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CITY GOVERNMENT OF SAN PABLO

DALUBHASAAN NG LUNSOD NG SAN PABLO


CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS


Fil 3 / DALUMAT NG/SA FILIPINO
Course Code/Title
Program/Year/Section: BSEd II B-Filipino
Semester : 1ST Academic Year : __2019-2020____
Instructor : Carlo Vallies Time/Days : 8:00-9:30 a.m./ MW
Academic Rank : __________________ No. of Students : 23
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
PRELIM MIDTERM FINAL
Name of Students
No. Signature and Signature Signature and Remarks
(Last Name, Given Name, M.I.)
Date and Date Date
1. ALCANTARA, MICHAEL V.
2. ALIMAGNO, LYDIA A.
3. AQUINO, RUBY ANN JOY C.
4. AQUIVIDO, MARK LOUIE J.
5. ARAGON, DEOLI M.
6. ARCEO, MIZAH SHYLA R.
7. BALMES, JANINE M.
8. BICLAR, CHRISTIAN M.
9. BON, LLOYD BRYANT E.
10. CABUHOC, MELODY JOY M.
11. CALLEJO, JEROME B.
12. DECAL, ISABELA NICOLE C.
13. DELA CRUZ, PENKIER VILLE
A.
14. DORIA, MA. KEESHIA M.
15. DUCOT, ERIC JOHN P.
16. FALIBLE, CHRISTIAN DARYLL
L.
17. GIMENA, NICA SAMANTHA C.
18. KALAW, LEIZL B.
19. PERAJA, JOMARK L.
20. PONTIPEDRA, JOSEPH D.
21. REYES, DAISY B.
22. ROBLES, JEWEL S.
23. SARMIENTO, ROYETTE C.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.

Submitted by:
Noted:
_______________________
Carlo Vallies
__________________________
Dr. Julieta P. Donato

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1
ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS
Fil 3 / DALUMAT NG/SA FILIPINO
Course Code/Title
Program/Year/Section: BSEd II A-Filipino
Semester : 1ST Academic Year : __2019-2020____
Instructor : Carlo Vallies Time/Days : 9:30-11:00 a.m./ MW
Academic Rank : __________________ No. of Students : 25
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
PRELIM MIDTERM FINAL
Name of Students
No. Signature and Signature Signature and Remarks
(Last Name, Given Name, M.I.)
Date and Date Date
1. ATIENZA, ARVIN F.
2. ATIENZA, HENRY JR. A.
3. BANAL, JOSHUA W.
4. BAUTISTA, VANESSA R.
5. BOSINOS, MARJORIE L.
6. CASTILLO, JERSON B.
7. DACUYA, CHRISCIAN FRANCES V.
8. DE LEON, JOCELLE R.
9. DE LEON, JOHN ROMEL P.
10. EGAMAO,KRISTINE AIRISH A.
11. EMPIMANO,RYAN
CHRISTOPHER N.
12. EXCONDE, JOHN
BENEDICT N.
13. GEROSA, RONMARK C.
14. GRUTAS, MICHELLE D.
15. HERNANDEZ, AUGUSTINE G.
16. MANZANO,DIANNE
CHRYSTINE D.
17. MARTIREZ,HAZEL JOY E.
18. MOJICA, MARIA FHE C.
19. NOPIA, EDMAR C.
20. PABELONIA, AUBREY M.
21. PABLO, ROSE ANN I.
22. SAN JUAN, JOHN REY D.
23. SEBASTIAN, LYKA D.
24. TESICO, JENELLA LOUISSE G.
25. VILLEGAS, MELANIE O.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.

Submitted by:
Noted:
_______________________
Carlo Vallies
__________________________

