Republic of the Philippines Document Code: BTN -104702-QF-

Department of Education ELLN-004

Region III
Revision: 00
Schools Division Office of Bataan
Schools District Office – Samal Annex Effectivity Date: 01-06-2020
Name of School: FC DEL
LAC FACILITATOR INFORMATION SHEET ROSARIO ELEMENTARY
SCHOOL

LAC FACILITATOR INFORMATION SHEET

Schools Division: BATAAN District: SAMAL

FC DEL ROSARIO
School: School Head: RODRIGO S. PANLAQUE JR.
ELEMENTARY SCHOOL
LAC Facilitator: JHELYN T. CAYETANO Gender: F
Date of Birth: Age:
Tel. No.: Email Address: @deped.gov.ph
Mobile No.: Facebook Name: JHELYN TORRES CAYETANO
Home Address: BAYAN, ORANI, BATAAN

What is the best way to reach you? Please Do you have easy access to the Internet? (i.e., rank
according to preference: It is easy for you to send and receive email,
Personal Mobile check FB, etc.)
Phone (landline)
Email Yes
FB message No
Others, please specify

Highest Educational Attainment: (check one) Course(s)/Degree(s) completed: (please

College specify)
With MA units
Master ’s Degree
With PhD units
PhD Degree

Designation/Assignments (please check all Teacher Rank:

that apply): Teacher I
Subject Teacher Teacher II
Class Adviser Teacher III
Administrator/Head Teacher Master Teacher I
Grade Level Coordinator: Master Teacher II
Others: (please specify): Others (please specify):

Grade Levels Currently Taught: Length of time teaching the present grade level:
Kindergarten Less than a year
Grade 1 1-5 years
Grade 2 6-10 years
Grade 3 11-15 years
Grade 4 - 6 16-20 years
Junior HS 21 years and above
Senior HS
 Previous grade levels taught: Number of years of teaching experience:
K to 3 Less than a year 11-15 years
Grade 4 to 6 1-5 years 16-20 years
Grade 7 to 10 6-10 years 21 years and above

Does your school have LACs other than the Have you attended training on early literacy
ELLN Digital LAC? and numeracy instruction? If yes, please specify
Yes the training program and the length (duration)
No of the program
Yes
__________________________________________
_____No

Prepared by: Checked & Verified:

JHELYN T. CAYETANO RODRIGO S. PANLAQUE JR

LAC Facilitator Head Teacher III

Noted: Received by:

JEOLFA G. REYES, EdD MILA D. CALMA

Public Schools District Supervisor Education Program Supervisor
Template prepared by Mr. Rhon Panlaque
09202019