ALTE

MASTERLIST OF MAPPED

District USON SOUTH Division: M

COMPLETE HOME ADDRESS

Sex (M/F)
NAME IP
Date of Birth Mother
(Last Name, First Name, Name Extension, Age (Yes or Religion
(mm/dd/yyyy) Tongue
Middle Name) No) House No./Street/
Barangay
Sitio/ Purok

ROMAN
LERA, NEDILITO LIBOT M 3/5/1975 42 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
LERA, MICHAEL PENA M 11/14/1998 19 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
LERA, MYLEN PENA F 9/25/2000 17 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
LERA, MICHELLE PENA F 12/23/2002 15 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
LERA, MICO PENA F 2/10/2006 11 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
LERA, MIDILYN PENA F 11/19/2007 10 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
IGLESIA NI
LALAGUNA, RODOLFO ARMA M 6/10/1946 71 MINASBATE PUROK 1 MONGAHAY
CRISTO
IGLESIA NI
CANLAS, MEGELA CONDE F 9/10/1937 80 MINASBATE
CRISTO
PUROK 1 MONGAHAY
ROMAN
CATARUNGAN, GINA ABAN F 10/28/1963 54 MINASBATE PUROK 1 MONGAHAY
CATHOLIC
CATARUNGAN, ALFRED M 4/16/1999 18 MINASBATE MONGAHAY
ROMAN
GASID, ALDRICK TAMAYO M 8/24/1977 40 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
BUHAGIN, GERALDINE CANTORIA F 2/26/1979 38 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
GASID, GEDRICK BUHAGIN M 9/8/2003 14 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
GASID, SEDRICK BUHAGIN M 5/11/2005 12 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
GASID, JORICK BUHAGIN M 4/16/2009 8 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
GASID, JOHN EDRICK BUHAGIN M 12/6/2012 5 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
ROMAN
GASID, HANYRICK PEREZ M 9/17/1980 37 MINASBATE
CATHOLIC
PUROK 1 MONGAHAY
F 38 ROMAN
OLIVA, ANABEL GARDE 12/12/1979 MINASBATE PUROK 1 MONGAHAY
CATHOLIC
MAPPED LEARNERS as of (MM/DD/YY)

MALE

FEMALE

TOTAL
 Department of Education
ALTERNATIVE LEARNING SYSTEM
OF MAPPED AND POTENTIAL LEARNERS (AF1)

MASBATE Region V Calenda

TE HOME ADDRESS PARENTS

Contact Number of Last Grade Level

Date Mapped
Learner Completed in Formal
Mother's Maiden Name (Last (mm/dd/yyyy)
Municipality/ Father's Name (Last Name, First (if available) School
Province Name, First Name, Middle
City Name, Middle Name)
Name)

USON MASBATE LERA, CARLITO ATABAY LIBOT, SONIA LALAGUNA GRADE 6 12/20/2017

USON MASBATE LERA, NEDILITO LIBOT PENA, ELISA BELLO GRADE 6 12/20/2017

USON MASBATE LERA, NEDILITO LIBOT PENA, ELISA BELLO GRADE 6 12/20/2017

USON MASBATE LERA, NEDILITO LIBOT PENA, ELISA BELLO GRADE 5 12/20/2017

USON MASBATE LERA, NEDILITO LIBOT PENA, ELISA BELLO GRADE 3 12/20/2017

USON MASBATE LERA, NEDILITO LIBOT PENA, ELISA BELLO GRADE 2 12/20/2017

USON MASBATE LALAGUNA, LITO RIVERA ARMA, NILDA SENA GRADE 6 12/20/2017

USON MASBATE CANLAS, JUAN MALANA CONDE, NORA MARCOS GRADE 6 12/20/2017
CATARUNGAN, ANDREW
USON MASBATE LAO ABANO, TESSA MAHINAY GRADE 4 12/20/2017

