House #/

Street/ Sitio/
Purok
Relationship
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
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M
Christian
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M
M
Christian
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M
Christian
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M
M
Christian
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M
Christian
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Christian
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School Form 1 (SF 1) School Register
(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)
School ID 120628 Region VII Division Negros Oriental District Vallehermoso
School Name Don Julian dela Vina Villegas Memorial ES School Year 2014 - 2015 Grade Grade 2 Section VIOLET
LRN
NAME
(Last Name, First Name, Middle
Name)
S
e
x

(
M
/
F
)
BIRTH DATE
(mm/dd/yyyy)
AGE
as of
1st
Friday
June
MOTHER
TONGUE
(Grade 1
to 3 Only)
IP
(Ethnic
Group)
RELIGION
ADDRESS PARENTS
GUARDIAN
(if Not Parent)
Contact
Number of
Parent or
Guardian
REMARKS
Barangay
Municipality/
City
Province
Father's Name (Last
Name, First Name,
Middle Name)
Mother's Maiden
Name (Last Name,
First Name,
Middle
Name
(Please refer to
the legend on
last page)
120628120005. ACOSTA, JURYNIE SENES 05-24-2007 7. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
ACOSTA,
AGUINALDO ELUM
MARGIELYN
SENES
AGUINALDO
ACOSTA
120628100001.
ALICANTE, JEFFREY
ANDALOSA
03-27-2003 11. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
ALICANTE,
CONSTANCIO
MARY
ANDALOSA
120628120010.
CADORNA, JAMES KYLE
EROSIDO
09-24-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
CADORNA, CENON
YURPO
PILARICA
EROSIDO
120628120012. CATUBAY, JOMBI OPSIMAR 04-06-2007 7. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
POGOY, ANTONIO
JOSELYN
CATUBAY
120628100021. ELUM, REMY ANDALOSA 12-06-2003 10. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
ELUM, RICKY
MARIVIC
CARALDE
ANDALOSA
120628120016. GIMARANGAN, JADE OPSIMAR 08-20-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
GIMARANGAN,
AGOSTO
FEDELIA
OPSIMAR
120628120017.
HONGOY, JUDITO TOLENTINO
JR
07-08-2007 6. Cebuano MOLOBOLO
VALLEHERM
OSO
NEGROS
ORIENTAL
HONGOY, JUDITO
OPSIMAR SR
JENELYN
TOLENTINO
120628120019. LEGASPI, JAMES ACOSTA 09-02-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
LEGASPI, JERRY
CATIAN
JOVITA
ACOSTA
120628120020. LEGASPI, JUVAN TORRES 02-16-2007 7. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
LEGASPI,
ARMANDO
JOY TORRES
120628130047.
MACAPOBRE, RICHMUND
SUHOT
03-10-2006 8. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
MACAPOBRE,
RICHARD
MA ROSARIO
TAGALOG
120628110034. MARCELLANA, GIAN TACSAN 10-16-2006 7. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
OPSIMAR, POLITO
PASINABO
MAGDALENA
TACSAN
MARCELLANA
120628120022. MENIERVA, JOEFEL LAOJAN 12-30-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
MENIERVA, FELIPE
JR
PATRICIA
LAOJAN
120628110039. PARA, JUNREY RABAYA 06-03-2006 8. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
,
DELIA RABAYA
PARA
120628120031. QUIRABO, JEMUEL ESPAOL 04-19-2007 7. TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
QUIRABO, JIMMY
HERMENIA
ESPANOL
120628120036. ROMANO, ARVIN MANGYAO 10-16-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
, BENJAMEN ELUM
ROMANO
DESIDERIA
MANYAO
120628120038. RONDUBIO, RENIEL CASIPONG 05-05-2007 7. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
RONDUBIO,
RONALD
MENIERVA
MARILOU
CASIPONG
120628120040. SAPLAD, LOWIE JAY CADORNA 02-27-2007 7. TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
SAPLAD, JULITO
LUPA
CADORNA
120628110053. SIABOC, RONNIE PITULAN JR 08-29-2004 9. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
SIABOC, RONNIE
TUAZON SR
RITCHIE ELOM
PITULAN
120628120041. SUHOT, JOEMARIE BAYNO 07-18-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
SUHOT, JOEMAR
SERGIA
BAYNO
120628130008. TEMPERATURA, JUVIE POGOY 03-06-2004 10. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
TEMPERATURA,
MAXIMO
AMANTILLO SR
ALECIA
MANGYAO
POGOY
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
F
Christian
ity
RELATIVE
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
Indicator Code BoSY
24.
12
36
120628130009.
TEMPERATURA, MAXIMO
POGOY JR
02-17-2002 12. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
TEMPERATURA,
MAXIMO
AMANTILLO SR
ALECIA
POGOY
120628130005.
TEMPERATURA, RICARDO
POGOY
04-24-2006 8. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
TEMPERATURA,
MAXIMO
AMANTILLO SR
ALECIA
POGOY
120628130007.
TEMPERATURA, RONNEL
TOMACMOL
04-28-2005 9. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
TEMPERATURA,
ROQUE
AMANTILLO
GEMMA AMPIL
TOMACMOL
120628120048.
ZAMORA, ALEX JAMES
OMBRERO
10-28-2006 7. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
,
SUSANA
OMBRERO
24 <=== TOTAL MALE
120628120004.
ACOSTA, EMMABELLE
JACULBE
12-18-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
ACOSTA, RICKY
ELUM
ERLINDA
TRJOC
JACULBE
120628120006. AJITO, ROSITA PARA 01-03-2007 7. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
,
TARSICIA
AJITO
120628120007. BAYOTAS, MARIEL TEJOC 05-02-2007 7. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
BAYOTAS, MARIO
LAGNASON
MIRALYN
MALOLOY-ON
TEJOC
120628120011.
CADORNA, MARY ROSE
TABOTABO
11-14-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
CADORNA, ROMEO
MERLINDA
TABOTABO
120628120013. ELUM, GI-AN NARVASA 10-29-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
ELUM, JORDAN
ESCORA
GINA
HONTONG
NARVASA
120628120014. ESTEMAR, FELIA BENIGAY 08-28-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
ESTEMAR,
GABRIEL
GEMARANGAN
FELISA
ANDALUSA
BENIGAY
120628120024. MEOZA, KRISTINA ENGCOT 07-17-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
MEOZA,
GREGORIO YORPO
LUCIANA ELUM
ENGCOT
120628120028. OPSIMAR, MARY ANOG 12-28-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
OPSIMAR, CIRILO
GEMMA PARA
ANOG
120628120029. PITULAN, JOAN CABUROG 10-27-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
PITULAN,
REYNALDO ERE
CARIDAD
BINAG
CABUROG
120628120035.
REQUISO, NIKKI JEAN
CADORNA
08-24-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
REQUISO,
ARTEMIO
ASUMBRADO
CHERRIE
YORPO
CADORNA
120628120037.
RONDUBIO, RACHELL ANN
DAVIS
08-07-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
RONDUBIO,
REYNALDO FAT
ROSITA
CASIPONG
DAVIS
120628120039. SAMOLIN, SHELLA MAE ELUM 12-01-2007 6. Cebuano TABON
VALLEHERM
OSO
NEGROS
ORIENTAL
SAMOLIN, GILBERT
MARILOU
ELUM
12 <=== TOTAL FEMALE
36 <=== COMBINED
List and Code of Indicators under REMARKS column
Code Required Information
Prepared by;
EDFEL CATHERENE F. SUMALINOG
EoSY Date:
CCT Control/reference number & Effectivity Date
Name of school last attended & Year
Specify
Specify Level & Effectivity Data
MALE
BoSY Date:
Certified Correct:
T/O
T/I
DRP
LE
Name of Public (P) Private (PR) School &
Effectivity Date
Name of Public (P) Private (PR) School &
Effectivity Date
Reason and Effectivity Date
Reason (Enrollment beyond 1st Friday of
CCT Receipient
Balik Aral
Learner With
Disability
Accelerated
CCT
B/A
LWD
ACL
EoSY Date:
Indicator Required Information REGISTERED EoSY
BoSY Date:
Generated on: Wednesday, July 30, 2014 9:31:53 PM
Revision 4
FEMALE
(Signature of Adviser over Printed Name) (Signature of School Head over Printed Name)
TOTAL
Transfered Out
Transfered In
Dropped