Beruflich Dokumente
Kultur Dokumente
Jamero, Epipanio,
Jamero, Elson, Cabantac Jr. M 8/24/1978 39.5 Cebuano Yes Catholic Madasigon Binatubo Mahinog Camiguin Cabantac, Juana, Pagaran 9175372184 G-III 5/23/2017
Feniza
8
Prepared by:
MAPPED LEARNERS ENROLLED LEARNERS
(Signature of Facilitator over Printed Name
MALE MALE
FEMALE FEMALE
TOTAL TOTAL Certified Correct: (Signature of PSDS over Printed Name)
AF-1
REMARKS
Interested
in ALS? Yes Enrolled in
ALS
or No
put code for mapped prospective learners
Yes /
Region I ba00000001
2nd alpha region
Name)
me)
ALS ENROLLMENT FORM
Region : Municipal :
City/Province : Barangay :
Date : LRN (if available) :
• Address :
House #/Street/Sitio Barangay Municipality/City Province
• Birth date (mm/dd/yyyy): _____/_____/________ Place of Birth (Municipality/City) _________________________
• Sex: Male Female • Civil status: Single Married Widow/er Separated Solo Parent Common Law
• Religion: ____________• IP (Specify ethnic group) : ______________ • Mother Tongue : _______________ PWD: Yes No
If YES, have you completed the program? YES NO If NO, state the reason:
_______________________________________ _____________________________
Facilitator: Signature and Date Learner: Signature and Date
Republic of the Philippines
Department of Education
ALTERNATIVE LEARNING SYSTEM
AF-3 (MASTER LIST OF ENROLLED AND STATUS OF LEARN
City/Municipality Name of
Barangay
Sex (M/F)
PIS Score
Birthdate Age First Date of
LRN Age
Last First Middle mmddyyyy Group Attendance
Basic Literate
Post Literate
Ext
Neo Literate
Name Name Name
(71-99)
(0-70)
(100)
FLT Score in FLT Score in FLT Score in
Reading Numeracy Writing
F LEARNERS)
Name of Facilitator
Position
ON
PROGRAM ENROLLED
Assesment
Status InfEd 4Ps beneficiary
(Completer/No (Specify (YES/NO)
n-Completer course)
FLT Score in Type of Mode of Program
Overall
Listening &
Speaking Score Program Delivery
Total
Prepared by:
Total
25 Certified Correct:
15
60 (Signature of PSDS over Printed Name)
Total
Republic of the Philippines AF-4
Department of Education
ALTERNATIVE LEARNING SYSTEM
AF-4 (MASTER LIST OF A&E REGISTRANTS)
Region
School Division
CLC ADDRESS
Sex (M/F)
Birthdate
(Last Name, First Name, A&E Test Level Date Registered Date of
LRN Middle Name, Ext) Registered Examination
Barangay Municipal
ADDRESS:
HOUSE # / SITIO / ST. BARANGAY MUNICIPALITY/CITY PROVINCE
______________
XT NAME: ______
PROVINCE
Female
Score
Post
Post
Post
0
Remarks (if applicable)
Remarks
haracter
moral character.
ndividual for
nt.
PSDS