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

Dr. Julieta P. Donato

Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1
ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS
Fil 3 / DALUMAT NG/SA FILIPINO
Course Code/Title
Program/Year/Section: BEEd II B
Semester : 1ST Academic Year : __2019-2020____
Instructor : Carlo Vallies Time/Days : 2:00-3:30 p.m./ MW
Academic Rank : __________________ No. of Students : 18
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
PRELIM MIDTERM FINAL
Name of Students
No. Signature and Signature Signature and Remarks
(Last Name, Given Name, M.I.)
Date and Date Date
1. ALBA, MARY JUNE E.
2. ALVAREZ, HAZEL L.
3. ARAMIL, FILIPINA C.
4. BORGONIA, MITZI C.
5. BORJA, PEARLY ANN
6. CULABAN, RECHER ERICKA
C.
7. DE LA TORRE, PRINCESS L.
8. ENRIQUEZ, JESSALYN E.
9. ESTROPE, ELENA M.
10. GUTIERREZ, JENNY L.
11. MARASIGAN, GISELLE I.
12. NEGOY, EUNICE P.
13. QUERONA, SHAIRA C.
14. RAMIREZ, LYKHA D.
16. RIVERA, RAIZA B.
17. ROXAS, MARIA CLARAMAY F.
18. SOLIS, VINCENT
19. VELASCO, PRINCESS DIANE
M.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.

Submitted by:
Noted:
_______________________
Carlo Vallies

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

__________________________
Dr. Julieta P. Donato

Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1

ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS


Fil 3 / DALUMAT NG/SA FILIPINO
Course Code/Title
Program/Year/Section: BSEd II Soc Stud
Semester : 1ST Academic Year : __2019-2020____
Instructor : Carlo Vallies Time/Days : 3:30-5:00 p.m./ MW
Academic Rank : __________________ No. of Students : 38
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
PRELIM MIDTERM FINAL
Name of Students
No. Signature and Signature Signature and Remarks
(Last Name, Given Name, M.I.)
Date and Date Date
1. Amante, Princess Reivee
2. Amat, Josefina
3. Artigas, Edgardo Jr.
4. Avila, Mar Jay
5. Cantor, Rhe-Ann
6. Carandang, Roseann
7. Carullo, John Aaron
8. Catipon, Angelica
9. Centeno, Micaella
10. Coronado, Francis Marie
11. Cosico, Yessamin
12. De Torres, Eleazar
13. Ema, Kathyrine
14. Esquivel, Jayrald
16. Estrellado, Ma. Olivia
17. Facundo, Gabriel
18. Hernandez, Jay Anne
19. Hopio, John Cyrus
20. Macazar, Marjorie
21. Malaluan, Glaiza
22. Manalo, Maria Angilla
23. Manalo, Neil Jay
24. Marasigan, John Christian
25. Mayo, Siena
26. Mercado, Edmalyn
27. Miralles, Cindy
28. Montalban, Sheila Marie
29. Nuarin, Clarisse Mae
30. Polecena, Anna Marie Gabriella
31. Ramira, Joanna Marie
32. Reyes, Angelito II
33. Reyes, April Joyce
34. Romero, Genesis Jhoy
35. Roque, Roman Gabriel
36. Tiquis, Lovely Ellaine
37. Tuico, John Rovic
38. Villanueva, Marvin
38. Yason, Mary Grace

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

Submitted by: Noted:


_______________________
Carlo Vallies
__________________________
Dr. Julieta P. Donato

Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1
ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS
Fil 107 / KULTURANG POPULAR
Course Code/Title
Program/Year/Section: BSEd II B-Filipino
Semester : 1ST Academic Year : __2019-2020____
Instructor : Carlo Vallies Time/Days : 5:00-6:30 a.m./ MW
Academic Rank : __________________ No. of Students : 19
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
Name of Students PRELIM MIDTERM FINAL
No. (Last Name, Given Name, Signature and Signature and Signature and Remarks
M.I.) Date Date Date
1. ALCANTARA, MICHAEL V.
2. ALIMAGNO, LYDIA A.
3. AQUINO, RUBY ANN JOY C.
4. AQUIVIDO, MARK LOUIE J.
5. ARAGON, DEOLI M.
6. ARCEO, MIZAH SHYLA R.
7. BALMES, JANINE M.
8. BICLAR, CHRISTIAN M.
9. DECAL, ISABELA NICOLE
C.
10. DORIA, MA. KEESHIA M.
11. DUCOT, ERIC JOHN P.
12. FALIBLE, CHRISTIAN
DARYLL L.
13. GIMENA, NICA SAMANTHA
C.
14. KALAW, LEIZL B.
15. PONTIPEDRA, JOSEPH D.
16. REYES, DAISY B.
17. ROBLES, JEWEL S.
18. SARMIENTO, ROYETH C.
19. BON, LLOYD BRYANT E.
20.
21.
22.
23.
24.
25.
27.
28.
29.
30.
31.
32.
33.
34.
35.

