DEPARTMENT OF EDUCATION EARLY REGISTRATION FORM School ID: ___________________________ School Name: ________________________ Kindergarten/Grade/Year Level: ________ Region:

_____________________________ Division: ____________________________ School District: _______________________

CATEGORY OF C/Y WITH DISA (for Children and Youth with Disa No. NAME SEX AGE BIRTHDATE (mmddyy) Address VI HI ID LD S/LI SED

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 Remarks*: 1. For Grade 1 Registrants: Has attended/not attended Kindergarten class. 2. For ALS: Information whether the child/youth prefers to learn through the ADM =Alternative Delivery Mode (MISOS, e-IMPACT, DORP) or ALS=Alternative Learning System. Category of C/with Disability**: Visual Impairment (VI), Hearing Impairment (HI), Intellectual Disability (ID), Learning Disability (LD), Speech/Language Impairment (S/LI), Serious Emotional Disturbance (SED), Autism (AU), Orthopedic Impairment (OI), Special Health Problem (SHP), Multiple Disabilities (MD).

MENT OF EDUCATION EGISTRATION FORM FORM 1c-SECONDARY (Regular) Region: _____________________________ Division: ____________________________ School District: _______________________ CATEGORY OF C/Y WITH DISABILITY** (for Children and Youth with Disabilities only)

AU

OI

SHP MD

Others

DEPARTMENT OF EDUCATION EARLY REGISTRATION FORM School ID: _312904__________________________ School Name: Guba National High School Kindergarten/Grade/Year Level: 2nd year HS Region: VII Central Visayas Division: Negros Oriental School District: Vallehermoso

CATEGORY OF C/Y WITH DISA (for Children and Youth with Disa No. NAME SEX AGE BIRTHDATE (mmddyy) Address VI HI ID LD S/LI SED

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Bacus, Jevie D. Bacus, Joven C. Barsolo, Jomar A. Benlot, Marlou D. Briones, Excel C. Candelansa, Renato C. Canonayon, Jason A. Catubig, Dave H. Catubig, Jovito C. Civil, Raymund D. Danielez, Jimel c. Danong, Noly Y. De Asis, Bernard Cris C. Endino, Erbert S. Esolana, Jason C. Espiritu, Jhonbic G. Garcia, Junnifer P. Genon, James B.

M M M M M M M M M M M M M M M M M M

14 1/4 15 1/4 13 1/4 18 1/4 15 1/4 14 1/4 16 3/4 14 1/4 14 1/4 15 1/4 14 3/4 16 3/4 17 1/4 15 1/4 17 1/4 13 1/4 19 1/4 15 1/4

10/18/1998 Pinocauan, Vallehermoso 2/11/1998 Pinocauan, Vallehermoso 1/26/1999 Calupa-an, Guihulngan City 12/26/1997 Pinocauan, Vallehermoso 12/25/1997 Pinocauan, Vallehermoso 11/29/1997 Pinocauan, Vallehermoso 5/16/1995 Guba, Vallehermoso 1/28/1998 Malangsa, Vallehermoso 2/15/1998 Malangsa, Vallehermoso 10/9/1996 Guba, Vallehermoso 5/11/1998 Guba, Vallehermoso 4/9/1995 Calupa-an, Guihulngan City 12/31/1994 Guba, Vallehermoso 1/10/1997 Pinocauan, Vallehermoso 12/3/1995 Calupa-an, Guihulngan City 11/2/1998 Guba, Vallehermoso 3/11/1994 Pinocauan, Vallehermoso 3/30/1998 Pinocauan, Vallehermoso

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

Genon, Jemuel D. Gile, Jearald N. Labrador, Jesrel G. Lamdag, Raymund B. Lumapay, Jay Arr P. Malalbago, Edilberto M. Mata, Francis Brian C. Navarro, Reynaldo S. Nitro, Gino T. Obena, Welmar C. Obena, Elmar C. Panares, Jhonneil B. Pasyol, Algen S. Pitulan, Joseph P. Repaso, Richard L. Rone, Melvin T. Sarona, Juven L. Saylanon, Rene Boy M. Sirinio, Neil M. Tabotabo, Marvin N. Tanudra, Rouil J. Temple, Jarry C. Ti-in, Dandie J. Ti-in, Darwin J. Tumacmol, Jr. Dionesio E. Tumacmol, Michael Y. Villarmia, Noel S. Zamora, Rogelio A. Alinsalorin, Cneryl A. Alvarado, Jomen B.

M M M M M M M M M M M M M M M M M M M M M M M M M M M M F F

15 1/4 13 3/4 14 3/4 18 1/4 16 3/4 14 3/4 12 3/4 16 3/4 15 3/4 17 1/4 18 3/4 14 1/4 16 1/4 17 1/4 13 3/4 16 1/4 15 1/4 14 3/4 18 1/4 14 1/4 15 1/4 15 3/4 16 1/4 11 3/4 13 1/4 18 1/4 15 3/4 14 3/4 16 3/4 14 3/4

12/4/1997 Pinocauan, Vallehermoso 6/6/1999 Guba, Vallehermoso 5/24/1997 Guba, Vallehermoso 3/21/1995 Guba, Vallehermoso 5/25/1995 Guba, Vallehermoso 4/8/1998 Pinocauan, Vallehermoso 5/28/1999 Calupa-an, Guihulngan City 6/27/1996 Pinocauan, Vallehermoso 8/21/1996 Guba, Vallehermoso 3/29/1996 Pinocauan, Vallehermoso 6/14/1994 Pinocauan, Vallehermoso 3/29/1999 Calupa-an, Guihulngan City 2/15/1997 Tabon, Vallehermoso 12/20/1994 Tabon, Vallehermoso 5/5/1998 Pinocauan, Vallehermoso 3/7/1996 Guba, Vallehermoso 12/31/1997 Pinocauan, Vallehermoso 1/5/1997 Guba, Vallehermoso 11/29/1994 Calupa-an, Guihulngan City 10/6/1998 Guba, Vallehermoso 10/5/1996 Bucalan, Canlaon City 1/9/1996 3/27/1996 7/4/2000 1/30/1999 2/27/1995 4/27/1996 6/26/1997 7/30/1995 8/14/1997 Calupa-an, Guihulngan City Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Pinocauan, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso

49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85

Amorado, Mary Jun M. Ampil, Nerissa S. Balancar, Maribel A. Balolot, Jenecil D. Baloran, Marciana N. Behic, Regeline L. Binondo, Lady Lee L. Cabunag, Judelene A. Calderon, Jovelyn N. Calderon, Nessiel L. Caralde, Susan M Canabano, Bernadeth E Caralde, Virginia B. Catubig, Mary Jane M. Civil, Jovelyn R. Danong, Michel T. Dela Cruz, Mary Ann D. Elladora, Maricel E. Ento, Nina B. Escribano, Ivy D. Escribano, Renalyn D. Fajardo, Eliza A. Garcia, Evelyn P. Genon, Analy O. Genon, Jeneshil E. Haincadto, Amegean R. Heredera, Helen O. Lariosa, Criselda M. Lasponia, Retchelyn B. Lasponia, Roxan B. Lesana, Mica T. Lumapay, Jenalyn T. Mangyao, Mary Ann P. Navales, Teresa V. Pahayahay, Aireen D. Paradero, Regine D. Paquiao, Cristina A.

F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F

14 1/4 15 3/4 14 1/4 14 1/4 14 3/4 15 3/4 15 1/4 13 3/4 15 1/4 15 3/4 13 3/4 18 1/4 15 1/4 16 1/4 15 3/4 13 3/4 14 1/4 14 3/4 19 1/4 12 3/4 13 1/4 15 1/4 14 1/4 13 1/4 14 1/4 14 1/4 14 1/4 15 3/4 21 1/4 14 1/4 13 1/4 13 3/4 13 1/4 17 1/4 18 3/4 14 1/4 15 3/4

10/20/1998 6/25/1996 1/9/1999 3/24/1999 5/24/1997 8/5/1996 1/14/1998 8/13/1999 1/23/1998 6/25/1996 6/26/1998 2/18/1995 1/15/1998 3/27/1997 9/15/1996 4/3/1998 12/16/1998 5/16/1997 1/15/1994 7/13/1999 10/30/1998 2/16/1998 3/5/1998 11/23/1998 3/28/1999 12/1/1998 1/24/1998 7/21/1996 11/13/1991 10/20/1997 12/29/1999 7/1/1999 12/15/1995 12/15/1995 7/19/1994 2/23/1999 7/18/1996

Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Calupa-an, Guihulngan City Pinocauan, Vallehermoso Guba, Vallehermoso Bucalan, Canlaon City Bucalan, Canlaon City Guba, Vallehermoso Guba, Vallehermoso Pinocauan, Vallehermoso Malangsa, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Pinocauan, Vallehermoso Guba, Vallehermoso Calupa-an, Guihulngan City Guba, Vallehermoso Pinocauan, Vallehermoso Pinocauan, Vallehermoso Pinocauan, Vallehermoso Pinocauan, Vallehermoso Calupa-an, Guihulngan City Guba, Vallehermoso Guba, Vallehermoso Calupa-an, Guihulngan City Calupa-an, Guihulngan City Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Guba, Vallehermoso Bucalan, Canlaon City Pinocauan, Vallehermoso

86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122

Pitulan, Manelyn b. Pueblo, Calocera C. Rayos, Allysa May M. Rone, Juvelyn T. Sarona, Cherilyn E.

F F F F F

14 3/4 17 3/4 14 3/4 14 1/4 14 3/4

4/16/1993 5/19/1994 9/4/1998 2/27/1998 5/7/1997

Tabon, Vallehermoso Bucalan, Canlaon City Pinocauan, Vallehermoso Guba, Vallehermoso Pinocauan, Vallehermoso

123 124 125 126 127 128 129 130 REMARKS

MENT OF EDUCATION EGISTRATION FORM FORM 1c-SECONDARY (Regular)

CATEGORY OF C/Y WITH DISABILITY** (for Children and Youth with Disabilities only)

AU

OI

SHP MD

Others

DEPARTMENT OF EDUCATION EARLY REGISTRATION FORM School ID: ___________________________ School Name: ________________________ Kindergarten/Grade/Year Level: ________ Region: _____________________________ Division: ____________________________ School District: _______________________

CATEGORY OF C/Y WITH DISA (for Children and Youth with Disa No. NAME SEX AGE BIRTHDATE (mmddyy) Address VI HI ID LD S/LI SED

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 Remarks*: 1. For Grade 1 Registrants: Has attended/not attended Kindergarten class. 2. For ALS: Information whether the child/youth prefers to learn through the ADM =Alternative Delivery Mode (MISOS, e-IMPACT, DORP) or ALS=Alternative Learning System. Category of C/with Disability**: Visual Impairment (VI), Hearing Impairment (HI), Intellectual Disability (ID), Learning Disability (LD), Speech/Language Impairment (S/LI), Serious Emotional Disturbance (SED), Autism (AU), Orthopedic Impairment (OI), Special Health Problem (SHP), Multiple Disabilities (MD).

MENT OF EDUCATION EGISTRATION FORM FORM 1c-SECONDARY (Regular) Region: _____________________________ Division: ____________________________ School District: _______________________ CATEGORY OF C/Y WITH DISABILITY** (for Children and Youth with Disabilities only)

AU

OI

SHP MD

Others

DEPARTMENT OF EDUCATION EARLY REGISTRATION FORM School ID: ___________________________ School Name: ________________________ Kindergarten/Grade/Year Level: ________ Region: _____________________________ Division: ____________________________ School District: _______________________

CATEGORY OF C/Y WITH DISA (for Children and Youth with Disa No. NAME SEX AGE BIRTHDATE (mmddyy) Address VI HI ID LD S/LI SED

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 Remarks*: 1. For Grade 1 Registrants: Has attended/not attended Kindergarten class. 2. For ALS: Information whether the child/youth prefers to learn through the ADM =Alternative Delivery Mode (MISOS, e-IMPACT, DORP) or ALS=Alternative Learning System. Category of C/with Disability**: Visual Impairment (VI), Hearing Impairment (HI), Intellectual Disability (ID), Learning Disability (LD), Speech/Language Impairment (S/LI), Serious Emotional Disturbance (SED), Autism (AU), Orthopedic Impairment (OI), Special Health Problem (SHP), Multiple Disabilities (MD).

MENT OF EDUCATION EGISTRATION FORM FORM 1c-SECONDARY (Regular) Region: _____________________________ Division: ____________________________ School District: _______________________ CATEGORY OF C/Y WITH DISABILITY** (for Children and Youth with Disabilities only)

AU

OI

SHP MD

Others