School Form 1 (SF 1) School Register

(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)

School ID 113160 Region V Division Catanduanes District Bagamanoc South

School Name Bacak Elementary School School Year 2021 - 2022 Grade Level Non-Graded Section MATIPID

GUARDIAN
ADDRESS PARENTS
(if Not Parent)
Age MOTHER Contact

Sex (M/F)
IP
LRN
NAME BIRTH DATE as of TONGUE (Ethnic
RELIGIO Number of
(Last Name, First Name, Middle Name) (mm/dd/yyyy) Octob (Grade 1 N Father's Name Mother's Maiden Parent or
Group) House #/
er 31 to 3 Only) Municipality/ (Last Name, First Name (Last Name, Guardian
Street/ Sitio/ Barangay Province Name Relationship
City Name, Middle First Name, Middle
Purok
Name) Name)

Bikol,
CATER, SEGISMUNDO,
CATER,JOHN MARK, Northern Christiani BAGAMANO CATANDUAN
113160190004 M 07-26-2013 8 BACAK FRANCISCO LIZA,GREGORI
SEGISMUNDO Catandua ty C ES
LOZADA O,
nes

1 <=== TOTAL MALE

Bikol,
CATER, SEGISMUNDO,
Northern Christiani BAGAMANO CATANDUAN
113160170007 CATER,FE, SEGISMUNDO F 06-26-2012 9 BACAK FRANCISCO LIZA,GREGORI
Catandua ty C ES
LOZADA O,
nes

1 <=== TOTAL FEMALE

2 <=== COMBINED

List and Code of Indicators under REMARKS column

Indicator Code Required Information Indicator Code Required Information REGISTERED BoSY EoSY Prepared by; Certified Correct:

Transfered Out T/O Name of Public (P) Private (PR) School & Effectivity CCT Receipient CCT CCT Control/reference number & Effectivity Date LOLITA PRESENTACION DELA ROSA
Date MALE 1
Balik Aral B/A Name of school last attended & Year SHARON TUMANLAO VILLENA (Signature of School Head over Printed Nam
Transfered In T/I Name of Public (P) Private (PR) School & Effectivity
Date Learner With LWD Specify (Signature of Adviser over Printed Name)
FEMALE 1
Disability
Dropped DRP Reason and Effectivity Date Accelerated ACL Specify Level & Effectivity Data
Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) BoSY Date: EoSY Date:
TOTAL 2
BoSY Date: EoSY Date:

Generated thru LIS

Generated on: Friday, July 8, 2022

gamanoc South

MATIPID

REMARKS

Learning
Modality (Please refer to
the legend on last
page)

Modular
(print)

Modular
(print)

ACION DELA ROSA

ead over Printed Name)

EoSY Date:

d thru LIS