SF Form
SF Form
SF Form
136685
School Name
LRN
NAME
(Last Name, First Name, Middle Name)
SSS V
Sex
(M/F)
136685080331
136685080025
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
136685080040
136685130445
136685080136
136676130103
136685080158
136685080182
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
136685080184
10
136685080197
11
136685080208
12
136685080210
13
136685080228
14
136685080257
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
15
136685080266
16
136685080286
17
136685080293
18
136685080308
19
136685080342
20
136685080411
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
21
136685080426
22
136685120784
23
136685080441
24
136685080508
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
136685080001
136685080004
113720800012
136685080021
136685080070
136685080086
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
136685070069
136685080105
136685080117
10
136685080180
11
136685080194
12
136685080200
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
13
136685080265
14
136685080304
15
136685080329
16
136685080037
17
136685080362
18
136685080368
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
19
136685080471
20
136685080473
21
136685080477
22
136685080482
23
136685080488
24
136685080500
NAME
(Last Name, First Name, Middle Name)
LRN
25
136685080506
Indicator
Code
Required Information
Transferred Out
T/O
Transferred IN
T/I
Dropped
DRP
Sex
(M/F)
NAME
(Last Name, First Name, Middle Name)
LRN
Late Enrollment
LE
Sex
(M/F)
LRN
NAME
(Last Name, First Name, Middle Name)
School ID
136685
School Name
LRN
136685120050
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
SSS V
Sex (M/F)
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
136685120051
136685110032
136685120039
136685110054
136685120240
136685120117
136685110115
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
136685110120
10
136685120584
11
136685120244
12
136685120245
13
136685120248
14
136685120066
15
136685110216
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
16
136685120249
17
136685110232
18
136685120252
19
136685120048
20
136685120259
21
136685110264
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
136685120261
136685120285
136685120262
136685140315
136685120147
136685110063
13668510086
136685110091
136685120266
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
10
136685120267
11
136685120269
12
136685120476
13
136685120100
14
136685120272
15
136685120276
16
136685120279
17
136685130588
18
136685120102
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
19
136685140316
20
136685110260
21
136685110263
22
136685100473
23
136685120281
NAME
(Last Name, First Name, Middle Name)
LRN
Indicator
Code
Required Information
Transferred Out
T/O
Transferred IN
T/I
Dropped
Late Enrollment
DRP
LE
Sex
(M/F)
School F
Region
NCR
Division
MOTHER
TONGUE
IP
(Ethnic
Group)
12/05/2002
11
Antipolo
Tagalog
None
10/22/2002
11
Marikina
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
MOTHER
TONGUE
IP
(Ethnic
Group)
07/01/2002
11
Antipolo
Tagalog
None
03/08/2003
11
Antipolo
Tagalog
None
06/19/2003
11
Marikina
Tagalog
None
10/10/2002
12
Marikina
Tagalog
None
06/17/2003
11
Marikina
Tagalog
None
03/31/2003
11
Antipolo
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
MOTHER
TONGUE
IP
(Ethnic
Group)
10/18/2001
12 1/2
Antipolo
Tagalog
None
12/19/2003
10 1/2
Antipolo
Tagalog
None
Antipolo
Tagalog
None
Marikina
Tagalog
None
03/17/2003
01/02/2003
11
11 1/2
08/12/2003
12
Antipolo
Tagalog
None
02/12/2003
11
Antipolo
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
11/20/2003
12 1/2
MOTHER
TONGUE
IP
(Ethnic
Group)
Antipolo
Tagalog
None
02/04/2003
11
Marikina
Tagalog
None
04/24/2003
11
Marikina
Tagalog
None
08/13/2003
