COMPLETE HOME ADDRESS REMARKS

Date

Sex (M/F)
NAME IP Last Grade Level
Date of Birth Mapped If already enrolled
(Last Name, First Name, Name Extension, Age Mother Tongue (Yes or Religion Completed in
(mm/dd/yyyy) House (mm/dd/ Interested in If Yes, in ALS, provide
Middle Name) No) Formal School
No./Street/ Barangay Municipality/ City Province yyyy) ALS? Preferred date of first
Sitio/ Purok Yes or No Program attendance
(DOFA) and LRN

LAYO, JALYEN GUMANON F 2/2/2001 23.3333 MATIGSALOG YES PANUBAD CAYAGA SAN FERNANDO II BUKIDNON G-7 2020 YES

SIBUGAN, MELANIE ANGGATAO F 12/21/1998 25.5 PANUBAD CAYAGA SAN FERNANDO II BUKIDNON G-8 2

ANGGATAO, REBECCA DALANGIN F PANUBAD CAYAGA SAN FERNANDO II BUKIDNON G-9 20

ARBOIS, CRISELDA PATINDOL F 12/3/1998 25.5 PANUBAD CAYAGA SAN FERNANDO II BUKIDNON G-6

SALINDIN, MARLYN DAWUNGAN F PANUBAD CAYAGA SAN FERNANDO II BUKIDNON G-8

G-4
SOLDE, SANA ERION F 3/1/1998 PANUBAD CAYAGA SAN FERNANDO II BUKIDNON

G-3
OGUIL, JENNY PANUGOD F 9/12/1996 27.75 ECCU CAYAGA SAN FERNANDO II BUKIDNON

G-4
VILLA, MARIVIC DALANGIN F 12/5/1990 33.5 ECCU CAYAGA SAN FERNANDO II BUKIDNON

G-4
CODYALE, LANIE PANUGOD F 9/4/1997 26.75 PANUBAD CAYAGA SAN FERNANDO II BUKIDNON
AF2 Republic of the Philippines
Department of Education
ALTERNATIVE LEARNING SYSTEM
ALS ENROLMENT FORM (AF2)
Learner's Basic Profile

Date : LRN (if available) :

Personal Information (Part I)

Last Name First Name Middle Name Name Extension

• Address:
House No./Street/Sitio Barangay Municipality/City Province
• Birthdate (mm/dd/yyyy): _____/_____/________ Place of Birth (Municipality/City) Contact #:

• Sex: □Male □Female • Civil Status: □Single □Married □Widow/er □Separated □Solo Parent (Box first)

• Religion: ____________• IP (Specify ethnic group) : ______________ • Mother Tongue : _______________ 4PS: □Yes □No PWD: □Yes □No
• Name of Father/Legal Guardian

Last Name First Name Middle Name Occupation

• Mother's Maiden Name

Last Name First Name Middle Name Occupation

Educational information (Part II)

• Last grade level completed
Elementary : □K □G-1 □G-2 □G-3 □G-4 □G-5 □G-6
Secondary : □G-7 □G-8 □G-9 □G-10
• Why did you drop out of school? (For OSY only)
□No school in Barangay □School too far from home □Needed to help family
□Unable to pay for miscellaneous and other expenses Others:

• Have you attended ALS learning sessions before? □YES □NO

If Yes:
Name of the Program: _____________________________________________ Level of Literacy: □Basic □Elem. □Sec. □InfEd
Year Attended: ___________ Have you completed the Program? (Yes/No) _______
If NO, state the reason:
• Are you interested to take up skills training?
If Yes, state the skills you want:

Accessibility and Availability (Part III)

• How far is it from your home to your Learning Center? in kms in hours and mins.
• How do you get from your home to your Learning Center? □Walking □Motorcycle □Bicycle □Others (Pls. Specify) ___________
• When can you attend your Learning Session?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday

What specific time

can you be at your
Learning Center?

_______________________________________ _____________________________
Facilitator: Signature and Date Learner: Signature and Date
 Republic of the Philippines
AF-3
Department of Education
ALTERNATIVE LEARNING SYSTEM
MASTERLIST OF ENROLLED LEARNERS WITH END OF PROGRAM/CY STATUS (AF-3)
District Division Region Calendar Year

Type of
Name of CLC Barangay City/Municipality
CLC

NON FORMAL EDUCATION

PROGRAM ENROLLED Assessment for Basic Literacy
Functional Literacy Assessment (FLT) Score

PIS Score
(ABL)

Sex (M/F)
NAME End of
Birthdate First Date of
LRN (Last Name, First Name, Middle Age Program/ Remarks
Attendance

Basic Literate
(mmddyyyy)

Post Literate
Neo Literate
Name, Name Extension) CY Status
Type of Listening & Overall
Mode of Program Delivery Reading Numeracy Writing
Program Speaking Score

<=== TOTAL MALE

<=== TOTAL FEMALE

<=== COMBINED

Learners Enrolled
Learners Enrolled by Program Male Female Total
by Program Delivery
Male Female Total

BLP Face to Face Prepared By:

A&E Elem. Independent Learning
A&E Sec. Radio-based Instruction
InFED Computer-based Instruction Signature of Facilitator over Printed Name

