Republic of the Philippines

Department of Education
CARAGA ADMINISTRATIVE REGION
DIVISION OF BUTUAN CITY
AGUSAN NATIONAL HIGH SCHOOL
SENIOR HIGH SCHOOL

STUDENT INFORMATION

Learner’s Reference Number (LRN) 132023121414

Last Name Apit
First Name Orlando Albert
Middle Name Mozol
Extension Name e.g. Jr., III (if applicable): None
Facebook Account Orlando Albert Apit
Contact Number 09518806889
Date of Birth November 24 2003
Age 17
Sex Male
Belongs to any Indigenous Peoples (IP) Community? No
Mother tongue Bisaya
Religion Christian BornAgain
Complete Address Purok-Tanguile Barangay Pangabugan Butuan City
Landmark near your house Near in damayan river
Zip Code 8600
Is your family a beneficiary of 4Ps? No

Parents/Guardian’s FATHER MOTHER’S MAIDEN GUARDIAN

Information NAME
Last Name Apit Apit
First Name Orlando Alberta
Middle Name Opon Mozol
Extension Name e.g. Jr., III (if
applicable):
Facebook Account Lando Apit Mavic Mozol Apit
Contact Number 09157463254 09389903294
Occupation Barangay council Admenistrative officer
Occupation Address Barangay pangabugan City Hall

SCHOOL LAST ATTENDED

Last Grade Level Completed Grade-10
Last School Year Completed 2020-2021
School Name Agusan National High School
School Address A,D Curato Street
Section Mercury
Adviser Mrs. Jacqueline Bautista Vidal

I hereby certify that the above information given are true and correct to the best of my knowledge and I allow the
Department of Education to use my child’s details to create and/or update his/her learner profile in the Learner Information
System. The information herein shall be treated as confidential in compliance with the Data Privacy Act of 2012.

Signature Over Printed Name of Parent/Guardian Date

Agusan National High School

Senior High School
T. Sanchez St., Butuan City
(085) 817 – 0875