ENGLISH 5

Name: __________________________________ Grade/Section: ________ Score: ___

School: ________________________________ Teacher: __________________________

FIRST QUARTER
WORKSHEET No. 15
Fill out Forms Accurately (School Forms)
Activity 1
Fill out the learner enrolment form below.

LEARNER ENROLMENT FORM

A. GRADE LEVEL AND SCHOOL INFORMATION

School Year: _______________________
Grade Level to enroll: ____________________
Name of School: ____________________________________
Address: ___________________________________________

STUDENT INFORMATION
Leraner Reference Number (LRN)

LAST NAME
FIRST NAME
MIDDLE NAME
EXTENSION NAME e.g. Jr., III (if applicable)__________________________

Date of Birth (Month/Day/Year)

Age
Place of birth _____________________
Citizenship _____________________
Religion _____________________

PARENT/ GUARDIAN INFORMATION

Father’s name Name________________________________________________
(Last Name) (First) (Middle Name)
Occupation_________________________

Mother’s name Name________________________________________________

(Last Name ) (First) (Middle Name)
Occupation_________________________

SCHOOLS DIVISION OF PASIG CITY 1

Caruncho Avenue, San Nicolas, Pasig City
Activity 2
Match the items in Column A with their descriptions in Column B. Write the
letter of the correct answer on blank provided.

COLUMN A COLUMN B

___________ 1. Name a. refers to where you are staying

___________ 2. Address b. the most important information
___________ 3. Citizenship c. it is the date when you were born
___________ 4. Date of birth d. refers to your nationality
___________ 5. Sex e. refers your gender, that is, either
male or female.

Activity 3
Fill out the learner admission form below.

ADMISSION FORM

STUDENT INFORMATION
Name_________________________________________________________________
(Last Name) (First Name) (Middle Name)

Learner Reference Number (LRN) _________________________

Schools Attended: ___________________________

Address_______________________________________________________
(House Number and Street) (Barangay)

_____________________________
(City/ Municipality)

Date of Birth (Month/Day/Year) _____________________

Age: ____________________

SCHOOLS DIVISION OF PASIG CITY 2

Caruncho Avenue, San Nicolas, Pasig City