Submitted by:
Noted:

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

_______________________
Carlo Vallies
__________________________
Dr. Julieta P. Donato

Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1
ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS
Fil 4 / PANITIKANG FILIPINO
Course Code/Title
Program/Year/Section: BEEd III
Semester : 1ST Academic Year : __2019-2020____
Instructor : Carlo Vallies Time/Days : 8:00-9:30 a.m./ TTH
Academic Rank : __________________ No. of Students : 7
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
PRELIM MIDTERM FINAL
Name of Students
No. Signature and Signature Signature and Remarks
(Last Name, Given Name, M.I.)
Date and Date Date
1. CABRERA, EDGINE B.
2. DAVID, JANEN VEA P.
3. DELFINO, JOHN MIKKO A.
4. GELIZON, RICA SAMANTHA H.
5. MOLDEZ ROSALIE M.
6. REYES, EZENITH M.
7. SERRANO, JHON REGGINS C.
8.
9.
10.
11.
12.
13.
14.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

38.

Submitted by:
Noted:
_______________________
Carlo Vallies
__________________________
Dr. Julieta P. Donato

Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1
ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS
DALUMAT NG/SA FILIPINO
Course Code/Title
Program/Year/Section: BSEd II English
Semester : 1ST Academic Year : __2019-2020____
Instructor : Carlo Vallies Time/Days : 11:00-12:30 p.m./ TTH
Academic Rank : __________________ No. of Students : 20
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
PRELIM MIDTERM FINAL
Name of Students
No. Signature and Signature Signature and Remarks
(Last Name, Given Name, M.I.)
Date and Date Date
1. ALMONTE, JOHN PAUL M.
2. ARATA, ANNE HERSHEY P.
3. ATIENZA, MECAELLA A.
4. BALIWAG, IVAN B.
5. FELIPE, RIZZ ANN
6. FLOR, THRICIA MAE H.
7. GUTIEREZ, JAIRA CLOVEL V.
8. MARIANO, ROSALINA L.
9. MATIENZO, REGINA A.
10. MUSICO, ROSE MARIE
11. PLATERO, YVOONE D.
12. RAMOS, ARLYN B.
13. REALINGO, CHEENA MAE A.
14. RECANA, MAYCEL L.
15. RIVERA, MARVIN O.
16. ROMASANTA, ALMIRA B.
17. SABINDO, ANGE L.
18. SANTOS, MA. NNYCON C.
19. URRIQUIA, JOEL ALBERT S.
21. VOCAL, GIRLIE V.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

37.
38.

Submitted by:
Noted:
_______________________
Carlo Vallies
__________________________
Dr. Julieta P. Donato

Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1
ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS
DALUMAT NG/SA FILIPINO
Course Code/Title
Program/Year/Section: BEEd II A
Semester : 1ST Academic Year : __2019-2020____
Instructor : Carlo Vallies Time/Days : 2:00-3:30 p.m./ TTH
Academic Rank : __________________ No. of Students : 19
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
PRELIM MIDTERM FINAL
Name of Students
No. Signature and Signature Signature and Remarks
(Last Name, Given Name, M.I.)
Date and Date Date
1. ARGUELLES, LAIKHA M.
2. CAAGBAY, HERCY B.
3. COMENDADOR, WENDIELYN
A.
4. COMENDADOR, JOSHUA C.
5. CONDINO, AILEEN M.
6. CORONADO, MARIEL
7. CORONADO, WHENADEL M.
8. DE VILLA, MA. ANTONETTE E.
9. DIOLE, PAULINE M.
10. DORADO, SHEILA C.
11. DULLER, MARINETH F.
12. ENGCO, JUDITH B.
13. FLORES, REALYN E.
14. HERNANDEZ, EASTER JOYCE
F.
15. LLANES, BEA M.
16. LUBIANO, KIM LOUIS A.
17. PANTONE, CINDY DIANNE V.
18. SERRANO, JHON REGGINS C.
19. TOLEDO, RICA ELLA G.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

35.
36.
37.
38.

