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

III- CSJDM MULAWIN NHS 305697

III- CSJDM MULAWIN NHS 305697

Teacher/ICT Coordinator
Requested by
DANIEL L. MANUEL
Position/Designation LIS 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
learners 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)

9 CONFUCIUS August 29, 2023 107154100116

8 TULIP August 30, 2023 129715140274

dinator School's Email Address

UEL 305697.sjdmc@deped.gov.ph
TOR

mpletely

rm with School Head signature

nd/or Form 138/School Form 9

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

Learner's Personal Information

First Name Middle Name Last Name

JOSHUA PARCON CADISAL

JULIUS GABITAN LIM

School's Contact Number School Head/System Admin Username

9178410629 301062_jprondina
er Support Division
d Basic Education Information System (BEIS)
onal Helpdesk
earner (Request Form 09)

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

- 1/18/2005 Male III-CSJDM

- 3/7/2009 Male III-CSJDM

Date Requested Endorsed by Signature

10/19/2023 School Head Name JUNARLITO P. RONDINA
 Unenrolled From

School Name School ID Grade Section School Year

MULAWIN NHS 305697 9 CONFUCIUS 2023-2024

MULAWIN NHS 305697 8 TULIP 2023-2024

ARLITO P. RONDINA
 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

9. Others TRANSFER TO ALS

9. Others TRANSFER TO ALS