EMPLOYEE CLEARANCE
Name:________________________ SY:__________________________
Position:______________________ Inclusive Dates:________________
Job requirement to surrender:
__________________________ ____________________________
__________________________ ____________________________
__________________________ ____________________________
__________________________ ____________________________
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SIGNATORIES
Name Signature Date
Registrar: ________________________ _____________ __________
Cashier: ________________________ _____________ __________
Coordinator________________________ _____________ __________
Guidance ________________________ _____________ __________
Principal ________________________ _____________ __________
Administrator_______________________ _____________ __________