11
Antipolo
Tagalog
None
12/25/2001
12 1/2
Antipolo
Tagalog
None
10/02/2002
11 1/2
Marikina
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
02/12/2002
12/22/2002
11
11 1/2
MOTHER
TONGUE
IP
(Ethnic
Group)
Antipolo
Tagalog
None
Antipolo
Tagalog
None
08/07/2002
12
Marikina
Tagalog
None
08/07/2002
12
Antipolo
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
MOTHER
TONGUE
IP
(Ethnic
Group)
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
02/22/2003
11
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
10/27/2002
11 1/2
Tagalog
None
01/01/2002
12 1/2
Tagalog
None
01/27/2003
11
Tagalog
None
07/09/2002
12
Tagalog
None
04/10/2002
12
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
MOTHER
TONGUE
IP
(Ethnic
Group)
07/21/2001
13
Tagalog
None
08/06/2002
12
Tagalog
None
08/13/2003
11
Tagalog
None
09/16/2002
12
Tagalog
None
04/20/2003
12
Tagalog
None
08/11/2002
12
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
04/30/2003
11
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
11/05/2001
12 1/2
Tagalog
None
12/31/2002
11 1/2
Tagalog
None
09/19/2002
11 1/2
Tagalog
None
09/21/2002
11 1/2
Tagalog
None
11/28/2002
12
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
11/26/2002
11 1/2
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
02/04/2001
11
Tagalog
None
06/01/2003
11
Tagalog
None
09/28/2002
11 1/2
Tagalog
None
10/29/2001
12 1/2
Tagalog
None
Tagalog
None
09/18/2003
12
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
01/23/2003
11 1/2
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
Code
CCT
B/A
LWD
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
MOTHER
TONGUE
IP
(Ethnic
Group)
ACL
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
Region
MOTHER
TONGUE
NCR
IP
(Ethnic
Group)
Division
AGE as of 1st
Friday June
MOTHER TONGUE
IP
(Ethnic Group)
12/26/2005
8 1/2
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
11/20/2005
01/20/2006
9
8 1/2
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
Tagalog
None
06/30/2006
Tagalog
None
09/01/2005
Tagalog
None
10/02/2005
Tagalog
None
11/25/2005
Tagalog
None
10/07/2005
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
10/16/2005
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
01/07/2006
8 1/2
Tagalog
None
04/12/2006
8 1/2
Tagalog
None
06/12/2006
Tagalog
None
10/28/2005
Tagalog
None
04/04/2005
9 1/2
Tagalog
None
01/08/2006
8 1/2
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
03/01/2006
10/06/2005
8 1/2
9
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
Tagalog
None
03/11/2006
8 1/2
Tagalog
None
01/21/2006
8 1/2
Tagalog
None
12/22/2005
8 1/2
Tagalog
None
03/07/2006
8 1/2
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
MOTHER
TONGUE
IP
(Ethnic
Group)
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
10/27/2005
8 1/2
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
05/13/2005
Tagalog
None
09/25/2005
Tagalog
None
Tagalog
None
11/23/2006
7 1/2
05/06/2006
Tagalog
None
05/04/2005
Tagalog
None
10/17/2005
8 1/2
Tagalog
None
03/30/2006
8 1/2
Tagalog
None
Tagalog
None
06/11/2005
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
10/14/2005
8 1/2
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
09/19/2005
Tagalog
None
04/09/2006
Tagalog
None
05/07/2006
Tagalog
None
12/16/2005
8 1/2
Tagalog
None
03/03/2006
8 1/2
Tagalog
None
Tagalog
None
08/03/2006
11/13/2005
8 1/2
Tagalog
None
12/15/2006
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
10/28/2006
08/17/2006
12/28/2005
7 1/2
8
8 1/2
MOTHER
TONGUE
IP
(Ethnic
Group)
Tagalog
None
Tagalog
None
Tagalog
None
07/28/2006
Tagalog
None
09/04/2006
Tagalog
None
AGE as of
BIRTH DATE (mm/dd/
BIRTH PLACE
1st Friday
yyyy)
(Province)
June
MOTHER
TONGUE
IP
(Ethnic
Group)