GRADE 5 12/20/2017

USON MASBATE GASID, PATRICK DAMAYO TAMAYO, MERA LIBOT 4TH YR. HS 12/20/2017
BUHAGIN, RODOLFO CANTORIA, ALONA
USON MASBATE TUPAS BUNCARAS
4TH YR. HS 12/20/2017
BUHAGIN, GERALDINE
USON MASBATE GASID, ALDRICK TAMAYO CANTORIA
GRADE 8 12/20/2017
BUHAGIN, GERALDINE
USON MASBATE GASID, ALDRICK TAMAYO CANTORIA
GRADE 7 12/20/2017
BUHAGIN, GERALDINE
USON MASBATE GASID, ALDRICK TAMAYO CANTORIA
GRADE 4 12/20/2017
BUHAGIN, GERALDINE
USON MASBATE GASID, ALDRICK TAMAYO CANTORIA
KINDER 12/20/2017

USON MASBATE GASID, EDRICK YTANG PEREZ, ALONE GUAGNE 2ND YR. COLL. 12/20/2017

USON MASBATE OLIVA, FRANK RAMOS GARDE, NIDA SEBELINA 2ND YR. COLL. 12/20/2017
ENROLLED LEARNERS as of Prepared By:
(MM/DD/YY)
ANTONIA U. MANANGAT
Signature of Facilitator over Printed Name
MALE

FEMALE

Certified Correct: Signature of PSDS over Printed Name

TOTAL
 Calendar Year 2017

REMARKS

If already enrolled in
Interested in ALS? If Yes, Preferred ALS, provide date of
Yes or No Program first attendance (DOFA)
and LRN

NO INFORMAL

NO INFORMAL

NO INFORMAL

NO

NO
NO

NO

YES INFORMAL

YES INFORMAL

YES INFORMAL

YES INFORMAL

YES INFORMAL

YES NON FORMAL

YES NON FORMAL

YES NON FORMAL

YES NON FORMAL

YES NON FORMAL

YES NON FORMAL

ANTONIA U. MANANGAT
Signature of Facilitator over Printed Name

Signature of PSDS over Printed Name

SFRT 2017
AF2 Republic of the Philippines
Department of Education
ALTERNATIVE LEARNING SYSTEM
ALS ENROLMENT FORM (AF2)
Learner's Basic Profile

Date : LRN (if available) :

Personal Information (Part I)

Last Name First Name Middle Name Name Extension

• Address:
House No./Street/Sitio Barangay Municipality/City Province
• Birthdate (mm/dd/yyyy): _____/_____/________ Place of Birth (Municipality/City)

• Sex: □Male □Female • Civil Status: □Single □Married □Widow/er □Separated □Solo Parent
• Religion: ____________• IP (Specify ethnic group) : ______________ • Mother Tongue : _______________ PWD: □Yes □No
• Name of Father/Legal Guardian

Last Name First Name Middle Name Occupation

• Mother's Maiden Name

Last Name First Name Middle Name Occupation

Educational information (Part II)

• Last grade level completed
Elementary : □K □G-1 □G-2 □G-3 □G-4 □G-5 □G-6
Secondary : □G-7 □G-8 □G-9 □G-10
• Why did you drop out of school? (For OSY only)
□No school in Barangay □School too far from home □Needed to help family
□Unable to pay for miscellaneous and other expenses Others:

• Have you attended ALS learning sessions before? □YES □NO

If Yes:
Name of the Program: _____________________________________________ Level of Literacy: □Basic □Elem. □Sec. □InfEd
Year Attended: ___________ Have you completed the Program? (Yes/No) _______
If NO, state the reason:

Accessibility and Availability (Part III)

• How far is it from your home to your Learning Center? in kms in hours and mins.
• How do you get from your home to your Learning Center? □Walking □Motorcycle □Bicycle □Others (Pls. Specify) ___________
• When can you attend your Learning Session?

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

What specific time

can you be at your
Learning Center?

_______________________________________ _____________________________
Facilitator: Signature and Date Learner: Signature and Date
SFRT 2017
 Republic of the Philippines
Department of Education

District USON MASBATE Division MASBATE Region V

PROGRAM ENROLLED Assessmen

Literacy

PIS Score
Sex (M/F)

NAME
Birthdate Mother
(Last Name, First Name, Middle Age
(mmddyyyy) Tongue

Basic Literate
Name, Name Extension)
Type of
Mode of Program Delivery
Program

<=== TOTAL MALE

<=== TOTAL MALE

<=== COMBINED

Learners Enrolled by Learners Enrolled

Program
Male Female Total
by Program Delivery
Male

BLP Face to Face

A&E Elem. Independent Learning
A&E Sec. Radio-based Instruction
InFED Computer-based Instruction
Learners Enrolled in
BLP Male Female Total Enrolled Learners Male
by Level
Basic Literate Number of 4P's Learners
Neo Literate Percent of Enrolled 4P's Learners
Post Literate
 AF-3

