Definition: is a process of removing ineligible learners from the masterlis

Submit to: Division Planning Officer, Schools Governance and Operatio

Note: Endorsement of School Head is required (signed and scanne

Present and Correct Enrollment

Region-Division School Name School ID

Pulong Sta. Cruz National 301260

Region IV-A-Laguna High School
Pulong Sta. Cruz National 301260
Region IV-A-Laguna High School
Pulong Sta. Cruz National
Region IV-A-Laguna High School 301260
 Teacher/ICT Coordinator
Requested by
JOHN DOMINIC O. GABRIEL
Position/Designation Teacher/ICT Coordinator

Note for school:

1. Fill-up the form correctly and completely
2. Attach this form as Excel file.
3. Attach a scanned copy of the form with School Head signa
4. Attach the following copies:
a. Birth Certificate
b. Form 137/School Form 10 and/or Form 138/School For
5. Encode the correct codes
6. If system error, provide screenshot

Note for Division Planning Officer:

1. Consolidate requests by school by issue
earners from the masterlist.
Governance and Operations Division
quired (signed and scanned). Please use worksheet/excel format for the matrix.

ect Enrollment

Date of First Attendance

Grade Section LRN
(MM/DD/YYYY)

8 Rosal August 29, 2022 108479120480

8 Orchids August 22, 2022 108479130395

7 GENEROSITY August 23, 2022 108479130563

dinator School's Email Address
pulongsta.cruz.nhs@gmail.com

mpletely

m with School Head signature

d/or Form 138/School Form 9

by issue
 ICTS - User Support Division
Learner Information System (LIS) and Basic Education Informat
National Helpdesk
Unenrollment of Learner (Request Form 09)

Learner's Personal Information

First Name Middle Name Last Name

JARED BARRAQUIO DE GUZMAN

MARY JOY BAUTISTA NUÑEZ

JOBERT BARCENAL ESTANIEL

School's Contact Number School Head/System Admin Username
Alvin D. Sta. Maria / adstamaria
User Support Division
and Basic Education Information System (BEIS)
ational Helpdesk
f Learner (Request Form 09)

on

Date of Birth
Ext Name Sex Region-Division
(MM/DD/YYYY)

August 12, 2007 Male

Region IV-A-Laguna

July 28, 2006 Female

Region IV-A-Laguna
January 08, 2005 Male Region IV-A-Laguna
Date Requested Endorsed by Signature
4/19/2023 School Head Name
 Unenrolled From

School Name School ID Grade Section School Year

Pulong Sta. Cruz 301260 8 ROSAL 2022-2023

National High School
Pulong Sta. Cruz 301260 8 ORCHID 2022-2023
National HighCruz
Pulong Sta. School
National High School 301260 7 GENEROSITY 2022-2023
 Reason for Unenrollment

1. Incorrect Grade Level (SHS)

2. 1st Sem Declined
3. Multiple Enrollment
4. Mistakenly Enrolled If Others, please
For SHS 5. No Appearance Since BOSY specify:
(Semester) 6. System Error
7. PEPT/ALS Passer
8.Tagging of Temporary Enrollment
9. Others

Others: Less than 1/4 attendance for 1st

9. Others qurter; no attendance for 2nd quarter up
to present

Others: Less than 1/4 attendance for 1st

9. Others qurter; no attendance for 2nd quarter up
to present

5. No Appearance since BOSY