Code
CCT
B/A
LWD
ACL
MARIKINA CITY
School Year
ADDRESS
RELIGION
Roman Catholic
Purok 5 Zone 8
Roman Catholic
59 Gold St.
ADDRESS
RELIGION
Roman Catholic
Baptist
Purok 1 Zone 8
7 St. Ignatius St. Ma. Corazon
Roman Catholic
40 Panganiban St.
Roman Catholic
Roman Catholic
14 Bronze St.
Roman Catholic
Purok 2
ADDRESS
RELIGION
Roman Catholic
Roman Catholic
Unit 3 Pagrai
Roman Catholic
Roman Catholic
Roman Catholic
85 Purok 5
Roman Catholic
Tumana
ADDRESS
RELIGION
Roman Catholic
Purok 2
Roman Catholic
Purok 4
BAC
28 Crimson St.
Iglesia ni Cristo
Tamenggo
Roman Catholic
Tumana
Roman Catholic
ADDRESS
RELIGION
Roman Catholic
31 Carmine St.
Roman Catholic
Roman Catholic
Roman Catholic
55 Zone 8
ADDRESS
RELIGION
ADDRESS
RELIGION
Adventist
Roman Catholic
Roman Catholic
42 Lime St.
Roman Catholic
Iglesia ni Cristo
Tamenggo
Roman Catholic
ADDRESS
RELIGION
Roman Catholic
Methodist
18 Sienna St.
Roman Catholic
83 Purok 3 Zone 8
Roman Catholic
17 Velvet St.
Roman Catholic
Friendly Village
Roman Catholic
Purok 5
ADDRESS
RELIGION
Roman Catholic
Roman Catholic
Baybay Sapa
Roman Catholic
80 Saarland St.
Roman Catholic
56 Santol St.
Roman Catholic
Roman Catholic
28 Aquamarine St.
ADDRESS
RELIGION
Roman Catholic
57 Bronze St.
Roman Catholic
98 Olive St.
BAC
Purok 5 Zone 8
Roman Catholic
Tamenggo
Roman Catholic
22 Panganiban
Iglesia ni Cristo
ADDRESS
RELIGION
Roman Catholic
Sulucan St.
