Enclosure No. 2 to DepEd Order No. 4, s. 2012 FORMA DEPARTMENT OF EDUCATION EARLY REGISTRATION FORM School ID: __ Region School Name: Dwwsion: —_ School Distict: ~ Kindergarten iGrade Near Level NAME SEX | AGE BIRTHDATE Address CATEGORY OF | Remarks* | cry WITH DISABILITY" {for Children and Youth with | Disabilities only) Remarks® 1, For Grade 1 Registrants: Has altendecinot attended Kindergarten class 2. For ALS: information whether the childiyouth prefers to learn through the ADM = alternative delivery mode (MISOSA, ¢-IMPACT, CORP) or ALS = alternative learning system Category of C/Y with Disabulty*™ Visual Imparment, Hearing Impairment, intellectual Disability, Learring Disability, Spcech/Language Imparment, Serious Emotional Disturbance, Autism, Orth Impairment, Special Meath Problem, Multiple Disabilities