AGE as of 1st

Friday of June
LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/ dd/yy)

ADDRESS
BIRTH PLACE
(Province)

IP
(Specify Ethnic
Group)

MOTHER TONGUE

(nos. of years
as per last
birthday)
AGBUNAG, MITS JAY AR ESMELO

NAME OF PARENTS

GUARDIAN (If not Parent)

REMARK/S
Contact Number
(Parent /Guardian)

RELIGION
House # / Street/Sitio/
Purok

Barangay

Municipality/ City

Province

Father (1st name only if family

name identical to learner)

Mother (Maiden: 1st Name, Middle & Last

Name)

Name

(Please refer to the legend on

last page)

Relationship

7/11/99

Occ.Mdo.

Tagalog

Roman Catholic

Marilao

New Dagupan

Calintaan

Occ. Mdo.

Salvador

Arsenia Ocumen Esmelo

8/9/98

Cavite

Tagalog

Roman Catholic

Purok 4

Magsikap

Rizal

Occ. Mdo.

Danilo

Mary Ann Tolentino Estoya

3/12/98

Occ.Mdo.

Tagalog

Roman Catholic

Mangat

San Pedro

Rizal

Occ. Mdo.

Rolly Sr.

Marites Cadahing Casas

12/26/99

Occ.Mdo.

Tagalog

Roman Catholic

Purok 5

Magsikap

Rizal

Occ. Mdo.

Haide Iquiron Cabangon

09205168015

1/18/99

Occ.Mdo.

Tagalog

Roman Catholic

Purok 4

Magsikap

Rizal

Occ. Mdo.

Reynold

Regina Cabangon Casidsid

09461127598

5/9/99

Occ.Mdo.

Tagalog

Roman Catholic

Bagong Sikat

San Jose

Occ. Mdo.

Lorenzo

Natividad Montemayor Ancinso

12/24/99

Tagalog

Pentecostal

Purok 5

Magsikap

Rizal

Occ. Mdo.

Jongie

Jesusa De Leon Sarmiento

5/1/00

Occ.Mdo.

Tagalog

Roman Catholic

Mangat

San Pedro

Rizal

Occ. Mdo.

7/4/99

Occ.Mdo.

Tagalog

Roman Catholic

Purok 5

Magsikap

Rizal

Occ. Mdo.

11/27/99

Occ.Mdo.

Tagalog

Roman Catholic

Saligsig

Magsikap

Rizal

9/13/99

Neg. Occ.

Bisaya

JMC

Malawaan

2/4/00

Occ.Mdo.

Tagalog

Pentecostal

Purok 2

6/16/00

Occ.Mdo.

Tagalog

Roman Catholic

11/6/97

Pasig City

Tagalog

5/20/00

Occ.Mdo.

Tagalog

2/18/00

Occ.Mdo.

Tagalog

Roman Catholic

M.

3/29/99

Occ.Mdo.

Tagalog

Roman Catholic

Caniwal

3/20/99

Occ.Mdo.

Tagalog

Roman Catholic

9/17/98

Occ.Mdo.

Tagalog

5/11/99

Occ.Mdo.

5
09296230718

6
Cam.Sur

Jonathan Lustina

Uncle

09207004782

7
Zenaida Balin Gonzales

09465327347

Noel

Gerlie Domingo Ambulo

09422412526

Occ. Mdo.

Charito

Josefa Macahilig Cahilig

09093042183

Rizal

occ. Mdo.

Eusebio

Jovelyn Agustino Oderio

09108731317

Magsikap

Rizal

Occ. Mdo.

Arnulfo

Remelyn Ramirez Jimena

09499130354

Malatikwang

New Dagupan

Calintaan

Occ. Mdo.

Tirso

Elizabeth Nodo Almonte

SDA

Purok 4

Magsikap

Rizal

Occ. Mdo.

Reynaldo

Merlita Verzon Gelacio

Roman Catholic

Malatikwang

New Dagupan

Calintaan

Occ. Mdo.

