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SGOD-Planning and Research Section

SGOD-PARS Form 1
LIS Approval Sheet
ISO 9001:2015

Requester Name

Contact Number

E-mail Address

School Name

Designation

Detailed Description of the LRN


Learner
First Name :

Middle Name :

Last Name :
Birthday

Gender

Area of Concern and Issues ____ LRN Approval


( Please Check) ____ Enrolment of Ineligible
____ Enrolment of learner with Gap
____ Correction of Grade Level

Submitted Documents ____Birth certificate


(Please check) ____ Form 137
____ Form 138

Action taken _____ Approved Request


_____ Disapproved Request due to
___________________________________________________
___________________________________________________
___________________________________________________

CARMENA A. GOZO
Planning Officer III

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