School Form 1 (SF 1) School Register

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

School ID School Name

Region

Division School Year

District Grade Level

ADDRESS RELIGION House # / Street/Sitio/ Purok Barangay Municipality/ City Province NAME OF PARENTS

Section
GUARDIAN (If not Parent) Contact Number (Parent /Guardian) Mother (Maiden) Name Relationsh ip (Please refer to the legend on last page) REMARK/S

LRN

NAME (Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE (mm/ dd/yy)

AGE as of 1st Friday of June (nos. of years as per last birthday)

BIRTH PLACE (Province)

MOTHER TONGUE

IP (Specify Ethnic Group)

Father (1st name only if family name identical to learner)

LRN

NAME (Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE (mm/ dd/yy)

AGE as of 1st Friday of June (nos. of years as per last birthday)

BIRTH PLACE (Province)

MOTHER TONGUE

IP (Specify Ethnic Group)

ADDRESS RELIGION House # / Street/Sitio/ Purok Barangay Municipality/ City Province

NAME OF PARENTS

GUARDIAN (If not Parent) Contact Number (Parent /Guardian)

REMARK/S

Father (1st name only if family name identical to learner)

Mother (Maiden)

Name

Relationsh ip

(Please refer to the legend on last page)

List and code of Indicators under REMARK column

Indicator
Transferred Out Transferred IN Dropped Late Enrollment

Code
T/O T/I DRP LE

Required Information
Name of Public (P) Private (PR) School & Effectivity Date Name of Public (P) Private (PR) School & Effectivity Date Reason and Effectivity Date Reason (Enrollment beyond 1st Friday of June)

Indicator
CCT Recipient

Code
CCT

Required Information
CCT Control/reference number & Effectivity Date Name of school last attended & Year Specify Specify Level & Effectivity Data
MALE FEMALE TOTAL

BoSY

EoSY

Prepared by:

Certified Correct:

Balik-Aral B/A Learner With DissabilityLWD Accelarated ACL

(Signature of Adviser over Printed Name)

(Signature of School Head over Printed Name)

Date:___________________________________

Date:__________________________________________________

_______