S

(This

School ID Region IX Division

School Name

AGE as of IP
NAME Sex BIRTH DATE MOTHER
LRN 1st Friday (Ethnic
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) TONGUE
June Group)
 AGE as of IP
NAME Sex BIRTH DATE MOTHER
LRN 1st Friday (Ethnic
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) TONGUE
June Group)
 AGE as of IP
NAME Sex BIRTH DATE MOTHER
LRN 1st Friday (Ethnic
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) TONGUE
June Group)
 AGE as of IP
NAME Sex BIRTH DATE MOTHER
LRN 1st Friday (Ethnic
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) TONGUE
June Group)
 AGE as of IP
NAME Sex BIRTH DATE MOTHER
LRN 1st Friday (Ethnic
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) TONGUE
June Group)
 AGE as of IP
NAME Sex BIRTH DATE MOTHER
LRN 1st Friday (Ethnic
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) TONGUE
June Group)

List and Code of Indicators under REMARKS column

Indicator Code Required Information Code
 AGE as of IP
NAME Sex BIRTH DATE MOTHER
LRN 1st Friday (Ethnic
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) TONGUE
June Group)

Transferred Out T/O Name of Public (P) Private (PR) School & Effectivity Date CCT

Transferred IN T/I Name of Public (P) Private (PR) School & Effectivity Date B/A
Dropped DRP Reason and Effectivity Date LWD
Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) ACL
 School Form 1 (SF 1) School Register
(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)

District

School Year Grade Level Section

ADDRESS PARENTS

RELIGION House #/ Father's Name (Last Mother's Maiden Name

Municipality/
Street/ Sitio/ Barangay Province Name, First Name, (Last Name, First Name,
City
Purok Middle Name) Middle Name)
 ADDRESS PARENTS

RELIGION House #/ Father's Name (Last Mother's Maiden Name

Municipality/
Street/ Sitio/ Barangay Province Name, First Name, (Last Name, First Name,
City
Purok Middle Name) Middle Name)
 ADDRESS PARENTS

RELIGION House #/ Father's Name (Last Mother's Maiden Name

Municipality/
Street/ Sitio/ Barangay Province Name, First Name, (Last Name, First Name,
City
Purok Middle Name) Middle Name)
 ADDRESS PARENTS

RELIGION House #/ Father's Name (Last Mother's Maiden Name

Municipality/
Street/ Sitio/ Barangay Province Name, First Name, (Last Name, First Name,
City
Purok Middle Name) Middle Name)
 ADDRESS PARENTS

RELIGION House #/ Father's Name (Last Mother's Maiden Name

Municipality/
Street/ Sitio/ Barangay Province Name, First Name, (Last Name, First Name,
City
Purok Middle Name) Middle Name)
 ADDRESS PARENTS

RELIGION House #/ Father's Name (Last Mother's Maiden Name

Municipality/
Street/ Sitio/ Barangay Province Name, First Name, (Last Name, First Name,
City
Purok Middle Name) Middle Name)

mn
Prepared by:
Required Information REGISTERED BoSY EoSY
 ADDRESS PARENTS

RELIGION House #/ Father's Name (Last Mother's Maiden Name

Municipality/
Street/ Sitio/ Barangay Province Name, First Name, (Last Name, First Name,
City
Purok Middle Name) Middle Name)

CCT Control/reference number & Effectivity Date MALE

(Signature of Adviser over Printed Name)

Name of school last attended & Year FEMALE

Specify
TOTAL
Specify Level & Effectivity Data BoSY Date: EoSYDate:
GUARDIAN
REMARKS
(If not Parent)
Contact Number
of Parent or
Guardian (Please refer to the
Name Relation-ship
legend on last page)
GUARDIAN
REMARKS
(If not Parent)
Contact Number
of Parent or
Guardian (Please refer to the
Name Relation-ship
legend on last page)
GUARDIAN
REMARKS
(If not Parent)
Contact Number
of Parent or
Guardian (Please refer to the
Name Relation-ship
legend on last page)
GUARDIAN
REMARKS
(If not Parent)
Contact Number
of Parent or
Guardian (Please refer to the
Name Relation-ship
legend on last page)
GUARDIAN
REMARKS
(If not Parent)
Contact Number
of Parent or
Guardian (Please refer to the
Name Relation-ship
legend on last page)
GUARDIAN
REMARKS
(If not Parent)
Contact Number
of Parent or
Guardian (Please refer to the
Name Relation-ship
legend on last page)

Certified Correct:
 GUARDIAN
REMARKS
(If not Parent)
Contact Number
of Parent or
Guardian (Please refer to the
Name Relation-ship
legend on last page)

er over Printed Name) (Signature of School Head over Printed Name)

EoSYDate: BoSY Date: EoSYDate: