School Form-11 COOKERY

School Form 1 School Register for Senior High School (SF1-SHS)
School Name Independencia NHS School ID 303608 District TALALORA Division SAMAR Region VIII
Semester 1st School Year 2020-2021 Grade Level 11 Track and Strand COOKERY
Section UWAY Course (For TVL Only) HOME ECONOMICS
COMPLETE ADDRESS PARENTS GUARDIAN

(if learner is not Living with Parent) REMARKS
Sex (M/F)
NAME Contact Number
BIRTHDATE AGE Religious Mother's Maiden Name Name (Please refer to the legend)
LRN (Last Name, First Name, Name of Parent/
Extension, Middle Name)
(mm/dd/yyyy) Affiliation House No./ Street/ Municipality/ Father's Name (Last Name, First Name, (Last Name, First Name,
Sitio/ Purok Barangay Province (Last Name, First Name, Name Relationship Guardian
City Extension, Middle Name) Name Extension, Middle Name Extension, Middle
Name) Name)
APORTO, ARCADIO,
1 !123906090006 APORTO, FRANCIS, MARCELLANA M 8/2/2003 17 CHRISTIANITY KAWAYAN TATABUNAN TALALORA WESTERN SAMAR
TOMACA
APORTO, EMMALYN PARENT
INDEPENDEN CABRITO, REGINO, DANDAY, MARILOU,
2 !123895090013 CABRITO, REGINO M 7/11/2003 17 CHRISTIANITY
CIA
TALALORA WESTERN SAMAR
CALIPAYAN JR. CASOY
PARENT 9263316367
CAISEDO, PEDRO, CAISEDO, IRENE,
3 !123471060009 CAISEDO, JUSTINE, MERCADO M 08/19/1999 21 CHRISTIANITY PUROK 3 IQUIRAN DARAM WESTERN SAMAR
TUBILLA MERCADO
MOTHER 9756672837
GUINTAMPIL
4 !123454090003 CANACANA, ROLDAN, DONAIRE M 12/7/2003 17 CHRISTIANITY PUROK 1
AN
DARAM WESTERN SAMAR CANACANA, SARAH, D MOTHER 9487221524
GUINTAMPIL
5 !123454090004 CANEZARES, NATHAN, DANTE M 8/5/2003 17 CHRISTIANITY PUROK 2
AN
DARAM WESTERN SAMAR CANEZARES, GINA MOTHER 9550820530
GUINTAMPIL HERMO, SAMUEL, DONAIRE, ANALYNDA,
6 !123864070035 HERMO, JONEL, DONAIRE M 12/1/2003 17 CHRISTIANITY PUROK 2
AN
DARAM WESTERN SAMAR
PARAGATOS RARUGAL
PARENT 9264867479
7 MAHINAY, KIM CARBONILLA M CHRISTIANITY POB. BRGY. 1 TALALORA WESTERN SAMAR

BECHACHINO, PAULITA,
8 !508061901093 NICANOR, JOEY, BECHACHINO M 02/13/1994 26 CHRISTIANITY PUROK 2 IQUIRAN DARAM WESTERN SAMAR NICANOR, PRUTO, HIKE
CAISEDO
PARENT
PLUMENTERA, LITO, PLUMENTERA,
9 !123906090050 PLUMENTERA, LITO, BORRICO M 11/16/2003 17 CHRISTIANITY TATABUNAN TALALORA WESTERN SAMAR
BORRICO MARILYN, PECAJAS
PARENT
GUINTAMPIL VALDEZ, NORA,
10 !123442070041 VALDEZ, ARJAY, DONAIRE M 09/20/2002 19 CHRISTIANITY PUROK 3
AN
DARAM WESTERN SAMAR
DONAIRE
MOTHER 916859070
10 <=== TOTAL MALE
INDEPENDEN ABON, JARRY, ENVERZO, ELVIE,
1 !123895090001 ABON, GINALYN, ENVERZO F 01/25/2003 17 CHRISTIANITY
CIA
PAGADUAN ORBONG
PARENT
AUTENTICO, BANAWA, MARIA,
2 !123905090016 AUTENTICO, JULIE MAE BANAWA F 07/22/2004 16 CHRISTIANITY MACATO ST. BRGY. 1 TALALORA WESTERN SAMAR
GAUDENCIO, RARUGAL MISLOS
PARENT 9754214092
INDEPENDEN BALANTAD, PAQUITO, SIMBORIO, MA. JUANITA,
3 !12389509006 BALANTAD, EMMA, SIMBORIO F 07/18/2003 17 CHRISTIANITY PUROK 1
CIA
SABIAN MARAYA
PARENT 9658658215
BALENA, ARNIEL, CONDESA, MARIBEL,
4 !123905120105 BALENA, MARINEL, CONDESA F 03/18/2005 15 CHRISTIANITY PUROK 1 MACALPE DARAM WESTERN SAMAR
CABASIG CALIMA
PARENT 9659248025
CALIPAYAN,
5 !123901090003 CALIPAYAN, LOIDELYN F 10/3/2005 15 CHRISTIANITY PLACER TALLALORA WESTERN SAMAR
LEONARDO, R.
CALIPAYAN, LOIDA PARENT
GUINTAMPIL CANACANA, JOEL, BUCATCAT, JULIA,
6 !123454090002 CANACANA, JONA MARIE, F 01/22/2004 CHRISTIANITY PUROK 1
AN
DARAM WESTERN SAMAR
BELARDO BECHACHINO
MOTHER
NAVATAS CAPALAR, LITO,
7 !123898090007 CAPALAR, MELODY, COSTELO F 6/9/2003 17 CHRISTIANITY PUROK 3
DAKU
QUINTO, SR.
CAPALAR, MICHEL C. MOTHER 9556616041
8 !123471090012 CASOY, AXCEL ROSE F 09/28/2003 17 CHRISTIANITY BURGOS DARAM WESTERN SAMAR CASOY, SONNY, DINOSO CASOY, AGNES, CALIPAY PARENT 9557760902
9 !1234460067 CUBIAN, ABEGAIL, FATIMA F 10/31/2000 20 CHRISTIANITY BACLAYAN DARAM WESTERN SAMAR CUBIAN, NOEL CUBIAN, REGILYN PARENT 9974364149
10 !123460120015 CUYOS, RENGIE, DOSAL F 12/22/2002 18 CHRISTIANITY PRK. 1 POSO DARAM WESTERN SAMAR CUYOS, JEFFREY, LAZO CUYOS, LOIDA, DOSAL PARENT 9753446538
11 !123906090016 DALAMPASIG, JOSEPHINE F 08/20/2002 18 CHRISTIANITY KAWAYAN TATABUNAN TALALORA WESTERN SAMAR DALAMPASIG, JOSEPH CHUA, VIVIAN PARENT
DANDAY, MARIO, SANTISO, MARY GRACE,
12 !123905120103 DANDAY, MARY ROSE, SANTISO F 04/28/2003 17 CHRISTIANITY PUROK 2 MACALPI DARAM WESTERN SAMAR
SANSAN CABANGANAN
PARENT 9061885901
GUINTAMPIL
13 !123454090005 DANTE, MAE ,CAYAS F 03/22/2004 16 CHRISTIANITY
AN
DARAM WESTERN SAMAR DANTE, CORAZON MOTHER 9061728504
INDEPENDEN DE LUNA, EDGAR,
14 !123895090017 DE LUNA, JENNELYN, DALIMIT F 4/4/2003 17 CHRISTIANITY
CIA
BECHACHINO
DE LUNA, JOENA PARENT 9068818628
NAVATAS DE LUNA, ALMA,
15 !123899070011 DE LUNA, ROSEVIE F 10/20/2001 19 CHRISTIANITY PUROK 1
GUT
COBILLA
MOTHER 9651293964
GUINTAMPIL DONAIRE, JOSEPHINE,
16 !123454090006 DONAIRE, ERICKA, MARCELINO F 08/27/2002 18 CHRISTIANITY PUROK 1
AN
DARAM WESTERN SAMAR DONAIRE, FLORO, DATE
MARCELINO
PARENTS 9554872248
GUINTAMPIL DONAIRE, SEGUNDINO, DONAIRE, YVETTE,
17 !123454090007 DONAIRE, JEANILYN, MACARAIG F 02/18/2004 16 CHRISTIANITY PUROK 1
AN
DARAM WESTERN SAMAR
RARUGAL MACARAIG
PARENTS 9153982093
DOSAL, GERALDINE.
18 !123460090011 DOSAL, ANA ROSE, GOSON F 11/12/2002 18 CHRISTIANITY PUROK 1 POSO DARAM WESTERN SAMAR
GOSON
MOTHER 9168611028
DOSAL, GERALDINE.
19 !123460120017 DOSAL, MARIA ANDREA, GOSON F 01/24/2001 19 CHRISTIANITY PUROK 1 POSO DARAM WESTERN SAMAR
GOSON
MOTHER 9168611028
INDEPENDEN DUENA, ROGELIO, ZABALA, MARLITA,
20 !123402090005 DUENA, MARGIELYN, ZABALA F 03/17/2003 17 CHRISTIANITY PUROK 2
CIA
PAGLIAWA ARINO
PARENT 9973679927
DURANA, LEO,
21 !123901090007 DURANA, LEA M. F 17 CHRISTIANITY PUROK 1 PLACER TALALORA WESTERN SAMAR
CALIPAYAN
DURANA, EMY, M PARENT
INDEPENDEN ENCINARES, JENNELITA,
22 !123895010015 ENCINARES, ROSEMARIE F 10/13/2003 17 CHRISTIANITY PUROK 2
CIA
TALALORA WESTERN SAMAR CABRITO, ROY, VINAS
BOGAYAN
PARENT 9264580499
ESTRADA, PELAGIO, NICANOR, EMELINA, QUINABATO, DELMAR,
23 !123905090037 ESTRADA, ROSEMARIE,NICANOR F 11/6/2002 18 CHRISTIANITY PUROK 3 IQUIRAN DARAM WESTERN SAMAR
CRAME BAISA RESCO
MOTHER
INDEPENDEN FLORES, WILLY, SAYSON, MARILYN,
24 !123895090021 FLORES, MARYJOY, SAYSON F 06/16/2002 18 CHRISTIANITY PUROK2
CIA
QUIMUEL BACLA-AN
MOTHER 9974211452
GULPAN, FRANCISCO,
25 !123906090021 GULPAN, MYRNA, DAGTA F 1/4/2004 16 CHRISTIANITY KAWAYAN TATABUNAN TALALORA WESTERN SAMAR
CONGE
DAGTA, MYRA, TABOY PARENT 9552787978
INDEPENDEN ISANAN, GERARDO, ISANAN, SUCITA,
26 !123895090023 ISANAN, JESSICA, QUINAWAYAN F 06/27/2004 16 CHRISTIANITY PUROK 3
CIA
AGDON QUINAWAN
PARNET 9971446912
27 KISKISAN, ROCHELLE F 5/9/2003 17 CHRISTIANITY PUROK 1 PLACER TALALORA WESTERN SAMAR KISKISAN, ARCADIA MOTHER 9677554108
CABACONG
28 !123905070008 LABAGRIEL, RICA, OBIN F 6/9/2002 18 CHRISTIANITY
AN
POB. 1 TALALORA WESTERN SAMAR LABAGRIEL, RICARDO LABAGRIEL, VIOLETA PARENT 9530383580
LABITAO, JACQUELINE, BALENA, SALVADOR, LABITAO, ALICIA,
29 !123480490005
JAMINDANG
F 09/26/2004 16 CHRISTIANITY PUROK 3 MACALPE DARAM WESTERN SAMAR
LOSA JAMINDANG
PARENT 9532204428
LUMACANG, DIONESIO, LUMACANG, MARGIE,
30 !121185090030 LUMACANG, JAMAICA, QUITON F 10/2/2004 16 CHRISTIANITY PUROK 2 IQUIRAN DARAM WESTERN SAMAR
ADAY QUITON
PARENT 9656614980
MARAYA, JOEY, CASAMA, GEMMA,
31 !123460080027 MARAYA, JOYZELLE, CASAMA F 11/5/2003 17 CHRISTIANITY PUROK 2 MACALPE DARAM WESTERN SAMAR
RARUGAL SABIAN
PARENT
CABACONG MENDIOLA, SERGIO, AVESTRUZ, JOCELYN,
32 !123905060056 MENDIOLA, SHEENA, AVESTRUZ F 5/4/2001 19 CHRISTIANITY
AN
POB. 1 TALALORA WESTERN SAMAR
SABULAO LACABA
PARENT 9656908171
INDEPENDEN OBZUNAR, RODRIGO, VILLEGAS, ANGELYN,
33 !123895090027 OBZUNAR, IRISH JOY, VILLEGAS F 07/22/2004 16 CHRISTIANITY PUROK 1
CIA
PATRIMONIO ORBONG
PARENT 9978978588
GUINTAMPIL OBZUNAR, RODRIGO,
34 !123454090012 OBZUNAR, MARY JOYCE, VALDEZ F 6/4/2003 17 CHRISTIANITY PUROK 2
AN
DARAM WESTERN SAMAR
PATRIMONIO
VALDEZ, MIRASOL PARENT 9056517506
INDEPENDEN BUENA, ARNEL PATRIMONIO, EDNA,
35 !123895090028 OBZUNAR, JAY ANN F 09/18/2003 17 CHRISTIANITY
CIA
ESPINOSA OBZUNAR
PARENT
SFRT 2017
COMPLETE ADDRESS PARENTS GUARDIAN
(if learner is not Living with Parent) REMARKS
Sex (M/F)
NAME Contact Number
BIRTHDATE AGE Religious Mother's Maiden Name Name (Please refer to the legend)
LRN (Last Name, First Name, Name of Parent/
Extension, Middle Name)
(mm/dd/yyyy) Affiliation House No./ Street/ Municipality/ Father's Name (Last Name, First Name, (Last Name, First Name,
Sitio/ Purok Barangay Province (Last Name, First Name, Name Relationship Guardian
City Extension, Middle Name) Name Extension, Middle Name Extension, Middle
Name) Name)
NAVATAS OGANIA, GREGORIO, DECOSTO, ANDREA,
36 !123898090021 OGANIA, ANITA, D. F 09/23/2002 18 CHRISTIANITY PUROK 2
DAKU
PARAGATOS BUSTAMANTE
PARENT 9971598029
PAPIONA, RODEL, PAPIONA, MARICEL,
37 !123455090009 PAPIONA, MA. LOLITA, BERBES F 12/1/2004 16 CHRISTIANITY MACALPE DARAM WESTERN SAMAR
LACAMRA BERBES
PARENT
INDEPENDEN PATRIMONIO, LAGOT, JOSEPHINE,
38 !123895090029 PATRIMONIO, CRIS JOY,LAGOT F 09/20/2002 18 CHRISTIANITY PUROK 1
CIA
CRISANTO, MENDEZ CONGE
PARENT 9261566438
CITY OF PATRIMONIO, CAYA, MARCELINA,
39 !123905130070 PATRIMONIO, EDNA, CAYA F 10/18/2000 20 CHRISTIANITY TULO
CALAMBA
LAGUNA
CONRADO, DURANS DELGADO
PARENT
INDEPENDEN QUIMUEL, MARLON, MANICANE, MELISSA,
40 !123895090031 QUIMUEL, LAIZA MAE,MANICANE F 4/11/2004 16 CHRISTIANITY PUROK 1
CIA
AGARO RARUGAL
PARENT 9757208906
GUINTAMPIL RAANDAAN, FLORO, RAANDAAN, REBECCA,
41 !123454090015 RAANDAAN, REA JOY, VALDEZ F 09/27/2003 17 CHRISTIANITY PUROK 1
AN
DARAM WESTERN SAMAR
LIBONAO VALDEZ
PARENT 9202128539
LOS RARUGAL, TERESITO, PALDEZ, ESTER
42 RARUGAL, GINALYN PALDEZ F 03/22/1997 23 CHRISTIANITY
MARTINEZ
GAVARA CAMBOIO
PARENT
BONIFACIO SABINADA, SABINADA, LETECIA,
43 !123905090074 SABINADA, KAREN, MACINOPA F 02/25/2003 17 CHRISTIANITY
ST.
LEODEGARIO, ARAZA MACINOPA
PARENT
CABACONG
44 !123905090079 TIOZON, LYDELLE, BIONG F 03/16/2004 16 CHRISTIANITY
AN
POB. 1 TALALORA WESTERN SAMAR TIOZON, PEDRO B. TIOZON, LYDIA B. PARENT 9051003919
GUINTAMPIL VALDEZ, MARCELO, VALDEZ, NORA,
45 !123454090017 VALDEZ, ARIANNE, DONAIRE F 02/20/2004 16 CHRISTIANITY PUROK 1
AN
DARAM WESTERN SAMAR
CABASIG J. DONAIRE
PARENT 9168590070
VERSOZA, STELITO, BASANEZ, DAISY,
46 !12345690028 VERSOZA, JECEL, BASANEZ F 01/18/2002 18 CHRISTIANITY PUROK 3 POSO DARAM WESTERN SAMAR
GOLONG ALBEZA
PARENT 9551558335
VILLATURA, ROSE-ANN, INDEPENDEN VILLATURA, JHONIE, DEVOCION, RHEALYN,
47 !123895090035 F 8/8/2002 18 CHRISTIANITY PUROK 2 TALALORA WESTERN SAMAR PARENT 9058582625
DEVOCION CIA GULONG MANICANE
47 <=== TOTAL FEMALE

57 <=== COMBINED
Legend: List and Code of Indicators under REMARKS column
Beginning of the Prepared By:
Indicator Code Required Information Indicator Code Required Information REGISTERED End of the Semester
Semester
Transferred T/O CCT Recipient CCT CCT Control/reference
Out number & Effectivity Date
MALE 10
Balik Aral B/A Name of school last attended
Transferred In & Year RONA FE L. ONTUCA
T/I
Name of School, Date of 1st Learner With LWE
Specify Exceptionality of the 47 Signature of Adviser over Printed Name
Attendance and Date of Last Exceptionality Learner FEMALE
Specify Level & Effectivity
Attendance if Transferred Out Accelerated ACL Date
Beginning of the Semester Date:10/05/2020 End of the Semester Date:
TOTAL 57
SFRT 2017
School Form 2 Daily Attendance Report of Learners for Senior High School (SF2-SHS)
INDEPENDENCIA NHS-SENIOR HIGH
School Name School ID 303608 District TALLAORA Division SAMAR
SCHOOL
Semester FIRST School Year 2020-2021 Grade Level 11 Track and Strand
Section UWAY Course/s (only for TVL) HOME ECONOMICS- Month of

DATE
NAME Total for the Month
No. (Last Name, First Name, Name Extension, Middle 5 6 7 8 9 10 12 13 14 15 16 17 19 20 21 22 23 24 26 27 28 29 30 31
Name) M T W TH F S M T W TH F S M T W TH F S M T W TH F S M T W TH F S ABSENT TARDY
1 APORTO, FRANCIS, MARCELLANA
2 CABRITO, REGINO
3 CAISEDO, JUSTINE, MERCADO
4 CANACANA, ROLDAN, DONAIRE
5 CANEZARES, NATHAN, DANTE
6 HERMO, JONEL, DONAIRE
7 MAHINAY, KIM CARBONILLA
8 NICANOR, JOEY, BECHACHINO
9 PLUMENTERA, LITO, BORRICO
10 VALDEZ, ARJAY, DONAIRE
10 <=== MALE | TOTAL Per Day ===>
1 ABON, GINALYN, ENVERZO
2 AUTENTICO, JULIE MAE BANAWA
3 BALANTAD, EMMA, SIMBORIO
4 BALENA, MARINEL, CONDESA
5 CALIPAYAN, LOIDELYN
6 CANACANA, JONA MARIE,
7 CAPALAR, MELODY, COSTELO
8 CASOY, AXCEL ROSE
9 CUBIAN, ABEGAIL, FATIMA
10 CUYOS, RENGIE, DOSAL
11 DALAMPASIG, JOSEPHINE
12 DANDAY, MARY ROSE, SANTISO
13 DANTE, MAE ,CAYAS
14 DE LUNA, JENNELYN, DALIMIT
15 DE LUNA, ROSEVIE
16 DONAIRE, ERICKA, MARCELINO
17 DONAIRE, JEANILYN, MACARAIG
18 DOSAL, ANA ROSE, GOSON
19 DOSAL, MARIA ANDREA, GOSON
20 DUENA, MARGIELYN, ZABALA
21 DURANA, LEA M.
22 ENCINARES, ROSEMARIE
23 Err:509
24 ESTRADA, ROSEMARIE,NICANOR
25 FLORES, MARYJOY, SAYSON
26 GULPAN, MYRNA, DAGTA
27 ISANAN, JESSICA, QUINAWAYAN
28 KISKISAN, ROCHELLE
29 LABAGRIEL, RICA, OBIN
30 LABITAO, JACQUELINE, JAMINDANG
31 LUMACANG, JAMAICA, QUITON
32 MARAYA, JOYZELLE, CASAMA

HS)
SAMAR VIII
COOKERY
OCTOBER
REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If TRANSFERRED
IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).
DATE
NAME Total for the Month
No. (Last Name, First Name, Name Extension, Middle 5 6 7 8 9 10 12 13 14 15 16 17 19 20 21 22 23 24 26 27 28 29 30 31
Name) M T W TH F S M T W TH F S M T W TH F S M T W TH F S M T W TH F S ABSENT TARDY
33 MENDIOLA, SHEENA, AVESTRUZ
34 OBZUNAR, IRISH JOY, VILLEGAS
35 OBZUNAR, MARY JOYCE, VALDEZ
36 OGANIA, ANITA, D.
37 PAPIONA, MA. LOLITA, BERBES
38 PATRIMONIO, CRIS JOY,LAGOT
39 PATRIMONIO, EDNA, CAYA
40 QUIMUEL, LAIZA MAE,MANICANE
41 RAANDAAN, REA JOY, VALDEZ
42 RARUGAL, GINALYN PALDEZ
43 SABINADA, KAREN, MACINOPA
44 TIOZON, LYDELLE, BIONG
45 VALDEZ, ARIANNE, DONAIRE
46 VERSOZA, JECEL, BASANEZ
47 VILLATURA, ROSE-ANN, DEVOCION
47<=== FEMALE | TOTAL Per Day ===>
57----Combined TOTAL Per Day
No. of Days of Classes:

GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance (blank) - Present; (x) - Absent; Tardy (half shaded = Upper for OCTOBER 20
2. To compute the following: Late Comer, Lower for Cutting Classes)
* Enrolment (as of 1st Friday of the semester)
2. REASONS/CAUSES FOR NO LONGER IN SCHOOL Late Enrolment during the month (beyond cut-off)
a. Percentage of Enrolment = x 100 (NLS)

Registered Learners as of end of the month Registered Learners as of end of the month
Enrolment as of 1st Friday of the school year

a. Domestic-Related Factors Percentage of Enrolment as of end of the month
a.1. Had to take care of siblings Average Daily Attendance
Total Daily Attendance a.2. Early marriage/pregnancy
b. Average Daily Attendance =
Number of School Days in reporting month a.3. Parents' attitude toward schooling Percentage of Attendance for the month
a.4. Family problems
Number of students absent for 5 consecutive days
Average daily attendance
c. Percentage of Attendance for the month = x 100
Registered Learners as of end of the month
b. Individual-Related Factors
3. Every end of the month, the Class Adviser will submit this form to the Office of the Principal for recording of summary table into School Form 4. Once b.1. Illness
No Longer in School (NLS)
signed by the School Head, this form should be returned to the Class Adviser. b.2. Overage
4. The Class Adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days b.4. Drug Abuse
b.5. Poor Academic Performance
Transferred Out
and/or those at risk of dropping out. b.6. Lack of Interest/Distractions
5. Attendance performance of learners will be reflected in the SF9-SHS of every grading period. b.7. Hunger/Malnutrition Transferred In
Shifting Out
c. School-Related Factors Shifting In

c.1. Teacher Factor
c.2. Physical Condition of Classroom
c.3. Peer Influence
I certify that this report is true and correct:
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. tribal wars & clan feuds)
d.3. Calamities/Disasters Signature of Class Ad
e. Financial-Related
e.1. Child labor, work Attested By:
MARIA J
f. Others (Specify) Signature of School H
a. Death
b. Transferred to School Abroad
c. Transferred to International School
d. Transferred to ALS
REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If TRANSFERRED
IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).
No. of Days of Classes:

Summary
20 M F TOTAL
the semester) 9 48 57
0 0 0
h (beyond cut-off)
9 47 56
of the month
end of the month
he month
5 consecutive days
ol (NLS) 0 0
ut
port is true and correct:
RONA FE L. ONTUCA
Signature of Class Adviser over Printed Name
MARIA J. ABAIGAR
Signature of School Head over Printed Name
School Form 3 Books Issued and Returned for Senior High School (SF3-SHS)
School Name School ID District Division
Semester School Year Grade Level Track and Strand
Section Course/s (only for TVL)
Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle
NAME
No. (Last Name, First Name, Name Extension,
Middle Name) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
TOTAL MALE ===>
1
2
3
4
5
6
7
8
9
10
11
12
13
SHS)
Region
/ ModuleTitle Book / ModuleTitle
REMARKS/ACTION TAKEN
(Please refer to the codes below)
(mm/dd/yy) Date (mm/dd/yy)
Returned Issued Returned
Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle
NAME
No. (Last Name, First Name, Name Extension,
Middle Name) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
TOTAL FEMALE ===>
COMBINED ===>
GUIDELINES: In case of lost/unreturned books, please provide information with the following code:
Prepared By:
1. Title of Books Issued to each learner must be recorded by the Class Adviser. A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
2. The Date of Issuance and the Date of Return shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code
3. The Total Number of Copies issued shall be reflected in the form. FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian (for code
4. The Total Number of Copies of Books Returned shall be reflected in the form. TDO), PTL=Paid by the Learner (for code NEG). References: DO No.23, s.2001, DO No.25, s.2003, DO No.14, s.2012.
5. All textbooks being used must be included. Additional copies of this form may be used if needed.
Signature of Class A
/ ModuleTitle Book / ModuleTitle
REMARKS/ACTION TAKEN
(Please refer to the codes below)
(mm/dd/yy) Date (mm/dd/yy)
Returned Issued Returned
ature of Class Adviser over Printed Name

School Form 4 Monthly Learners' Movement and Attendance for Senior High School (SF4-SH
School Name District Division Region
School ID Semester School Year
ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN SHIFTED O
REGISTERED
LEARNERS (A) (A+B) (A) (A+B) (A) (A+B) (A)
(As of End Cumulative Cumulative Cumulative Cumulative Cumulative Cumulative Cumulative
TRACK STRAND Daily % for the
Number as
(B) Total for
Number as of Number as
(B) Total for
Number as Number as
(B) Total for
Number as of Number as
(B) Total for
of the Month) Average Month the Month the Month the Month the Month
of Previous End of the of Previous of End of the of Previous End of the of Previous
Month Month Month Month Month Month Month
M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M
TOTAL FOR GRADE 11
TOTAL FOR GRADE 12

GRAND TOTAL
Prepared and Submitted By:

SF4-SHS)
Region
For the Month of
SHIFTED OUT SHIFTED IN
(A+B) (A) (A+B)

Cumulative Cumulative Cumulative
(B) Total for (B) Total for
Number as of Number as Number as of
the Month the Month
End of the of Previous End of the
Month Month Month
F T M F T M F T M F T M F T
School Form 5A End of Semester and School Year Status of Learners for Senior High School (SF5A-SHS)
School Name School ID District
Semester School Year Grade Level
Track and Strand Course/s (only for TVL)
BACK SUBJECT/S END OF

LEARNER'S NAME END OF SCHOOL
No. LRN List down subjects where learner obtained a rating SEMESTER
(Last Name, First Name, Name Extension, Middle Name) YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)
MALE
FEMALE
Prepared By:
Certified Correct By:
Reviewed By:
GUIDELINES:
This form shall be accomplished after each semester in a school year, leaving the End of School Year Status Column and Summary Table for End of School Year Status blank/unfilled at the end of the 1st Semeste
data elements shall be filled up only after the 2nd semester or at the end of the School Year.
BACK SUBJECT/S END OF
LEARNER'S NAME END OF SCHOOL
No. LRN List down subjects where learner obtained a rating SEMESTER
(Last Name, First Name, Name Extension, Middle Name) YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)
This form shall be accomplished after each semester in a school year, leaving the End of School Year Status Column and Summary Table for End of School Year Status blank/unfilled at the end of the 1st Semeste
data elements shall be filled up only after the 2nd semester or at the end of the School Year.
INDICATORS:
End of Semester Status
Complete - number of learners who completed/satisfied the requirements in all subject areas (with grade of at least 75%)
Incomplete - number of learners who did not meet expectations in one or more subject areas, regardless of number of subjects failed (with grade less than 75%)
Note: Do not include learners who are No Longer in School (NLS)
End of School Year Status

Regular - number of learners who completed/satisfied requirements in all subject areas both in the 1st and 2nd semester
Irregular - number of learners who were not able to satisfy/complete requirements in one or both semesters
ool (SF5A-SHS)
Division Region
Section
SUMMARY TABLE 1ST SEM

STATUS MALE FEMALE TOTAL
COMPLETE
INCOMPLETE
TOTAL
SUMMARY TABLE 2ND SEM

COMPLETE
INCOMPLETE
TOTAL
SUMMARY TABLE (End of the School Year Only)

REGULAR
IRREGULAR
TOTAL
Prepared By:
Certified Correct By:
Reviewed By:
Signature of Division Representative over Printed Name
e end of the 1st Semester. These

School Form 5B List of Learners with Complete SHS Requirements (SF5B-SHS)
School Name School ID District Division Region
Semester School Year Section
Track and Strand Course/s (only for TVL)
Completed SHS in
2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification Level
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)
MALE
SUMMARY TABLE A
Learners who
completed SHS
Program within 2
SYs or 4 semesters
Learners who
completed SHS
Program in more
than 2 SYs or 4
semesters
TOTAL
SUMMARY TABLE B
NC III
NC II
NC I
TOTAL
Note: NCs are recorded here for documentation but is not a requirement for
graduation.
Completed SHS in
2 SYs? (Y/N)
National
No. LRN
Note: NCs are recorded here for documentation but is not a requirement for
graduation.
GUIDELINES:
1. This form should be accomplished by the Class Adviser at End of School
Year.
2. It should be compiled and checked by the School Head and
passed to the Division Office before graduation.
FEMALE
Reviewed By:
Certified Correct & Submitted By:
Reviewed By:
Signature of Division Representative over Printed Name

Completed SHS in
2 SYs? (Y/N)
National
No. LRN
School Form 6 Summarized Report of Learner Status as of End of Semester and School Year for Senior High School (SF6-SHS)
Semester School Year
END OF SCHOOL YEAR

END OF SEMESTER STATUS
(Fill up only at the end of the second sem
GRADE LEVEL
COMPLETE INCOMPLETE TOTAL REGULAR IRREGULAR
MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE
GRADE 11
TRACK/STRAND/COURSE
SUB TOTAL
GRADE 12
TRACK/STRAND/COURSE
SUB TOTAL
TOTAL
Prepared and Submitted By: Reviewed & Validated By: Noted By:
Signature of School Head over Printed Name Signature of Division Representative over Printed Name Signature of Division
GUIDELINES:
1. After receiving and validating the report on Status of Learners submitted by the Class Adviser, the School Head shall compute the grade level total per track/strand/course and school t
2. This report shall be forwarded to the Division Office by the end of the semester.
3. Column for End of School Year shall be accomplished at the end of SY or every after the 2nd semester
4. Protocols of validation & submission are under the discretion of the Schools Division Superintendent.
6-SHS)
Region
OOL YEAR
the second semester.)
ULAR TOTAL
TOTAL MALE FEMALE TOTAL
ature of Division Superintendent over Printed Name
e and school total.

SF 8
Department of Education
School Form 8 Learner's Basic Health and Nutrition Report for Senior High School (SF8-SHS)
(For All Grade Levels)
School Name INDEPENDENCIA NHS-SHS District TALALORA Division SAMAR Region VIII
School ID 303608 Grade 11 Section UWAY Track/Strand (SHS) TVL-COOKERY School Year 2020-2021
Learner's Name Nutritional Status

Birthdate Weight Height Height² Height for
No. LRN (Last Name, First Name, Name Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category Age (HFA)
Extension, Middle Name) (kg/m²)
MALE
1 !123906090006 APORTO, FRANCIS, MARCELLANA 8/2/2003 17 40 111
2 !123895090013 CABRITO, REGINO 7/11/2003 17 54 163
3 !123471060009 CAISEDO, JUSTINE, MERCADO 08/19/1999 21
4 !123454090003 CANACANA, ROLDAN, DONAIRE 12/7/2003 17
5 !123454090004 CANEZARES, NATHAN, DANTE 8/5/2003 17
6 !123864070035 HERMO, JONEL, DONAIRE 12/1/2003 17
7 !508061901093 NICANOR, JOEY, BECHACHINO 02/13/1994 26
8 !123906090050 PLUMENTERA, LITO, BORRICO 11/16/2003 17
9 !123442070041 VALDEZ, ARJAY, DONAIRE 09/20/2002 19
FEMALE
1 !123895090001 ABON, GINALYN, ENVERZO 01/25/2003 17
2 !123905090016 AUTENTICO, JULIE MAE BANAWA 07/22/2004 16
3 !12389509006 BALANTAD, EMMA, SIMBORIO 07/18/2003 17
4 !123905120105 BALENA, MARINEL, CONDESA 03/18/2005 15
5 !123901090003 CALIPAYAN, LOIDELYN 10/3/2005 15
6 !123454090002 CANACANA, JONA MARIE, 01/22/2004 16
7 !123898090007 CAPALAR, MELODY, COSTELO 6/9/2003 17
8 !123471090012 CASOY, AXCEL ROSE 09/28/2003 17
9 !1234460067 CUBIAN, ABEGAIL, FATIMA 10/31/2000 20
10 !123460120015 CUYOS, RENGIE, DOSAL 12/22/2002 18
11 !123906090016 DALAMPASIG, JOSEPHINE 08/20/2002 18
12 !123905120103 DANDAY, MARY ROSE, SANTISO 04/28/2003 17
13 !123454090005 DANTE, MAE ,CAYAS 03/22/2004 16
14 !123895090017 DE LUNA, JENNELYN, DALIMIT 4/4/2003 17
15 !123899070011 DE LUNA, ROSEVIE 10/20/2001 19
16 !123454090006 DONAIRE, ERICKA, MARCELINO 08/27/2002 18
17 !123454090007 DONAIRE, JEANILYN, MACARAIG 02/18/2004 16
18 Err:509
19 !123460090011 DOSAL, ANA ROSE, GOSON 11/12/2002 18
20 !123460120017 DOSAL, MARIA ANDREA, GOSON 01/24/2001 19
21 !123402090005 DUENA, MARGIELYN, ZABALA 03/17/2003 17
22 !123901090007 DURANA, LEA M.
23 !123895010015 ENCINARES, ROSEMARIE 10/13/2003 17
24 Err:509 Err:509 Err:509 17
25 !123905090037 ESTRADA, ROSEMARIE,NICANOR 11/6/2002 19
26 !123895090021 FLORES, MARYJOY, SAYSON 06/16/2002 19
27 !123906090021 GULPAN, MYRNA, DAGTA 1/4/2004 16
28 !123895090023 ISANAN, JESSICA, QUINAWAYAN 06/27/2004 16
29 0 KISKISAN, ROCHELLE 5/9/2003 17
30 !123905070008 LABAGRIEL, RICA, OBIN 6/9/2002 18
31 !123480490005 LABITAO, JACQUELINE, JAMINDANG 09/26/2004 16
32 !121185090030 LUMACANG, JAMAICA, QUITON 10/2/2004 0
33 Err:509 Err:509 Err:509 18
34 !123460080027 MARAYA, JOYZELLE, CASAMA 11/5/2003 0
35 !123905060056 MENDIOLA, SHEENA, AVESTRUZ 5/4/2001 0
36 !123895090027 OBZUNAR, IRISH JOY, VILLEGAS 07/22/2004 0
37 !123454090012 OBZUNAR, MARY JOYCE, VALDEZ 0
38 !123898090021 OGANIA, ANITA, D. 09/23/2002 0
39 !123455090009 PAPIONA, MA. LOLITA, BERBES 0
40 !123895090029 PATRIMONIO, CRIS JOY,LAGOT 09/20/2002 0
41 !123905130070 PATRIMONIO, EDNA, CAYA 10/18/2000 0
42 !123895090031 QUIMUEL, LAIZA MAE,MANICANE 38088 0
43 !123454090015 RAANDAAN, REA JOY, VALDEZ 09/27/2003 0
44 !123905090074 SABINADA, KAREN, MACINOPA 02/25/2003 0
45 !123905090079 TIOZON, LYDELLE, BIONG 03/16/2004 0
46 !123454090017 VALDEZ, ARIANNE, DONAIRE 02/20/2004 0
47 !12345690028 VERSOZA, JECEL, BASANEZ 01/18/2002 0
48 !123895090035 VILLATURA, ROSE-ANN, DEVOCION 37476 0
SUMMARY TABLE
Nutritional Status Height for Age (HFA)

Summary Table Summary Table
SEX
Severely
Severely Wasted Wasted Normal Overweight Obese TOTAL Stunted Normal Tall Total
Stunted
MALE
FEMALE
TOTAL
Date of Assessment: Conducted/Assessed By: Certified Correct By: Reviewed By:

5/10/2020 RONA FE L. ONTUCA MARIA J. ABAIGAR
SFRT 2017
Learner's Name Nutritional Status
Birthdate Weight Height Height² Height for
No. LRN (Last Name, First Name, Name Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category Age (HFA)
Extension, Middle Name) (kg/m²)
SFRT 2017
SFRT 2017
School Form 7 School Personnel Basic Profile and Assignment for Senior High School (SF7-SHS)
Semester School Year
(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non-Teaching Items (C ) Other Appointments and Funding S
Appointment:
Title of Designation
Title of Plantilla Position Title of Plantilla Position (Contractual,
Number of Number of (as it appears in the contract/document:
(as it appears in the appointment (as it appears in the appointment Substitute,
Incumbent Incumbent Teacher, Clerk, Security Guard, Driver etc.)
document/PSIPOP) document/PSIPOP) Volunteer, Others
specify)
EDUCATIONAL QUALIFICATION Daily Program (time

Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Class & Other Ancillary (Enumerate DAY
Source Designation Degree/ Specialization/ From
Number Position, Descending) (Regular/ Minor Assignments sections (M/T/W/
-T.I.N.) Probationary/ Postgraduate Specialized taught) (00:00)
TH/F)
Part Time) Training Attended
First Semester:
Second Semester:
Advisory:
Ancillary Assignment/s:
Ave. Minutes per D
First Semester:
Second Semester:
Advisory:
Ave. Minutes per D
First Semester:
Second Semester:
Advisory:
Ave. Minutes per D
First Semester:
Second Semester:
Advisory:
Ave. Minutes per D
First Semester:
EDUCATIONAL QUALIFICATION Daily Program (time
Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Class & Other Ancillary (Enumerate DAY
Source Designation Degree/ Specialization/ From
Number Position, Descending) (Regular/ Minor Assignments sections (M/T/W/
-T.I.N.) Probationary/ Postgraduate Specialized taught) (00:00)
TH/F)
Part Time) Training Attended
Second Semester:
Advisory:
Ave. Minutes per D
First Semester:
Second Semester:
Advisory:
Ave. Minutes per D
GUIDELINES:
1. This form shall be accomplished at the beginning of each semester by the School Head and is submitted to the Division Office. In case of movement of teachers and other
personnel during the semester, an updated SHSF-7 must be submitted to the Division Office at the end of the semester.
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank to the lowest. Sig
3. Please reflect subjects being taught including advisory class or ancillary assignment (if any). Other administrative duties must also be reported.
4. Daily Program Column is for teaching personnel only. Updated as of:
SHS)
Region
nd Funding Sources
Number of Incumbent
Fund Source
(SEF, PTA,
NGO's etc.) Teaching Non-Teaching
Remarks:
ogram (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
To Teaching JHS- please indicate the number
(00:00) Minutes per of teaching minutes per week)
Week
e. Minutes per Day
e. Minutes per Day
e. Minutes per Day
e. Minutes per Day

Remarks:
ogram (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
To Teaching JHS- please indicate the number
(00:00) Minutes per of teaching minutes per week)
Week
e. Minutes per Day
e. Minutes per Day
ated as of:
School Form 7, Page ___ of ________

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School Form 1 School Register for Senior High School (SF1-SHS)

COMPLETE ADDRESS PARENTS GUARDIAN

7 MAHINAY, KIM CARBONILLA M CHRISTIANITY POB. BRGY. 1 TALALORA WESTERN SAMAR

47 <=== TOTAL FEMALE

Section UWAY Course/s (only for TVL) HOME ECONOMICS- Month of

1 APORTO, FRANCIS, MARCELLANA

3 CAISEDO, JUSTINE, MERCADO

4 CANACANA, ROLDAN, DONAIRE

5 CANEZARES, NATHAN, DANTE

6 HERMO, JONEL, DONAIRE

7 MAHINAY, KIM CARBONILLA

8 NICANOR, JOEY, BECHACHINO

9 PLUMENTERA, LITO, BORRICO

10 VALDEZ, ARJAY, DONAIRE

10 <=== MALE | TOTAL Per Day ===>

1 ABON, GINALYN, ENVERZO

2 AUTENTICO, JULIE MAE BANAWA

3 BALANTAD, EMMA, SIMBORIO

4 BALENA, MARINEL, CONDESA

6 CANACANA, JONA MARIE,

7 CAPALAR, MELODY, COSTELO

8 CASOY, AXCEL ROSE

9 CUBIAN, ABEGAIL, FATIMA

10 CUYOS, RENGIE, DOSAL

12 DANDAY, MARY ROSE, SANTISO

13 DANTE, MAE ,CAYAS

14 DE LUNA, JENNELYN, DALIMIT

16 DONAIRE, ERICKA, MARCELINO

17 DONAIRE, JEANILYN, MACARAIG

18 DOSAL, ANA ROSE, GOSON

19 DOSAL, MARIA ANDREA, GOSON

20 DUENA, MARGIELYN, ZABALA

25 FLORES, MARYJOY, SAYSON

26 GULPAN, MYRNA, DAGTA

27 ISANAN, JESSICA, QUINAWAYAN

29 LABAGRIEL, RICA, OBIN

30 LABITAO, JACQUELINE, JAMINDANG

31 LUMACANG, JAMAICA, QUITON

32 MARAYA, JOYZELLE, CASAMA

33 MENDIOLA, SHEENA, AVESTRUZ

34 OBZUNAR, IRISH JOY, VILLEGAS

35 OBZUNAR, MARY JOYCE, VALDEZ

37 PAPIONA, MA. LOLITA, BERBES

38 PATRIMONIO, CRIS JOY,LAGOT

39 PATRIMONIO, EDNA, CAYA

40 QUIMUEL, LAIZA MAE,MANICANE

41 RAANDAAN, REA JOY, VALDEZ

42 RARUGAL, GINALYN PALDEZ

43 SABINADA, KAREN, MACINOPA

44 TIOZON, LYDELLE, BIONG

45 VALDEZ, ARIANNE, DONAIRE

46 VERSOZA, JECEL, BASANEZ

47 VILLATURA, ROSE-ANN, DEVOCION

47<=== FEMALE | TOTAL Per Day ===>

57----Combined TOTAL Per Day

No. of Days of Classes:

a. Percentage of Enrolment = x 100 (NLS)

School Form 7, Page _ of ______