not to commit any forms of cheating against my opponent just to win.
It will be my responsibility to uphold peace and order, in myself and towards others, inside and outside the school. I am a symbol
of responsibility, and an AUTHENTICATED Assumptionist, not by name, but through my works and deeds.


SIGNATURE OVER PRINTED NAME:



SIGNATURE OF STUDENT SIGNATURE OF PARENT/GUARDIAN SIGNATURE OF SSC MODERATOR


DATE: ___________________________________ DATE: _______________________________ DATE: ___________________________________