Enclosure No. 2 to DepEd Order No. 89, s.

2012
DEPARTMENT OF EDUCATION
EARLY REGISTRATION
School ID:
School Name:

Region:
Division:
School District:
Kindergarten/Grade/Year Leve l & Section

No.

NAME

SEX

AGE

BIRTHDATE

Address

(mm-dd-yyyy)

(Brgy, Mun., Prov.)

(in year-month)
(Surname, First MI)
A-Z

(Male;
Female)

as of
June 03, 2013

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14
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Remarks*:
1. For Grade 1 Registrants: Has attended/not attended Kindergarten class
2. For ALS: Information whether the child/youth prefers to learn through ADM=Alternative
Delivery Mode (MISOSA, e-IMPACT, DORP) or ALS=Alternative Learning System
Category of Child/Youth with Disability**: Visual Impairment, Hearing Impairment, Intellectual Disability,
Learning Disability, Speech/Language Impairment, Serious Emotional Disturbance, Autism, Orthopedic
Impairment, Health Problem, Multiple Disabilitties

Submitted by:
designed by:
datch_051981@yahoo.com

Name and Signature of Class Adviser

1/14/2013

Cell Phone Number

Form 1

ARMM
Maguindanao I

Category of
Children/Youth
with Disability**
(for C/Y with
Disability Only

ature of Class Adviser

Remarks*
Birthdate
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one Number