Learners Enrolled in BLP

by Level
Male Female Total Enrolled Learners Male Female Total Certified Correct By:
Basic Literate Number of 4P's Learners
Neo Literate Percent of Enrolled 4P's Learners
Signature of PSDS over Printed Name
Post Literate
 Republic of the Philippines AF-4
Department of Education
ALTERNATIVE LEARNING SYSTEM
MASTERLIST OF A&E REGISTRANTS (AF-4)
District Division Region

Place of Registration Center

(Name of School/Center, Barangay, Municipality)
(Testing Center) (Barangay) (Municipality/City)

CLC DETAILS

Sex (M/F)

Birthdate
NAME
A&E Test Level Date of
LRN (Last Name, CLC Registered
Date Registered
Examination
First Name, Middle Name, Ext) CLC Name Barangay Municipal
Type

<=== TOTAL MALE

<=== TOTAL FEMALE

<=== COMBINED

Registered Male Female Total Prepared By:

Elementary Signature of Facilitator over Printed Name
Secondary
Taker Male Female Total Certified Correct By:
Elementary
Secondary Signature of PSDS/DC over Printed Name
F-4
 Republic of the Philippines AF-5
Department of Education
ALTERNATIVE LEARNING SYSTEM

LEARNER'S PERMANENT RECORD (AF-5)

DISTRICT: LANTAPAN WEST DIVISION: BUKIDNON REGION: X

LEARNER'S INFORMATION LRN:510012102102

LAST NAME: DEHAY FIRST NAME: CLIFF VONN EXTENSION: ______ MIDDLE NAME: GAVIA

ADDRESS: PUROK 1 ALANIB LANTAPAN BUKIDNON

HOUSE NO./ SITIO / ST. BARANGAY MUNICIPALITY/CITY PROVINCE

BIRTHDATE: MONTH 03/ DATE 11 / YEAR 1995 SEX: Male Female

LEARNER'S EDUCATIONAL STATUS

Program Enrolled : JUNIOR HIGH SCHOOL LEVEL Program Enrolled : JUNIOR HIGH SCHOOL LEVEL
Delivery Mode : MODULAR (PRINT) Delivery Mode : MODULAR (PRINT)
CLC Name : ALANIB CLC Name : ALANIB
CLC Address : Alanib, Lantapan, Bukidnon CLC Address : Alanib, Lantapan, Bukidnon
Name of Facilitator : Ranney Rey S. Alejo Name of Facilitator : Ranney Rey S. Alejo
Calendar Year : 2021-2022 Calendar Year : 2021-2022

Score Score
ASSESSMENT RESULTS ASSESSMENT RESULTS
Pre Post Pre Post
PIS Score 11 11 PIS Score 11 11
Assesment for Basic Literacy (ABL) Pre Post Assesment for Basic Literacy (ABL) Pre Post
Basic Literate N/A N/A Basic Literate N/A N/A
Neo Literate N/A N/A Neo Literate N/A N/A
Post Literate N/A N/A Post Literate N/A N/A
Functional Literacy Assessment Pre Post Functional Literacy Assessment Pre Post
FLT Score in Reading 10 11 FLT Score in Reading 10 11
FLT Score in Numeracy 11 10 FLT Score in Numeracy 11 10
FLT Score in Writing 5 7 FLT Score in Writing 5 7
FLT Score in Listening & Speaking 6 6 FLT Score in Listening & Speaking 6 6
Overall Score 32 34 Overall Score 32 34
InfEd Remarks InfEd Remarks
N/A N/A N/A N/A
N/A N/A N/A N/A
N/A N/A N/A N/A
A & E STATUS Remarks A & E STATUS Remarks
Program Status COMPLETED Program Status COMPLETED
Test Taken Sec. Level Test Taken Sec. Level
Date of Examination June 03,2022 Date of Examination June 03,2022
Testing Center OLD KIBANGAY ES Testing Center OLD KIBANGAY ES
Location of Testing Center Kibangay Lantapan Location of Testing Center Kibangay Lantapan
Accreditation and Equivalency (A&E) Test Result 88% Accreditation and Equivalency (A&E) Test Result 88%
Certificate of Transfer Certificate of Transfer
Eligible for Admission to : Eligible for Admission to :

Certificate of Good Moral Character Certificate of Good Moral Character

This is to certify that the above-named is a learner of good moral character. This is to certify that the above-named is a learner of good moral character.
This certification is issued upon request of the concerned individual due to This certification is issued upon request of the concerned individual due to
his/her desire to pursue formal schooling/other CLC or for employment. his/her desire to pursue formal schooling/other CLC or for employment.

Prepared By: Certified Correct By: Prepared By: Certified Correct By:
RANNEY REY S. ALEJO MILDRECH D. SINGGIL RANNEY REY S. ALEJO MILDRECH D. SINGGIL
Facilitator PSDS/District Coordinator/EPSA Facilitator PSDS/District Coordinator/EPSA
 Department of Education
ALTERNATIVE LEARNING SYSTEM
MASTERLIST OF MAPPED AND POTENTIAL LEARNERS (AF1)

District EAST 2 Division: CAGAYAN DE ORO Calendar Year 2019

COMPLETE HOME ADDRESS REMARKS

NAME
Sex (M/F)
Last Grade
Date of Birth IP House Date Mapped Interested in
(Last Name, First Name, Name (mm/dd/yyyy)
Age Mother Tongue
(Yes or No)
Religion Level Completed
(mm/dd/yyyy) If Yes, Preferred
No./Street/ Barangay Municipality/ City Province in Formal School ALS?
Extension, Middle Name) Sitio/ Purok Yes or No
Program