School Form 1 (SF 1) School Register

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

School ID 302780 Region N.I.R Division SILAY CITY District SECONDARY

School Name DOA MONTSERRAT LOPEZ MHS School Year 2017 -2018 Grade Level Section
GUARDIAN
ADDRESS PARENTS REMARKS
(If not Parent)
IP
NAME Sex BIRTH DATE AGE as of 1st BIRTH PLACE MOTHER Contact Number of
no. LRN (Ethnic RELIGION House #/ Street/ Father's Name (Last Mother's Maiden Name
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) Friday June (Province) TONGUE Municipality/ Parent or Guardian (Please refer to
Group) Sitio/ Barangay Province Name, First Name, (Last Name, First Name, Name Relationship the legend on last
City
Purok Middle Name) Middle Name) page)

ROMAN
1 117804050002 Abela Louie Gutierrez M 11/17/1999 17 Hiligaynon CATHOLIC
Mckinley St. IV SILAY CITY NEG. OCC Lyn

ROMAN Antiporda, Severino Ballisteros, Isabel

2 1170804050027 Antiporda, Isidro Ballesteros M 1/24/2000 17 Hiligaynon Sawmil Guinhalaran SILAY CITY NEG. OCC
CATHOLIC Calanda Conserman
ROMAN Canopin, Teresita
3 117804050052 Barnig Jonas Canopin M 6/6/1996 21 Hiligaynon Sawmil Guinhalaran SILAY CITY NEG. OCC Barnia, Teotinao Quinco
CATHOLIC Labastera
ROMAN
4 1368050022 Benedicto, Havey Jay Rubio M 10/16/1999 17 Hiligaynon Lantad Lantad SILAY CITY NEG. OCC Bindot, Bobby Rubio, Roselyn C
CATHOLIC
ROMAN
5 302780120057 Blazo, Christopher Alabes M 9/24/1999 17 Hiligaynon Barra Bat-os Mambulac SILAY CITY NEG. OCC
CATHOLIC
ROMAN
6 117802050018 Cabatawan, Jeff Carl Ramos M 2/3/2000 17 Hiligaynon Mangingisda Guinhalaran SILAY CITY NEG. OCC Cabawatan, Jeffrey Ramos, Carolina
CATHOLIC
ROMAN
7 117827050021 Caceres, Glynce Ino M 4/2/2000 17 Hiligaynon Antonio Luna Mambulac SILAY CITY NEG. OCC Gerald Caceres S. Ino, Mary Jean
CATHOLIC
ROMAN
8 117804050128 Eramiz, Edrian Jodilla M 12/27/1999 17 Hiligaynon Marble St. V SILAY CITY NEG. OCC Eramiz, Edivert Mariveles Jordina, Hanna
CATHOLIC
ROMAN
9 117804050135 Faustinorio, Christian Camagay M 10/13/1999 17 Hiligaynon Ysabel St. IV SILAY CITY NEG. OCC Faustinorio, Greg Camagay, Maria Leonora
CATHOLIC
ROMAN
10 117827050054 Fernandez, Michael Francisco M 6/28/1998 18 Hiligaynon Langka St. V SILAY CITY NEG. OCC
CATHOLIC
ROMAN
11 1178010500360 Gallego, John Ross Anam-anam MM 2/20/1999 18 Hiligaynon Had. Panaogao IV SILAY CITY NEG. OCC Gallego, Ricardo Gallego, Cristita
CATHOLIC
ROMAN
12 117827050062 Guarin Carl Ivan Llarinas M 4/19/1999 18 Hiligaynon CATHOLIC
Gomez II SILAY CITY NEG. OCC Guarin, Sammy Llarinas, Lauryn

ROMAN TALISAY
13 302780120150 Jaranilla, Kerr Christian Ruales M 1/23/2000 17 Hiligaynon CATHOLIC
Matab-ang Matab-ang NEG. OCC Jaranilla, Enrique Jaranilla, Rowena
CITY
ROMAN
14 117807050111 Javelona, Joel Jr. Matapaja M 9/25/1999 17 Hiligaynon Prk. Matagoy II SILAY CITY NEG. OCC Javelona, Joel Javelona, Marison
CATHOLIC
ROMAN
15 Macabes, Alfred A. M 11/12/1999 17 Hiligaynon CATHOLIC
Matagoy RIZAL SILAY CITY NEG. OCC Macabes, Cecelia

ROMAN
16 302780120386 Magueriano, Gio-mel Canarias M 8/11/1999 17 Hiligaynon Had. Napilas ELOPEZ SILAY CITY NEG. OCC Magueriano, Giovanie Canarias, Melba
CATHOLIC
ROMAN
17 117807050132 Malacaman, Christian Anonas M 2/7/1999 18 Hiligaynon Prk. Ipil-Ipil Mambulac SILAY CITY NEG. OCC Malacaman, Cornelio Iso Anunas, Julie Heponia
CATHOLIC
ROMAN
18 117827050103 Mana, Steve Martin M Hiligaynon Prk. Ipil-Ipil Mambulac SILAY CITY NEG. OCC Mana, Carolina Alapan Mana, Carolina Alapan
CATHOLIC
ROMAN
19 Omban, Reylee M 1/11/1999 18 Hiligaynon CATHOLIC
Rizal RIZAL SILAY CITY NEG. OCC Omban, Reynaldo Caya, Jubilee Capindo

ROMAN
20 302780120076 Pagunsan, Jude Ryan Obut M 7/23/1999 17 Hiligaynon Patag Patag SILAY CITY NEG. OCC
CATHOLIC
ROMAN
21 117808050052 Pagunsan, John Michael B M 11/8/1999 17 Hiligaynon Patag Patag SILAY CITY NEG. OCC Pagunsan, Gie Lamis Obut, Anastacia Pamplona
CATHOLIC
ROMAN
22 117804050295 Perez, Bryan James De Guzman M 11/20/1999 17 Hiligaynon CATHOLIC
Rizal RIZAL SILAY CITY NEG. OCC

ROMAN Rebadomia, Jose Merben

23 117827050122 Rebadomia, Jaybe Galima M 7/9/1998 18 Hiligaynon Prk. Maabiabihon Mambulac SILAY CITY NEG. OCC Galina, Judelyn Villaruel
CATHOLIC Tanez
ROMAN
24 117805050021 Serrano, Francis Batisla-on M 7/26/1999 17 Hiligaynon CATHOLIC
Had. Guinsangan Hawaiian SILAY CITY NEG. OCC Serrano, Jolly Batisla-on, Jore
 GUARDIAN
ADDRESS PARENTS REMARKS
(If not Parent)
IP
NAME Sex BIRTH DATE AGE as of 1st BIRTH PLACE MOTHER Contact Number of
no. LRN (Ethnic RELIGION House #/ Street/ Father's Name (Last Mother's Maiden Name
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) Friday June (Province) TONGUE Municipality/ Parent or Guardian (Please refer to
Group) Sitio/ Barangay Province Name, First Name, (Last Name, First Name, Name Relationship the legend on last
City
Purok Middle Name) Middle Name) page)

ROMAN Sumpay, Bernardo

25 117807050208 Sumpay, Brayn Rivas M 1/26/2000 17 Hiligaynon Had. Maquina RIZAL SILAY CITY NEG. OCC Rivas, Minerva Romero
CATHOLIC Balgona
ROMAN
26 302780120088 Templado, Andrian Penaflor M 8/18/1994 22 Hiligaynon Rizal RIZAL SILAY CITY NEG. OCC
CATHOLIC

27 Male=26

28 117827050005 Adordo, Reneann V.