Required Information
CCT Control/reference number & Effectivity Date
Name of school last attended & Year
Specify
ADDRESS
RELIGION
Specify Level & Effectivity Data
ADDRESS
RELIGION
MARIKINA CITY
School Year
ADDRESS
RELIGION
Roman Catholic
Purok 2
ADDRESS
RELIGION
Roman Catholic
219 Purok 1
Roman Catholic
Purok 1 Zone 8
Roman Catholic
54 Panorama St.
Roman Catholic
Roman Catholic
Roman Catholic
187 Purok 1
Roman Catholic
72 Azure St.
ADDRESS
RELIGION
Roman Catholic
INC
33 Panorama St.
2 Liamzon St. Ma. Corazon
Roman Catholic
Roman Catholic
Purok 3 Zone 8
Roman Catholic
26 Purok 5 Zone 8
Roman Catholic
Roman Catholic
77 Eastdrive St.
ADDRESS
RELIGION
Roman Catholic
Roman Catholic
27 Sienna St.
Roman Catholic
Purok 5 Zone 8
Roman Catholic
47 Tangerine St.
Roman Catholic
Purok 5 Zone 8
Roman Catholic
99 Narra St.
ADDRESS
RELIGION
ADDRESS
RELIGION
Roman Catholic
Roman Catholic
52 Sapphire St.
Roman Catholic
75 Yellowbell St.
Roman Catholic
44 P. Oliveros St.
Roman Catholic
1 Katipunan St.
Roman Catholic
44 Peach St.
Roman Catholic
84 Sulucan st.
Roman Catholic
Roman Catholic
ADDRESS
RELIGION
Roman Catholic
90 Narra St.
Roman Catholic
Roman Catholic
Purok 3 Zone 8
Roman Catholic
Blk 3 L4 Tumana
Roman Catholic
Roman Catholic
24 Carmel St.
INC
94 Makiling St.
Roman Catholic
ADDRESS
RELIGION
Mormon
B5 L20 Tumana
Roman Catholic
39 Tangerine St.
Roman Catholic
14 Panorama St.
Roman Catholic
Roman Catholic
ADDRESS
RELIGION
Required Information
CCT Control/reference number & Effectivity Date
Name of school last attended & Year
Specify
Specify Level & Effectivity Data
chool Register
and Profile)
District
2014-2015
Grade Level
ADDRESS
Barangay
Municipality/ City
Province
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
ADDRESS
Barangay
Municipality/ City
Province
Cupang
Antipolo
NCR
Cupang
Antipolo
NCR
Concepcion Dos
Marikina
NCR
Concepcion Dos
Marikina
NCR
de Guzman, Chryster
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
ADDRESS
Barangay
Municipality/ City
Province
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Arizala, Allan
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
ADDRESS
Barangay
Municipality/ City
Province
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
n/a
Cupang
Antipolo
Rizal
ADDRESS
Barangay
Municipality/ City
Province
Concepcion Dos
Marikina
NCR
Mayamot
Antipolo
Rizal
Cornelio, Clarito
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
ADDRESS
Barangay
Municipality/ City
Province
ADDRESS
Barangay
Municipality/ City
Province
Mayamot
Antipolo
Rizal
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
ADDRESS
Barangay
Municipality/ City
Province
Cupang
Antipolo
Rizal
Botor, Jake
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
Concepcion Uno
Marikina
NCR
Cupang
Antipolo
Rizal
ADDRESS
Barangay
Municipality/ City
Province
Cupang
Antipolo
Rizal
Mayamot
Antipolo
Rizal
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
Concepcion Dos
Marikina
NCR
Mayamot
Antipolo
Rizal
ADDRESS
Barangay
Municipality/ City
Province
Concepcion Dos
Marikina
NCR
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
Marikina Hghts.
Marikina
NCR
ADDRESS
Barangay
Cupang
Municipality/ City
Province
Antipolo
Rizal
REGISTERED
BoSY
MALE
24
FEMALE
25
TOTAL
49
ADDRESS
Barangay
Municipality/ City
Province
TOTAL
ADDRESS
Barangay
Municipality/ City
Province
ster
and Profile)
District
2014-2015
Grade Level
ADDRESS
Barangay
Cupang
Municipality/ City
Province
Antipolo
Rizal
ADDRESS
Barangay
Municipality/ City
Province
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
Marikina Hghts.
Marikina
NCR
Marikina Hghts.
Marikina
NCR
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
ADDRESS
Barangay
Municipality/ City
Province
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Marikina Hghts.
Marikina
NCR
Marikina Hghts.
Marikina
NCR
ADDRESS
Barangay
Municipality/ City
Province
Concepcion Dos
Marikina
NCR
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
Cupang
Antipolo
Rizal
Marikina Hghts.
Marikina
NCR
ADDRESS
Barangay
Municipality/ City
Province
ADDRESS
Barangay
Municipality/ City
Province
Mayamot
Antipolo
Rizal
Andeza, Jet D.
Concepcion Dos
Marikina
NCR
Bercida, Parlo C.
Mayamot
Antipolo
Rizal
Bernardino, Celso V.
Cupang
Antipolo
Rizal
Briones, Arnold O.
Concepcion Dos
Marikina
NCR
Catingkoy, Dave H.
Concepcion Dos
Marikina
NCR
Cordero, Ronald V.
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Dizon, Dennis M.
ADDRESS
Barangay
Municipality/ City
Province
Marikina Hghts.
Marikina
NCR
Feliciano, Antonio F.
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Cupang
Antipolo
Rizal
Jabines, Renato I.
Mayamot
Antipolo
Rizal
Concepcion Dos
Marikina
NCR
Motay, Ramon D.
Concepcion Dos
Marikina
NCR
Ordoa,Frederick
Mayamot
Antipolo
Rizal
Pacheco, Monatano A.
ADDRESS
Barangay
Municipality/ City
Province
Cupang
Antipolo
Rizal
Parasdas, Lovy S.