Calendar Year 2017

NON FORMAL EDUCATION

ssessment for Basic

Functional Literacy Assessment (FLT) Score
Literacy (ABL) End of
Program/ Remarks
Post Literate
Neo Literate

CY Status
Listening & Overall
Reading Numeracy Writing
Speaking Score

Female Total
Prepared By:

Signature of Facilitator over Printed Name

Female Total Certified Correct By:

Signature of PSDS over Printed Name

F-3
 Republic of the Philippines
Department of Education
ALTERNATIVE LEARNING SYSTEM
MASTERLIST OF A&E REGISTRANTS (AF-4)
District Division Region

Place of Registration Center

(Name of School/Center, Barangay, Municipality)
(Testing Center) (Barangay) (Municipality/City)

NAME CLC DETAILS

Sex (M/F)

Birthdate
A&E Test Level Date
LRN CLC
(Last Name, First Name, Middle Registered Registered
CLC Name Barangay Municipal
Name, Ext) Type

<=== TOTAL MALE

<=== TOTAL FEMALE

<=== COMBINED

Registered Male Female Total Prepared By:

Elementary Signature of Facilitator over Printed Name
Secondary
 Taker Male Female Total Certified Correct By:
Elementary
Secondary Signature of PSDS/DC over Printed Name
 AF-4

y/City)

Date of
Examination

ed Name
ed Name
 Republic of the Philippines
Department of Education
ALTERNATIVE LEARNING SYSTEM

LEARNER'S PERMANENT RECORD (AF-5)

DISTRICT: DIVISION: REGION:

LEARNER'S INFORMATION LRN:_________________

___
LAST NAME: FIRST NAME: _____________________ NAME EXTENSION: ______ MIDDLE NAME: ___________

ADDRESS:
HOUSE NO./ SITIO / ST. BARANGAY MUNICIPALITY/CITY PROVINCE

BIRTHDATE: MONTH _____/ DATE__________ / YEAR______________ SEX: Male Female

LEARNER'S EDUCATIONAL STATUS

Program Enrolled : Program Enrolled :
Delivery Mode : Delivery Mode :
CLC Name : CLC Name :
CLC Address : CLC Address :
Name of Facilitator : Name of Facilitator :
Calendar Year : Calendar Year :

Score Score
ASSESSMENT RESULTS ASSESSMENT RESULTS
Pre Post Pre
PIS Score PIS Score
Assesment for Basic Literacy (ABL) Pre Post Assesment for Basic Literacy (ABL) Pre
Basic Literate Basic Literate
Neo Literate Neo Literate
Post Literate Post Literate
Functional Literacy Assessment Pre Post Functional Literacy Assessment Pre
FLT Score in Reading FLT Score in Reading
FLT Score in Numeracy FLT Score in Numeracy
FLT Score in Writing FLT Score in Writing
FLT Score in Listening & Speaking FLT Score in Listening & Speaking
Overall Score 0 0 Overall Score 0
InfEd Remarks InfEd Remark

A & E STATUS Remarks A & E STATUS

Program Status Program Status
Test Taken Test Taken
Date of Examination Date of Examination
Testing Center Testing Center
Location of Testing Center Location of Testing Center
Accreditation and Equivalency (A&E) Test Result Accreditation and Equivalency (A&E) Test Result

Certificate of Transfer Certificate of Transfer

Eligible for Admission to : Eligible for Admission to :
 Certificate of Good Moral Character Certificate of Good Moral Character
This is to certify that the above-named is a learner of good moral character. This is to certify that the above-named is a learner of good moral charac
This certification is issued upon request of the concerned individual due to This certification is issued upon request of the concerned individual due
his/her desire to pursue formal schooling/other CLC or for employment. his/her desire to pursue formal schooling/other CLC or for employment.

Prepared By: Certified Correct By: Prepared By: Certified Correct By:

Facilitator PSDS/District Coordinator/EPSA Facilitator PSDS/District Coordinato

 AF-5

______________

___________________

CE

Female

Score
Post

Post

Post

0
Remarks

Remarks
racter
moral character.
dividual due to
mployment.

Coordinator/EPSA