Submitted by:
Noted:
_______________________
Carlo Vallies
__________________________
Dr. Julieta P. Donato

Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1
ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS
DALUMAT NG/SA FILIPINO
Course Code/Title
Program/Year/Section: BSEd II SCIENCE
Semester : 1ST Academic Year : __2019-2020____
Instructor : Carlo Vallies Time/Days : 3:30-5:00 p.m./ TTH
Academic Rank : __________________ No. of Students : 17
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
PRELIM MIDTERM FINAL
Name of Students
No. Signature and Signature Signature and Remarks
(Last Name, Given Name, M.I.)
Date and Date Date
1. CARRERAS, JAMEMHEA M.
2. CASTILLO, ROSE Z.
3. COSTALES, SHIARY LEIGH M.
4. GONZALES, CAMILLE D.
5. LAMOC, WJYSTHER S.
6. MACALAM, REYLAND U.
7. MARASIGAN, MA. WILMAE R.
8. MONTEJO, PRINCE KENNETH
O.
9. MORTIL, JOSHUA
10. OCTOMAN, GRACE SHELLA, C
11. PAGULAYAN, NICA ANGEL C.
12. PONTANOZA, PAULINE P.
13. REYES, BLEZE M.
14. SALOJO, MIKE IAN P.
15. TESICO, CHRISTIN G.
16. URREA, ANGELICA D.
17. MANAOG, ARRA CAMILLE S.
18.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

34.
35.
36.
37.

Submitted by:
Noted:
_______________________
Carlo Vallies
__________________________
Dr. Julieta P. Donato

Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1
ACKNOWLEDGMENT RECEIPT OF EXAMINATION PAPERS
KULTURANG POPULAR
Course Code/Title
Program/Year/Section: BSEd II A-Filipino
Semester : __1st______________ Academic Year : __2019-2020____
Instructor : __Carlo Vallies_______ Time/Days : 5:00-6:30 p.m. / TTH
Academic Rank : __________________ No. of Students : 26
This is to acknowledge receipt of EXAMINATION PAPER in the course stated above.
PRELIM MIDTERM FINAL
Name of Students
No. Signature and Signature Signature and Remarks
(Last Name, Given Name, M.I.)
Date and Date Date
1. ATIENZA, ARVIN F.
2. ATIENZA, HENRY JR. A.
3. BANAL, JOSHUA W.
4. BAUTISTA, VANESSA R.
5. BOSINOS, MARJORIE L.
6. CASTILLO, JERSON B.
7. DACUYA, CHRISCIAN FRANCES V.
8. DE LEON, JOCELLE R.
9. DE LEON, JOHN ROMEL P.
10. EGAMAO,KRISTINE AIRISH A.
11. EMPIMANO,RYAN CHRISTOPHER
N.
12. EXCONDE, JOHN BENEDICT.
N
13. GEROSA, RONMARK C.
14. GRUTAS, MICHELLE D.
15. HERNANDEZ, AUGUSTINE G.
16. MANZANO,DIANNE
CHRYSTINE D.
17. MARTIREZ,HAZEL JOY E.
18. MOJICA, MARIA FHE C.
19. NOPIA, EDMAR C.
20. PABELONIA, AUBREY M.
21. PABLO, ROSE ANN I.
22. SAN JUAN, JOHN REY D.
23. SEBASTIAN, LYKA D.
24. TESICO, JENELLA LOUISSE G.
25. VILLEGAS, MELANIE O.
26. FABRO, CHERIELEE
28.
29.
30.

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com
CITY GOVERNMENT OF SAN PABLO
DALUBHASAAN NG LUNSOD NG SAN PABLO
CHED Recognized Local College
TESDA Recognized Programs
ALCU Commission on Accreditation – Level 1 Accredited
Excellence • Leadership • Service Member, Association of Local Colleges and Universities
Member, Local Colleges and Universities Athletic Association, Inc.

31.
32.
33.
34.
35.
36.
37.
38.

Submitted by:
Noted:
_______________________
Carlo Vallies
__________________________
Dr. Julieta P. Donato
Form No.: DLSP-ACAD-F06 Revision No.: 01 Effectivity: January 21, 2019 Page 1 of 1

Address: Brgy. San Jose, City of San Pablo, Laguna Tel. no. (049) 523-6455/503-1269 E-mail: dlsp_reg@yahoo.com - (Registrar’s Office), dlspsanpablocity1997@gmail.com

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