Concepcion Dos
Marikina
NCR
Pascual, Jenazar E.
Concepcion Dos
Marikina
NCR
Santosidad, Argie G.
Marikina Hghts.
Marikina
NCR
Cupang
Antipolo
Rizal
ADDRESS
Barangay
Municipality/ City
Province
REGISTERED
BoSY
MALE
27
FEMALE
27
TOTAL
54
MARIKINA II
SIX
Section
PARENTS
HYDROGEN
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
ra
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
bukay
alicillo
dan
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
apones
co
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
ral
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
ore
rion
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
Cruz
mogino
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
era
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
na
GUARDIAN
(If not Parent)
Name
Relation-ship
GUARDIAN
PARENTS
EoSY
Prepared by:
EULALIA P. OCAMPO
(Signature of Adviser over Printed Name)
Name
Relation-ship
GUARDIAN
PARENTS
EoSYDate:
Name
Relation-ship
Name
Relation-ship
MARIKINA II
Three
GUARDIAN
PARENTS
Section
EINSTEIN
GUARDIAN
PARENTS
Name
Relation-ship
PARENTS
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
Magno, Jovelyn C.
Millare, Jo-Ann O.
Ladreno, Charito T.
Verac, Jill R.
De Guzman, Rose Ann O.
Lopez, Ma. Cristine R.
Santos, Ruby F.
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
GUARDIAN
(If not Parent)
Name
Relation-ship
PARENTS
GUARDIAN
(If not Parent)
Name
Relation-ship
GUARDIAN
PARENTS
EoSY
ROMINA C. VELASCO
(Signature of Adviser over Printed Name)
EoSYDate:
Name
Relation-ship
ROGEN
REMARKS
Contact Number of
Parent or Guardian
09354715294
09354715244
REMARKS
Contact Number of
Parent or Guardian
09123767357
09187455400
09068147724
09982760634
REMARKS
Contact Number of
Parent or Guardian
09068335532
09497337255
09309328667
09997705856
09309311002
6462037
REMARKS
Contact Number of
Parent or Guardian
09216044368
09202398680
0999401578
09468775295
09284993709
09304864263
REMARKS
Contact Number of
Parent or Guardian
4705269
09261403520
09289571438
09331996180
REMARKS
Contact Number of
Parent or Guardian
REMARKS
Contact Number of
Parent or Guardian
0948662939
09995521547
09391887571
6795933
0910925704
09173629725
REMARKS
Contact Number of
Parent or Guardian
09216642690
09231293090
09397840851
09196648181
09297711499
REMARKS
Contact Number of
Parent or Guardian
09294082498
0909344279
2502250
09322017265
0948143015
09351162688
REMARKS
Contact Number of
Parent or Guardian
09237353611
0910996349
09084506150
09287639879
09195840394
REMARKS
Contact Number of
Parent or Guardian
09219572955
Certified Correct:
CAROLINA O. GUEVARA
(Signature of School Head over Printed Name)
REMARKS
Contact Number of
Parent or Guardian
BoSY Date: June 2, 2014
REMARKS
Contact Number of
Parent or Guardian
NSTEIN
REMARKS
Contact Number of Parent or
Guardian
09205841672
REMARKS
Contact Number of
Parent or Guardian
09305678700
09283982784
09165297951
09089830172
4770035
09488305456
5017084
REMARKS
Contact Number of
Parent or Guardian
09334855902
09124338452
09464429420
09186327509
0923418448
09237215751
09258780831
REMARKS
Contact Number of
Parent or Guardian
09175305584
09216962544
09279159196
09177533697
09204348125
09227781432
REMARKS
Contact Number of
Parent or Guardian
REMARKS
Contact Number of
Parent or Guardian
09105242216
09102083461
457-4170
09163770652
09072620550
REMARKS
Contact Number of
Parent or Guardian
REMARKS
Contact Number of
Parent or Guardian
REMARKS
Contact Number of
Parent or Guardian
Certified Correct:
CAROLINA O. GUEVARA
(Signature of School Head over Printed Name)
EoSYDate:
School ID
136685
Name of School
LEARNER'S NAME
(Last Name, First Name, Middle Name)
1Addatu, Cedrick T.
