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FORM 2: LAC Facilitator Information Sheet

This form should be accomplished by the designated LAC Facilitator on or before the first LAC
session.

Region:III

Division:AURORA

NAME Male/Female: Date of Birth: Age:


MARVIN D. MALE 33
CAMACHO:

Contact details: Email: Mobile Number: Facebook Name:


Marvin.camacho2@d 09163428665 Marvin Camacho
eped.gov.ph

Preferred contact (Indicate all: email, phone, Skype, Viber, WhatsApp, Zoom,
mode: Googlemeet, FB, Messenger, etc.)
Online LAC Session Zoom
Google Meet
Messenger

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