School Level Only

NAME OF SCHOOL
SCHOOL ID

INDIVIDUAL REGISTRATION FORM GRADE

BASIC PROFILE One letter per box. DATA PROCESSING:

Learner Reference Number (LRN) : Date of Registration:
FAMILY NAME
FIRST NAME
MIDDLE NAME Registration In-charge
DATE OF BIRTH GENDER
m m d d y y y y (M/F) Date of Entrance:
ADDRESS :
STATUS Other Details:
Regular Mother Tongue : 4Ps Class Adviser
Transferee Religion : IPs
Balik - Aral Ethnicity : ECD Date Encoded in L.I.S.:
Repeater Dialect : PWD

ENROLMENT PROFILE L.I.S. In-charge

Previous Enrolment Remarks:
School ID No.: Grade Level: PWD ,State below:
Name of School:
Name of Adviser:

PARENT'S / GUARDIAN INFORMATION Documents Submitted:

Father's Name Birth Certificate
FAMILY NAME: NSO Copy
FIRST NAME: LCR Copy
MIDDLE NAME: DepED Form 137

Mother' Maiden Name DepED Form 138

FAMILY NAME: Good Moral Cert.
FIRST NAME: Clearance
MIDDLE NAME:
Guardian Name Other Notes:
FAMILY NAME:
 FIRST NAME:
MIDDLE NAME:
RELATIONSHIP:
MOBILE PHONE NUMBER :
Certified True and Correct : Attested by:

Thumb Mark, if
cannot sign.
Signature over Printed Name Date Signed Class Adviser
dohly.bucarile@deped.gov.ph
 LUNA NATIONAL VOCATIONAL HIGH SCHOOL
Alcala, Luna, La Union
321018
ALS- EST ENROLMENT FORM
PROGRAM DATA PROCESSING:
ABM HUMSS STEM GA TVL
Date of Registration:
Indicate combination if TVL:

BASIC PROFILE One letter per box.

Learner Reference Number (LRN) :

Registration In-charge
FAMILY NAME

FIRST NAME Date of Entrance:

MIDDLE NAME

DATE OF BIRTH GENDER

m m d d y y y y (M/F) Class Adviser
ADDRESS :

STATUS Other Details:

Date Encoded in L.I.S.:
Regular Mother Tongue : 4Ps

Transferee Religion : IPs

Balik - Aral Ethnicity : ECD

L.I.S. In-charge
Repeater Dialect : PWD
Remarks:
ENROLMENT PROFILE
Previous Enrolment PWD, State below:
School ID No.: Grade Level:
Name of School: Documents Submitted:
Name of Adviser: Birth Certificate
NSO Copy
PARENT'S / GUARDIAN INFORMATION
Father's Name LCR Copy

FAMILY NAME: DepED Form 137

FIRST NAME: DepED Form 138

MIDDLE NAME: Good Moral Cert.

Mother' Maiden Name Clearance

FAMILY NAME:

FIRST NAME:

MIDDLE NAME:

Guardian Name Other Notes:

FAMILY NAME:

FIRST NAME:

MIDDLE NAME:

RELATIONSHIP:

MOBILE PHONE NUMBER :

Certified True and Correct : Attested by:

Thumb Mark, if
cannot sign.
Signature over Printed Name Date Signed Class Adviser