William

Juvy Sioco Gallos

09106636453

Bagong Sikat

San Jose

Occ. Mdo.

George

Cecilia Espiritu Lapuz

09106680915

Magsikap

Rizal

Occ. Mdo.

Jerry Sr.

Rowena Valdez Marinas

Purok 2

Magsikap

Rizal

Occ. Mdo.

Elmer

Rosalina Panginin Solinap

09108655511

Roman Catholic

Saligsig

Magsikap

Rizal

Occ. Mdo.

Emeliano

Helen Alonsabe Catague

09482580836

Tagalog

Roman Catholic

Marilao

New Dagupan

Calintaan

Occ. Mdo.

George

Remedios Soriano Rito

09108708115

Occ.Mdo.

Tagalog

ROman Catholic

Marilao

New Dagupan

Calintaan

Occ. Mdo.

Nido

Boberlita Mameng Maslog

Occ.Mdo.

Tagalog

Catholic

Purok 2

Magsikap

Rizal

Occ. Mdo.

Antonio

Melinda Egaa Carida

Occ.Mdo.

Tagalog

Roman Catholic

Mangat

San Pedro

Rizal

Occ. Mdo.

Cerlito Sr.

Merie Francisco Esbieto

Occ.Mdo.

Tagalog

Roman Catholic

Purok 3

Magsikap

Rizal

Occ. Mdo.

Renato

Josephine Manongdo Bawayan

09089693422

Occ.Mdo.

Tagalog

Roman Catholic

Malatikwang

New Dagupan

Calintaan

Occ. Mdo.

Henry

Joeselin Apolonio Capague

09078044425

10

11

12

13
Daisy Tacderan

Aunt

09109352742

14

15

16

17

18

19
110078050036

VALENA, GERALD RITO

20

16
110078050037

VALEA, MARVIN MASLOG

3/14/97

21

18
110200050073

VELASCO, JESTONI CARIDA

8/25/96

110198050039

VELENSO,CERLITO JR.,ESBIETO

12/27/99

22

15
110200050074

VIAA, JONATHAN BAWAYAN

12/11/99

110078050041

ZAGUIRRE, IAN CHRISTOPER CAPAGUE

4/10/98

24

15

25

17

LRN

26
27
28
29
30
31
32
33
34
35

09295422920

18

23

NAME
(Last Name, First Name,
Middle Name)

Sex
(M/F)

BIRTH
DATE
(mm/
dd/yy)

