Schools Division of Antique - Schedule of Appointment
(Schools Division of Antique Schedule of Appointment Form)

This schedule of appointment allowed only Twenty (20) transactions every day.

Note : Enabled the send me a copy of my responses.
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Name *
Contact Number *
District / Name of School *
Section/Unit Want To Visit *
Date of Appointment *
MM
/
DD
/
YYYY
Preferred Time *
Time
:
Purpose *
Have you or any immediate family members been to any of the following affected country/countries in the last 14 days? ( China, Iran, South Korea, USA, Singapore and Italy) *
Have you or any immediate family members come into close contact with confirmed case of COVID-19 Virus in the last 14 days? *
Have you experienced any cold or flu-like symptoms in the last 14 days (to include fever, cough, sore throat, respiratory illness and difficulty breathing)? *
I hereby voluntarily give my consent in providing my personal data or information for the purpose(s) described in this document. I also understand that my consent does not prevent the existence of other criteria for lawful processing of personal data and does not waive any of my rights under RA 10173 – Data Privacy Act of 2012 and other applicable laws. *
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This form was created inside of Department of Education.