Republic of the Philippines

DEPARTMENT OF EDUCATION
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN
Lingayen

SCHOOL STANDARD FAMILY REUNIFICATION RELEASE FORM

School Year 2019-2020

SCHOOL ANDA INTEGRATED SCHOOL

GRADE AND SECTION 5-MATIYAGA
NAME OF CLASS ADVISER RUSTY J. DELA CRUZ
EMERGENCY and DATE

Location(meeting place for Released to (Write the name if not

No. Name of Learner Name of Parent/Guardian/Fetcher Contact No. Signature
reinification the same with Column 3)

1 ACQUILITA, JAYSON CABALQUINTO ARQUILITA, DEOGRACIAS

MOSTOLES
2 BAS, MARJELO CASPE BAS, LORENZO 09078115926
3 CABALLERO, NORIEL SALTING 09308512479/092
CABALLERO, DANIEL CATIVO
19630511
4 CABAONG, LUIS JENN MOLINA CABAONG, JULIUS MAGBANUA 09486994339
5 CACHO, LAURENCE ASPA CACHO, PERFECTO CAIGA 09383261144
6 CALE, CJ MIRADOR CALE, JAMES MIRADOR
7 CALICDAN, MARK LANCE ANDAJER CALICDAN, RICHEL ALVIOR
8 CAPA, ADRIAN PAUL CORPUZ CAPA, SAMSON MACADENDEN 09302851033
9 CARANAY, JAYDEN RUSSEL
CARANAY, JOLLY BOY CAMBA 09460269078
MENSALVAS
10 CASIS, JAY IAN GARIBAY CASIS, EDWIN CAMBA JR 09489784811
11 CATAP, MICHAEL JR CATABAY CATAP, MICHAEL MANZANO JR 09309874647
12 CELESTE, EMMANUEL OFRANCIA CELESTE, PERCIVAL CABUNGAN 09501431234
13 CONSUELO,DANIEL, ABRIGO CONSUELO, DAN GAMUEDA 09187693285
14 LAROCO, JOSEPH EMMANUEL
LAROCO, LESTER LAZO 09070262224
TUGADE
15 MENDOZA,JOMAR, MENDOZA 09303958768
16 REGACHO, CHRISTIAN CACHO REGACHO, ARTURO CADLAON 09468945937
17 TAGLUCOP, JOSHUA CARIñO TAGLUCOP, MARLON CRUEL
18 TOLEDO, MARLON ACENAS TOLEDO, MARVIN DELA RAGA 09465087297
19 ASPA, JUDY ANN SANTOS ASPA, JOEY ALURA 09081990685
20 CABALQUINTO,AYUMI, CARIDO CABALQUINTO, RONNIE CALUYA 09107719096
21 CALE,ANGELICA, CANIEDO CALE, PETER CARRANZA 09090322598
22 CAROLINO, ELAIZA MAE HAGUNOS CAROLINO, MACARIO BAUZON 09070260439
23 DELOS SANTOS, EMY ROSE DE
DELOS SANTOS, EMIL CABALLAR 09770846204
CASTRO
24 ESON,DIVINE, CAROLINO ESON, REDEN NERPIO 09107780087
25 LAZO, DONNA MAY CACHO LAZO, DOMECIANO CACHO JR 09077997133
26 MEDINA, ANGEL GRACE CASTA MEDINA, ARTHUR CUESTA 09198391446
27 MOLINA, RAINE MERIAN CELESTE MOLINA, ROMERO PALEB 09217381469
28 SALTING, MARY ANN VALERA SALTING, ROLANDO CABALLAR 09104100872
29 SALVATUS PRINCESS LIERAH CARRION, ORLIE C. 09301132800
30 SUAREZ, SHANE ANN TESORO SUAREZ, RYAN VASQUEZ
31 TEJANO, CHARMINE ANGELIKA
TEJANO, RONNIE TORINO JR 09187396029
GARIBAY
32 TUAZON, RAEVEN MITCH DETERALA TUAZON, RONALD ANINGO 09384864253
Remarks (Released by and time
of release)