2Balano, Charlez Angelo C.
3Barrera, Steve Craig B.
4Bartolome, Louie A.
5Briones, Evander G.
2
M
LEARNER'S NAME
(Last Name, First Name, Middle Name)
6Canete, Carlo S.
7de Guzman, Nikko M.
8delos Santos Jr, Jimmy James Y.
9Desoloc, Rizel Ashley
10Dionisio, Alfredo III B.
11Eborde, Daniel
12Eniceo, Reyben A.
13Gamboa, Virgilio III R.
14Gaona, Edwin Carl A.
2
M
LEARNER'S NAME
(Last Name, First Name, Middle Name)
2
M
LEARNER'S NAME
(Last Name, First Name, Middle Name)
24
25
26
27
MALE | TOTAL Per Day
2
M
LEARNER'S NAME
(Last Name, First Name, Middle Name)
1Abellon, Danica G.
2Aguire, Mae Angielle
3Ayuson, Samantha Kelly C.
4Beato, Angelica G.
5Berlon, Lea F.
6Bermundo, Merry Joy S.
7Borja, Angel Rose D.
8Deluvio, Rhona Jane C.
9Gebrallo, Jocelyn S.
10Juayno, Kelly Charies S.
2
M
LEARNER'S NAME
(Last Name, First Name, Middle Name)
11Llavor, Jaerah B.
12Magayones, Dainna Rose R.
13Marabat, Sienne B.
14Mislang, Ericka Claire L.
15Najera, Melissa L.
16Olivar, Charina Marie L
17Raygon, Allyssa Joy D.
18Reluya, Irrah Lei C.
19Sison, Rien Gabrielle B.
20Sumaylo, Venice B.
2
M
LEARNER'S NAME
(Last Name, First Name, Middle Name)
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2
M
LEARNER'S NAME
(Last Name, First Name, Middle Name)
2
M
Average Daily
Attendance =
4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summa
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who wer
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
LEARNER'S NAME
(Last Name, First Name, Middle Name)
2
M
(This repla
2014-2015
School Year
10
11
12
TH
TH
10
11
12
TH
TH
10
11
12
TH
TH
10
11
12
TH
TH
10
11
12
TH
TH
10
11
12
TH
TH
10
11
12
TH
TH
10
11
12
TH
TH
summary table into School Form 4. Once signed by the principal, this form should be returned to the adviser.
ho were absent for 5 consecutive days and/or those at risk of dropping out.
10
11
12
TH
TH
2014-2015
(1st row for date)
13
16
17
18
19
20
23
24
TH
16
17
18
19
20
23
24
TH
16
17
18
19
20
23
24
TH
x
x
16
17
18
19
20
23
24
TH
16
17
18
19
20
23
24
TH
16
17
18
19
20
23
24
TH
16
17
18
19
20
23
24
TH
dviser.
16
17
18
19
20
TH
x 100
x 100
23
24
M
T
(blank) - Present; (x)- Absent; Tardy (half shaded= Up
16
17
18
19
20
23
24
TH
JUNE
THREE
Grade Level
25
26
27
30
TH
Section
TH
25
26
27
30
TH
x
x
TH
25
26
27
30
TH
TH
25
26
27
30
TH
TH
25
26
27
30
TH
TH
25
26
27
30
TH
TH
25
26
27
30
TH
y (half shaded= Upper for Late Commer, Lower for Cutting Classes)
TH
Month:
25
26
27
30
TH
TH
F
* Enrolment as
Registered Learner
Percentage of Enrolm
Average D
Percentage of Att
Number of students ab
Trans
Tran
25
26
27
30
TH
TH
F
I certify that this is a true and correct report.
Attested by:
NEWTON
Total for the Month
ABSENT
TARDY
TARDY
TARDY
TARDY
TARDY
TARDY
TARDY
No. of Days of
Classes:
Summary
M
TOTAL
TARDY
24
24
48
24
24
48
24
24
48
24
24
48
100%
100%
100%
2.0%
2%
Transferred out
Transferred in
TARDY
Evangelina A. Sabuad
(Signature of Teacher over Printed Name)
CAROLINA O. GUEVARA
(Signature of School Head over Printed Name)
K TO 12 LEARNER'S MATERIAL
School ID
136685
SSS Village Elementary School
School Name
Edukasyon sa Pagpapakatao
NO.
LEARNER'S NAME
Name, First Name, Middle Name)
(Last
Date
Issued
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
Date
Returned
Issued
Edukasyon sa Pagpapakatao
NO.
LEARNER'S NAME
Name, First Name, Middle Name)
(Last
Date
Issued
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
Date
Returned
Issued
Edukasyon sa Pagpapakatao
NO.
LEARNER'S NAME
Name, First Name, Middle Name)
(Last
Date
Issued
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
27/27
Date
Returned
Issued
Edukasyon sa Pagpapakatao
NO.
LEARNER'S NAME
Name, First Name, Middle Name)
(Last
Date
Issued
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
Date
Returned
Issued
Edukasyon sa Pagpapakatao
NO.
LEARNER'S NAME
Name, First Name, Middle Name)
(Last
Date
Issued
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
6/23/2014
Date
Returned
Issued
Edukasyon sa Pagpapakatao
NO.
LEARNER'S NAME
Name, First Name, Middle Name)
(Last
Date
Issued
6/23/2014
6/23/2014
6/23/2014
27/27
54/54
GUIDELINES:
1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form.
5. All textbooks being used must be included. Additional copies of this form may be used if needed.
Date
Returned
Issued
2014-2015
School Year
Three
Grade Level
Title:
Date
Date
Date
te
Returned
Section
Issued
Returned
Issued
Returned
Issued
Date
Returned
Issued
Title:
Date
Date
Date
te
Returned
Issued
Returned
Issued
Returned
Issued
Date
Returned
Issued
Title:
Date
Date
Date
te
Returned
Issued
Returned
Issued
Returned
Issued
Date
Returned
Issued
Title:
Date
Date
Date
te
Returned
Issued
Returned
Issued
Returned
Issued
Date
Returned
Issued
Title:
Date
Date
Date
te
Returned
Issued
Returned
Issued
Returned
Issued
Date
Returned
Issued
Title:
Date
Date
Date
te
Returned
Issued
Returned
Issued
Returned
Issued
Date
Returned
Issued
In case of lost/unreturned books, please provide information with the following code:
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code FM), TLTR=Teacher prepa
submission to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO
Newton
a & Title:
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please
refer to the legend on last
page)
Date
Returned
Issued
Returned
a & Title:
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please
refer to the legend on last
page)
Date
Returned
Issued
Returned
a & Title:
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please
refer to the legend on last
page)
Date
Returned
Issued
Returned
a & Title:
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please
refer to the legend on last
page)
Date
Returned
Issued
Returned
a & Title:
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please
refer to the legend on last
page)
Date
Returned
Issued
Returned
a & Title:
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please
refer to the legend on last
page)
Date
Returned
Issued
Returned
Prepared By:
INES T. CATACUTAN
(Signature over printed name)
Date BoSY:June 2, 2014 Date EoSY: ___________
School ID
Region
Division
School Name
GRADE/
YEAR LEVEL
SECTION
NAME OF ADVISER
REGISTERED
LEARNERS
(As of End of the
Month)
M
ATTENDANCE
Daily Average
M
DROPPED OU
(A) Cumulative as of
Previous Month
M
ELEMENTARY/SECONDARY:
KINDER
GRADE 1/GRADE 7
GRADE 2/GRADE 8
GRADE 3/GRADE 9
GRADE 4/GRADE 10
GRADE 5/GRADE 11
GRADE 6/GRADE 12
TOTAL FOR NON-GRADED
TOTAL
GUIDELINES:
1. This form shall be accomplished every end of the month using the summary box of SF2 submitted by the teachers/advisers to update figures for the month.
2. Furnish the Division Office with a copy a week after June 30, October 30 & March 31
Page _____ of _____ pages
District
School Year
DROPPED OUT
TRANSFERRED OUT
(A+B) Cumulative as of (A) Cumulative as of
End of the Month
Previous Month
M
TRANSFERRED IN
(A+B) Cumulative as of (A) Cumulative as of
End of the Month
Previous Month
M
(A+B) Cumulative as
of End of the Month
M
Region
Division
School ID
School Year
School Name
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT
column is for K to 12 Curricu
level that are still im
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
TOTAL MALE
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT
column is for K to 12 Curricu
level that are still im
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT
column is for K to 12 Curricu
level that are still im
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
TOTAL FEMALE
COMBINED
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT
column is for K to 12 Curricu
level that are still im
List of Graduates)
District
Curriculum
Grade Level
Section
LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)
MALE
FEMALE
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
TOTAL
LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)
FEMALE
BEGINNNING
(B: 74% and below)
ADVANCED
(A: 90%
and above)
PREPARED BY:
Class Adviser
(Name and Signature)
TOTAL
LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)
School Head
(Name and Signature)
REVIEWED BY:
GUIDELINES:
1. For All Grade/Year Levels
2. To be prepared by the Adviser. Final rating per subject area should
be taken from the record of subject teachers. The class adviser should
compute for the General Average.
3. On the summary table, reflect the total number of learners
promoted, retained and *irregular (*for grade 7 onwards only) and the
level of proficiency according to the individual General Average.
LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)
4. Must tally with the total enrollment report as of End of School Year
GESP /GSSP (EBEIS)
5. Protocols of validation & submission is under the discretion of the
Schools Division Superintendent
School Form 5: Page ____ of ________
School ID
Region
Division
School Name
District
GRADE 1 /GRADE 7
GRADE 2 / GRADE 8
GRADE 3 / GRADE 9
GRADE 4 / GRADE 10
SUMMARY TABLE
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
BEGINNNING
74% and below)
DEVELOPING
75%-79%)
(B:
(D:
APPROACHING PROFICIENCY
(AP: 80%-84%)
PROFICIENT
(P: 85%
-89%)
ADVANCED
90% and above)
(A:
TOTAL
Noted by:
DIVISION REPRESENTATIVE
GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the grade level total and school total.
2. This report together with the copy of Report for Promotion submitted by the class adviser shall be forwarded to the Division Office by the end of the school year.
3. The Report on Promotion per grade level is reflected in the End of School Year Report of GESP/GSSP.
4. Protocols of validation & submission is under the discretion of the Schools Division Superintendent.
f Proficiency
School Year
GRADE 5 / GRADE 11
GRADE 6 / GRADE 12
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
School ID
Region
Division
School Name
District
Number of
Incumbent
(as it ap
contract/document: Teach
Guard, Driver etc.)
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
GUIDELINES:
1. This form shall be accomplished at the beginning of the school year by the school head. In case of movement of teachers and other personnel during the school year, an updated Form 19 must be subm
Office .
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank down to the lowest.
3. Please reflect subjects being taught and if teacher handling advisory class or Ancillary Assignment. Other administrative duties must also reported.
4. Daily Program Column is for teaching personnel only.
Assignment List,
Teachers)
School Year
(C ) Other Appointments and Funding Sources
esignation
Appointment:
(Contractual, Substitute, Fund Source
Volunteer, others
(SEF, PTA, NGO's etc.)
specify)
Number of Incumbent
Teaching
NonTeaching
DAY
(M/T/W/TH/
F)
From
(00:00)
DAY
(M/T/W/TH/
F)
From
(00:00)
DAY
(M/T/W/TH/
F)
From
(00:00)