110196050005

ALMONIA, GRASYA ILAVA

110198050001

ALMONIA, SHAIDY DELA CRUZF

###

110198050005

BACENCE, JOVELYN SUALOG

7/30/99

110200050012

CALLE LOVELY ROSE AMBULO F

###

110200050013

CASIMERO, AIRA JANEAM BATITF

8/5/99

110200050015

DAVID, JHOVELYN TAPALES

1/10/99

301591140027

EGUIRON, HONEY JOY BRAVANF

2/1/99

169511050008

EVANGELIO, MARIA MAY URBF

5/14/99

110078050009

FERNANDO, DIANNE KAYE MAF

11/4/99

110200050025

GUANTIA, AIRA JADE AGBUNAGF

8/13/98

110078050018

MABITAZAN, MYCEL MAGBANU F

###

110200050034

MATIAS, MIJIA LEE MANLABAO F

4/18/00

110198050025

NOMAT, MAVEL MAGBUDHI

###

110078050022

NOVELOZO, MARY GRACE BEGF

5/18/99

301591120009

NUDO, RICHELLE FLORENDO F

9/6/98

110200050043

PANAGSAGAN, AIRA AMBULO F

7/1/98

169511050019

PATRICIO, ABEGEL QUILANTANF

12/8/97

110200050046

PERIDO, JAMAICA MATIAS

1/13/00

110198050027

PINUELA, AIRA MAE SANTIAG F

2/25/00

110198050029

PUDAN, ERICA PRADO

8/30/99

110200050054

RICA, RUBY JOY ESPARTERO F

3/19/00

110200050060

ROMUALDO, EDILYN SOLINAP F

6/19/99

110200050061

ROSETE, KATRINA CHAVEZ

6/20/98

110200050066

SANTIAGO , ROSE SABUSAP

###

110200050067

SARONA, REMELYN ESTRABEL F

9/18/99

110200050069

SUALOG, ELENA VENTURERO F

4/26/99

110198050038

TAMBOONG, JEZZA MAY GREGF

1/28/00

110078050034

TORMA , ARJANE ROSE MANAF

2/19/00

110200050075

VICTORIANO, VANESSA SOLANF

4/4/00

3/23/00

AGE as of
1st Friday
of June

BIRTH
PLACE
(Province)

MOTHER
TONGUE

15

Antique

Tagalog

15

Occ. Mdo.

15

Occ. Mdo.

15

(nos. of
years as
per last
birthday)

IP
(Specify
Ethnic
Group)

ADDRESS

NAME OF PARENTS

GUARDIAN (If not Parent)

RELIGION
House # /
Street/Sitio/
Purok

Barangay

Municipality/ City

Province

Roman Catholic

Purok 4

Magsikap

Rizal

Occ. Mdo

Tagalog

INC.

Payompon

Magsikap

Rizal

Tagalog

Roman Catholic

Mangat

San Pedro

Rizal

Occ. Mdo.

Tagalog

Roman Catholic

Purok 1

Magsikap

15

Occ. Mdo.

Tagalog

Roman Catholic

Purok 1

16

Occ. Mdo.

Tagalog

Roman Catholic

16

Occ. Mdo.

Tagalog

16

Occ. Mdo.

15

Sablayan

16

Father (1st name only

Mother (Maiden: 1st Name,
if family name
Middle & Last Name)
identical to learner)

Name

Relationship

Contact
Number
(Parent
/Guardian)

Eduardo

Marifi Maat Ilava

Occ. Mdo

Eddie

Shirley Carman Dela Cruz

Occ. Mdo

Lorenzo

Salvacion Alvaro Sualog

09127252881

Rizal

Occ. Mdo

Eduardo

Elsie Dagohoy Ambulo

09076359638

Magsikap

Rizal

Occ. Mdo

Ernesto

Erma Ambulo Batitia

09099733746

Purok 5

Magsikap

Rizal

Occ. Mdo

Felix Jr.

Maribel Solinap Tapales

Roman Catholic

Caniwal

Magsikap

Rizal

Occ. Mdo

Villardo

Myrna Flores Bravante

Tagalog

Roman Catholic

Mendigorin

Malawaan

Rizal

Occ. Mdo

Efren Jr.

Mary grace Artocilla Urbina

09203921481

Ilokano

Roman Catholic

Marilao

New Dagupan

Calintaan

Occ. Mdo

Vicente

Rochel Magsipoc Martinez

09214850032

Occ. Mdo.

Tagalog

Roman Catholic

Purok 5

Magsikap

Rizal

Occ. Mdo

Victor

Alicia Guevarra Agbunag

15

Occ. Mdo.

Tagalog

Methodist

Occ. Mdo

Sonny

Marry Ann Apolinario Magbanua

15

Occ. Mdo.

Tagalog

Roman Catholic

Saligsig

Magsikap

Rizal

Occ. Mdo

Ariel

Analiza Dampitan Manlabao

15

Occ. Mdo.

Tagalog

Roman Catholic

Mangat

San Pedro

Rizal

Occ. Mdo

Florentino

Merlie Roldan Magbudhi

16

Val. City

Tagalog

Roman Catholic

Malatikwang

New Dagupan

Calintaan

Occ. Mdo

Rodrigo

Marilyn Morico Begino

09102372791

16

Occ. Mdo.