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

50

51

52

53
 GUARDIAN
ADDRESS PARENTS REMARKS
(If not Parent)
IP
NAME Sex BIRTH DATE AGE as of 1st BIRTH PLACE MOTHER Contact Number of
no. LRN (Ethnic RELIGION House #/ Street/ Father's Name (Last Mother's Maiden Name
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) Friday June (Province) TONGUE Municipality/ Parent or Guardian (Please refer to
Group) Sitio/ Barangay Province Name, First Name, (Last Name, First Name, Name Relationship the legend on last
City
Purok Middle Name) Middle Name) page)

54

55

56

List and Code of Indicators under REMARKS column

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

Transferred Out T/O Name of Public (P) Private (PR) School & Effectivity Date CCT Recipient CCT CCT Control/reference number & Effectivity Date MALE
RODITO RUBICA BADIAN
Adviser Secondary School Principal II
Transferred IN T/I Name of Public (P) Private (PR) School & Effectivity Date Balik-Aral B/A Name of school last attended & Year FEMALE

Dropped DRP Reason and Effectivity Date Learner With Dissability LWD Specify
TOTAL
Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) Accelarated ACL Specify Level & Effectivity Data BoSY Date: 06/05/2017 EoSYDate: BoSY Date: EoSYDate:
 School Form 2 (SF2) Daily Attendance Report of Learners

School ID 302780 School Year 2017 - 2018 Report for the Month of JUNE

Name of School DOA MONTSERRAT LOPEZ MEMORIAL HIGH SCHOOL Grade Level Section
LEARNER'S NAME (1st row for date) Total for the
REMARKS (If DROPPED OUT, state reason, please
Month
6-5 6-6 6-7 6-8 6-9 6-12 6-13 6-14 6-15 6-16 6-19 6-20 6-21 6-22 6-23 6-26 6-27 6-28 6-29 6-30 refer to legend number 2.
(Last Name, First Name, Middle Name) If TRANSFERRED IN/OUT, write the name of School.)
M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F ABSENT TARDY
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
 36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
FEMALE | TOTAL Per Day
Combined TOTAL PER DAY
GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month: No. of Days of Summary
JUNE
Classes: 18
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance. (blank) - Present; (x)- Absent; Tardy (half shaded= Upper for M F TOTAL
2. Dates shall be written in the columns after Learner's Name. Late Commer, Lower for Cutting Classes)
3. To compute the following: 2. REASONS/CAUSES FOR DROPPING OUT
* Enrolment as of (1st Friday of June)
Registered Learners as of end of the month a. Domestic-Related Factors Late Enrollment during the month
a. Percentage of Enrolment = x 100
Enrolment as of 1st Friday of the school year a.1. Had to take care of siblings (beyond cut-off)
b. Average Daily Attendance = Total Daily Attendance a.2. Early marriage/pregnancy Registered Learners as of end of the month
Number of School Days in reporting month a.3. Parents' attitude toward schooling
Average daily attendance a.4. Family problems
c. Percentage of Attendance for the month = x 100 Percentage of Enrolment as of end of the month
Registered Learners as of end of the month b. Individual-Related Factors
b.1. Illness
Average Daily Attendance
4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summary table b.2. Overage
into School Form 4. Once signed by the principal, this form should be returned to the adviser. b.3. Death
Percentage of Attendance for the month
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 b.4. Drug Abuse
consecutive days and/or those at risk of dropping out. b.5. Poor academic performance
Number of students absent for 5 consecutive days: 0 0 0
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period. b.6. Lack of interest/Distractions
* Beginning of School Year cut-off report is every 1st Friday of the School Year b.7. Hunger/Malnutrition
Drop out 0 0 0
c. School-Related Factors
c.1. Teacher Factor
Transferred out 0 0 0
c.2. Physical condition of classroom
c.3. Peer influence
Transferred in 0 0 0
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds) I certify that this is a true and correct report.
d.3. Calamities/Disasters
e. Financial-Related
e.1. Child labor, work Adviser
f. Others (Specify) Attested by:
RODITO RUBICA BADIAN
Secondary School Principal II
 School Form 3 (SF3) Books Issued and Returned
(This replaces Form 1 & Inventory of Textbooks)

School ID 302780 School Year 2017 - 2018

School Name DOA MONTSERRAT LOPEZ MHS Grade Level Section

Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title
LEARNER'S NAME REMARKS/ACTION TAKEN
NO. (Last Name, First (Please refer to the
Name, Middle Name) Date Date Date Date Date Date Date Date legend on last page)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
 Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title
LEARNER'S NAME REMARKS/ACTION TAKEN
NO. (Last Name, First (Please refer to the
Name, Middle Name) Date Date Date Date Date Date Date Date legend on last page)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
TOTAL FOR FEMALE | TOTAL COPIES
TOTAL LEARNERS | TOTAL COPIES
GUIDELINES: In case of lost/unreturned books, please provide information with the following code: Prepared By:
1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form. A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
3. The Total Number of Copies issued at BoSY shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for (Signature over printed name)
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. code FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Date BoSY: 06/05/2017 Date EoSY: ___________
5. All textbooks being used must be included. Additional copies of this form may be used if needed. Custodian (for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003,
DO#14, 2.2012.
 School Form 4 (SF4) Monthly Learner's Movement and Attendance
(This replaces Form 3 & STS Form 4-Absenteeism and Dropout Profile)

School ID 302780 Region NIR Division SILAY CITY District SECONDARY

School Name DOA MONTSERRAT LOPEZ MEMORIAL HIGH SCHOOL School Year 2017 - 2018 Report for the Month of JUNE

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN

REGISTERED
GRADE/ LEARNERS (A+B) Cumulative (A+B) Cumulative (A+B)
YEAR SECTION NAME OF ADVISER (As of End of Percentage for (A) Cumulative as (A) Cumulative as (A) Cumulative as
Daily Average (B) For the Month as of End of the (B) For the Month as of End of the (B) For the Month Cumulative as of
LEVEL the Month) the Month of Previous Month
Month
of Previous Month
Month
of Previous Month
End of the Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T
48.11
12 12-1 THEA S. SAYSON 6 47 53 5.33 44.94 50.88 92 98 89

ELEMENTARY/SECONDARY:
KINDER
GRADE 1/GRADE 7
GRADE 2/GRADE 8
GRADE 3/GRADE 9
GRADE 4/GRADE 10
GRADE 5/GRADE 11
GRADE 6/GRADE 12
TOTAL FOR NON-GRADED
TOTAL
GUIDELINES: Prepared and Submitted by:
1. This form shall be accomplished every end of the month using the summary box of SF2 submitted by the teachers/advisers to update figures for the month.
2. Furnish the Division Office with a copy a week after June 30, October 30 & March 31
(Signature of School Head over Printed Name)
Page _____ of _____ pages
 School Form 5 (SF 5) Report on Promotion & Level of Proficiency
(This replaces Forms 18-E1, 18-E2, 18A and List of Graduates)

Region N.I.R Division SILAY CITY District SECONDARY

School ID 302780 School Year 2017 - 2018 Curriculum K - 12

School Name DOA MONTSERRAT LOPEM MEMORIAL HIGH SCHOOL Grade Level Section

INCOMPLETE SUBJECT/S
GENERAL
(This column is for K to 12 Curriculum and remaining
AVERAGE
ACTION TAKEN: RBEC in High School. Elementary grades level that are still
(Numerical Value in 2
LEARNER'S NAME PROMOTED, implementing RBEC need not to fill up these columns)
No. LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
RETAINED From previous school years
honor learners, and
Descriptive Letter) completed as of end of current As of end of current School Year
School Year
1 SUMMARY TABLE
2 STATUS MALE FEMALE TOTAL

3
PROMOTED
4
5
IRREGULAR
6
7
RETAINED
8
9
10 LEVEL OF PROFICIENCY
11 MALE FEMALE TOTAL

12 BEGINNNING
(B: 74% and
13 below)
14 DEVELOPING
15 (D: 75%-79%)
APPROACHING
16 PROFICIENCY
17 (AP:
80%-84%)
18 PROFICIENT
19 (P: 85% -89%)

20 ADVANCED
(A: 90% and
21 above)
22
23 PREPARED BY:
24
 INCOMPLETE SUBJECT/S
GENERAL
(This column is for K to 12 Curriculum and remaining
AVERAGE
ACTION TAKEN: RBEC in High School. Elementary grades level that are still
(Numerical Value in 2
LEARNER'S NAME PROMOTED, implementing RBEC need not to fill up these columns)
No. LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
RETAINED From previous school years
honor learners, and
Descriptive Letter) completed as of end of current As of end of current School Year
School Year
25 Class Adviser
26 (Name and Signature)
27
28 CERTIFIED CORRECT & SUBMITTED:
29 RODITO RUBICA BADIAN
30 Secondary School Principal II
31
32
33 REVIEWED BY:
34
35 (Name and Signature)
36 Division Representative
37 GUIDELINES:
38 1. For All Grade/Year Levels
39
2. To be prepared by the Adviser. Final rating per subject
40 area should be taken from the record of subject teachers.
The class adviser should compute for the General Average.
41
42 3. On the summary table, reflect the total number of
learners promoted, retained and *irregular (*for grade 7
43 onwards only) and the level of proficiency according to the
44 individual General Average.

45 4. Must tally with the total enrollment report as of End of

46 School Year GESP /GSSP (EBEIS)

47
48
49
50
51
52
53
54
5. Protocols of validation & submission is under the
TOTAL FEMALE discretion of the Schools Division Superintendent

COMBINED School Form 5: Page ____ of ________

 INCOMPLETE SUBJECT/S
GENERAL
(This column is for K to 12 Curriculum and remaining
AVERAGE
ACTION TAKEN: RBEC in High School. Elementary grades level that are still
(Numerical Value in 2
LEARNER'S NAME PROMOTED, implementing RBEC need not to fill up these columns)
No. LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
RETAINED From previous school years
honor learners, and
Descriptive Letter) completed as of end of current As of end of current School Year
School Year
 Republic of the Philippines
Department of Education
Negros Island Region
Division of Silay City
Doa Montserrat Lopez Memorial High School
City of Silay

End of School Year Status for SHS Masterlist of Learners

As of SY 2017 - 2018

Track: Program:
Grade Level: Class:

EXTENSION END OF SEMESTER STATUS End of School Year

NO LRN LAST NAME FIRST NAME MIDDLE NAME SEX Remarks
NAME
1ST SEM 2ND SEM Status by Program
1 In School Completer Regular
2 In School Completer Regular
3 In School Completer Regular
4 In School Completer Regular
5 In School Incomplete Irregular
6 In School Completer Regular
7 In School Incomplete Irregular
8 In School Incomplete Irregular
9 In School Incomplete Irregular
10 In School Completer Regular
11 In School Incomplete Irregular
12 In School Completer Regular
13 In School Incomplete Irregular
14 In School Completer Regular
15 In School Completer Regular
16 In School Completer Regular
17 No Longer in
In School Dropped Out Did not enroll in 2nd sem
18 No School
Longer in
In School Dropped Out Did not enroll in 2nd sem
School
19 In School Incomplete Irregular
20 In School Incomplete Irregular
21 In School Incomplete Irregular
22 In School Completer Regular
23 In School Incomplete Irregular
24 In School Completer Regular
25 No Longer in
No Longer in School Dropped Out Did not enroll in 2nd sem
School
26 In School Completer Regular
27 No Longer in
In School Dropped Out Did not enroll in 2nd sem
School
28 In School In School Regular
29 In School In School Regular
30 In School In School Regular
31 In School In School Regular
32 In School In School Regular
33 In School In School Regular
34 In School In School Regular
35 In School In School Regular
36 In School In School Irregular
37 No Longer in
In School Dropped Out Did not enroll in 2nd sem
School
38 In School Completer Regular
39 In School Completer Regular
40 In School Completer Regular
41 In School Completer Regular
42 In School Completer Regular
43 In School Completer Regular
44 In School Completer Regular
45 In School Completer Regular
46 In School Completer Regular
47 In School Completer Regular
48 In School Completer Regular
49 In School Completer Regular
50 In School Completer Regular
51 In School Completer Regular
52 In School Completer Regular
53 In School Completer Regular
54 In School Completer Regular

Prepared by:

Certified Correct:
Adviser

Registrar I