Tagalog

Roman Catholic

Matabiaga

Malawaan

Rizal

Occ. Mdo

Ronaldo

Vilma Castro Florendo

09397688999

16

Occ. Mdo.

Tagalog

Roman Catholic

Purok 5

Magsikap

Rizal

Occ. Mdo

Robert

Teresita Domingo Ambulo

09107568137

17

Occ. Mdo.

Tagalog

Roman Catholic

Mendigorin

Malawaan

Rizal

Occ. Mdo

Hernani

15

Occ. Mdo.

Tagalog

Roman Catholic

Payompon

Magsikap

Rizal

Occ. Mdo

Reyno

Jelyn Valdez Matias

15

Occ. Mdo.

Tagalog

Roman Catholic

Mangat

San Pedro

Rizal

Occ. Mdo

Alberto

Emma Tamboong Santiago

16

Occ. Mdo.

Tagalog

Roman Catholic

Mangat

San Pedro

Rizal

Occ. Mdo

Edito

Elialyn De los Santos Prado

15

Occ. Mdo.

Tagalog

Roman Catholic

Payompon

Magsikap

Rizal

Occ. Mdo

Roberto

16

Occ. Mdo.

Tagalog

Roman Catholic

Purok 5

Magsikap

Rizal

Occ. Mdo

Eddie

17

Occ. Mdo.

Tagalog

Roman Catholic

Purok 5

Magsikap

Rizal

Occ. Mdo

15

Occ. Mdo.

Tagalog

Roman Catholic

Purok 3

Magsikap

Rizal

15

Occ. Mdo.

Tagalog

Roman Catholic

Saligsig

Magsikap

Rizal

16

Occ. Mdo.

Tagalog

Roman Catholic

Purok 1

15

Occ. Mdo.

Tagalog

Roman Catholic

Mangat

15

Occ. Mdo.

Tagalog

Roman Catholic

15

Occ. Mdo.

Tagalog

Roman Catholic

Malatikwang
New Dagupan Calintaan

Magsikap
San Pedro

Red HillsNew Dagupan

Purok 4

Rizal
Rizal

Calintaan

Magsikap

Rizal

09096643529
Jasmin Ento

Aunt

09096195042

09469707516
Arnelia V. Mayo

Rosalinda Casilagan Quilantang

none

09289707879

09308057361
09465227532
091224948476

09463247141

Evelyn Baton Solinap

09305696476

Nicanor

Josielita Francisco Chavez

09128815676

Occ. Mdo

Rolando

Melinda Menerales Sabusap

09107566862

Occ. Mdo

Constancio

Erlinda Bandiola Estrabela

09283456328

Occ. Mdo

Eleno

Percelita Maceda Venturero

09336126924

Occ. Mdo

Jenaldo

Emily Cabico Gregorio

09478981232

Occ. Mdo

Arnel

Julie Ann Almonte Manay

09282859001

Erma Tacderan Solano

09463026041

Richard

(Please refer to the

legend on last page)

09468752447

Maribel Baton Espartero

Occ. Mdo

REMARK/S

List and code of Indicators under REMARK column

Prepared by:
Indicator

Code

Required Information

Indicator

Code

Required Information

BoSY

Transferred Out

T/O

Name of Public (P) Private (PR) School

CCT Recipient

CCT

CCT Control/reference number & Effectivity Date

MALE

24

Transferred IN
Dropped
Late Enrollment

T/I
DRP
LE

Name of Public (P) Private (PR) School

Balik-Aral
Reason and Effectivity Date
Learner With Dissabil
Reason (Enrollment beyond 1st FridayAccelarated

B/A
LWD
ACL

Name of school last attended & Year

Specify
Specify Level & Effectivity Data

FEMALE

29

TOTAL

54

Certified Correct:

EoSY
MARICAR BERAYO-DAGOHOY

(Signature of Adviser over Printed Name)

BoSY Date:

EoSYDate:

GRACE D. OSANO
Principal I

BoSY Date:

EoSYDate: