Department of Education

ALTERNATIVE LEARNING SYSTEM

MASTERLIST OF MAPPED AND POTENTIAL LEARNERS (AF1)

District CLAVERIA Division: MASBATE Region

COMPLETE HOME ADDRESS PARENTS

Sex (M/F)
NAME IP
Date of Birth Mother
(Last Name, First Name, Name Age (Yes or Religion House
(mm/dd/yyyy) Tongue Municipality/ Father's Name (Last Name, First Name, Mother's Maiden Name (Last Na
Extension, Middle Name) No) No./Street/ Barangay Province
City Middle Name) Name, Middle Name)
Sitio/ Purok

Cebuan Roman
Azares, Jhoana Alba F 8/15/1992 28 2 Pasig Claveria Masbate Felipe Andojar Azares Melchora Lasiga Alba
o Catholic
Cebuan Roman
Ebansabal, Juana Budida M 6/10/1940 80.5 2 Pasig Claveria Masbate Jacinto Deontoy Ebansabal Locia Doncillo Budida
o Catholic
Cebuan Roman
Albao, Maximo Rosello M 4/8/1936 85 2 Pasig Claveria Masbate Lucio Deontoy Albao Muay Templado Rosall
o Catholic
Cebuan Roman
Lawin, Nena Teonesio M 4/5/1947 74 2 Pasig Claveria Masbate Roango Cabiano Lawin Neta Cabinetoy Teones
o Catholic
Cebuan Roman
Gabonada, CristinaTemplado M 1/27/1980 41 2 Pasig Claveria Masbate Reaynr Lawin Gabonada Mlanly Aragon Templad
o Catholic
Cebuan Roman
Egloso, Marife Lasigas M 3/11/1992 25 2 Pasig Claveria Masbate Nestor Badillo Egloso Emelda Rodriguez Lasig
o Catholic
Cebuan Roman
Serafin, Loreto Cabinetoy F 10/9/1959 61 2 Pasig Claveria Masbate Edgar Sebay Serafin Omty Desuyo Cabineto
o Catholic
Cebuan Roman
Emalyn, Cabiano Bordaje M 10/26/1977 43 2 Pasig Claveria Masbate Manuel Teonesio Cabiano Joahon Sese Bordaje
o Catholic
Cebuan Roman
Desuyo, Jape Pepito M 1/13/1990 31 2 Pasig Claveria Masbate Egan Sese Desuyo Jocelyn Teonesio Pepit
o Catholic
Cebuan Roman
Geraldo, Jonal Badillo M 10/2/1975 45 2 Pasig Claveria Masbate Dondon Losong Geraldo Joi Sese Badillo
o Catholic
Cebuan Roman
Ebazsabal Riza Codilla F 3/2/1982 39 2 Pasig Claveria Masbate Roger Cabiano Ebazsabal Lorda Sese Codilla
o Catholic
Cebuan Roman
Divino Diego Cabiao M 10/10/1972 48 2 Pasig Claveria Masbate Topa Desuyo Divino Jenny Sese Cabiao
o Catholic
Cebuan Roman
Lasigas, Claire Sese M 11/12/1973 47 2 Pasig Claveria Masbate Costa Divino Lasigas Anter Lasiga Sese
o Catholic
Cebuan Roman
Verallo, Denicavan Tembal F 3/3/1999 22 1 Pasig Claveria Masbate Daniel Temblor Verallo Kathirine Lawin Temba
o Catholic
Cebuan Roman
Ocap, Joan Fernandez F 7/27/1985 35 1 Pasig Claveria Masbate Julieto Ebazsabal Calampiano Emelda Macabe Ocap
o Catholic
Cebuan Roman
Donsalida, Ronalyn Sebay F 7/17/1990 30 2 Pasig Claveria Masbate Ramon Lawin Macasinay Juanilla Cabinetoy Seba
o Catholic
Cebuan Roman
Quintanilla, Jerome Temblor M 11/17/1998 22 2 Pasig Claveria Masbate Jaime Codilla Quintalla Meral Jean Son Quintal
o Catholic
Cebuan Roman
Lawin, John Paul Macabe M 1/22/1999 22 2 Pasig Claveria Masbate Policarpio Collibar Lawin Rose Etoc Macabe
o Catholic
Cebuan Roman
Joshua, Claveria Lawin M 8/26/1998 22 2 Pasig Claveria Masbate Peter Calampiano Claveria Maricel Azares Lawin
o Catholic
Cebuan
Palmes, Zyrakanll Pepito F 7/6/2000 20 Iglesia 2 Pasig Claveria Masbate Roger Hanoy Palmes Edna Son Pepito
o
Cebuan Seven
Codilla, Victorino Son M 12/8/1994 26 3 Pasig Claveria Masbate Victor Sese Codilla Jenny Sanay Son
o Aventist
Cebuan
Son, Garmielyn Cantapay F 7/9/1998 22 Iglesia 2 Pasig Claveria Masbate Locy Son Dantoy Tibontibon Lody Rapsing Son
o
Cebuan Roman
Annuevo, Manuel Cantonjos F 10/19/1993 27 2 Pasig Claveria Masbate Rodel Codilla Annonuevo Mancedel Latiaga Canton
o Catholic
Almenie, Jonalyn Lorence Cebuan
F 7/22/2000 20 Iglesia 2 Pasig Claveria Masbate George Alonzoloren Almonie Marlyn Azares Ebazsab
Ebazsabal o
Cebuan Roman
Garde, John Lorence Ebazsabal M 11/9/2003 17 2 Pasig Claveria Masbate Ronald Sanay Garde Lorennce Albao Ebazsab
o Catholic
Cebuan Roman
Gonmiea, Claireann Albao F 8/13/2001 19 2 Pasig Claveria Masbate Efraem Columna Gonmiea Beverly Bantiling Albao
o Catholic
Cebuan Roman
Veraces, Angelo Verallo M 6/21/1991 29.5 1 Pasig Claveria Masbate Roger Arizala Veraces Linda Tembal Verallio
o Catholic
Cebuan
Son, Arman Pepito M 11/26/2000 20 Iglesia 1 Pasig Claveria Masbate Renante Almine Son Marilyn Rapsing Pepito
o
Cebuan
Austina, Babylyn Pepito F 10/19/1989 31 Iglesia 1 Pasig Claveria Masbate Carlos Banaag Austina Margaritoc Punay Pepit
o
Cebuan Roman
Lepetin, Alic, Contabo M 5/5/1997 24 2 Pasig Claveria Masbate Renante Codilla Lepetin Judith Cortes Contabo
o Catholic
Cebuan Roman
Amoroto, Rolen Mahinay M 4/26/1989 32 2 Pasig Claveria Masbate Vicente Temblor Amoroto Lorna Columna Mahina
o Catholic
Cebuan
Pepito, Liza Tubiero F 4/28/1989 32 Iglesia 2 Pasig Claveria Masbate Lino De Jesus Pepito Glora Dejito Tubiero
o
Cebuan Roman
Recaña, Riza Detablan F 8/12/1980 40 2 Pasig Claveria Masbate Felix Sangay Ebarzsabal Liza Cantoba Detablan
o Catholic
Cebuan Roman
Almiñe, Jerwin Arizala M 4/18/1985 36 2 Pasig Claveria Masbate Emelio Almoite Almiñe Janeta Regala Arizala
o Catholic
Cebuan Roman
Dadula, Aiza Tulda F 6/29/1986 34.5 2 Pasig Claveria Masbate Darwin Ocap Dadula Mancia Codilla Tulda
o Catholic
Cebuan
Pepito, Joanne Almiñe F 1/31/1991 30 Iglesia 2 Pasig Claveria Masbate Jenny Son Pepito Jenny Atnas Almiñe
o
Cebuan Roman
Canio, Allan Joseph Amatos M 9/2/1992 28 2 Pasig Claveria Masbate Edward Carmen Canio Gina Collibar Amatos
o Catholic
Cebuan Roman
Lasigas, Ronie Cabindas M 11/7/1987 33 2 Pasig Claveria Masbate Almiñe Lasigas Lorna Doria Cabrias
o Catholic
Cebuan Roman
Pepito, Jemadel Almine F 8/9/2000 20 2 Pasig Claveria Masbate Richard Pojol Pepito Nora Cortes Almiñie
o Catholic
 MAPPED LEARNERS as of (MM/DD/YY) ENROLLED LEARNERS as of (MM/DD/YY) Prepared By:

MALE 38 MALE 23
FEMALE 27 FEMALE 15
Certified Correct:
TOTAL 65 TOTAL 38
 BICOL Calendar Year 2018

REMARKS
Last Grade If already
Date
Contact Number of Level enrolled in
Mapped
Learner Completed
s Maiden Name (Last Name, First (mm/dd/yyyy Interested in If Yes, Preferred
ALS, provide
(if available) in Formal ALS? date of first
Name, Middle Name) ) Program
School Yes or No attendance
(DOFA) and
LRN
Melchora Lasiga Alba Grade 9 NO
Locia Doncillo Budida Grade 9 NO
Muay Templado Rosallo Grade 7 NO
Neta Cabinetoy Teonesio Grade 7 NO
Mlanly Aragon Templado Grade 7 NO
Emelda Rodriguez Lasiga Grade 5 NO

Omty Desuyo Cabinetoy Grade 9 NO

Joahon Sese Bordaje Grade 9 YES A&E SEC.

Jocelyn Teonesio Pepito Grade 7 YES A&E SEC.

Joi Sese Badillo Grade 9 NO

Lorda Sese Codilla Grade 9 NO

Jenny Sese Cabiao Grade 7 NO

Anter Lasiga Sese Grade 5 NO

Kathirine Lawin Tembal 1st Year YES A&E SEC.

Emelda Macabe Ocap 1st Year YES A&E SEC.

Juanilla Cabinetoy Sebay 2nd Year YES A&E SEC.

Meral Jean Son Quintalla 2nd Year NO

Rose Etoc Macabe 2nd Year YES A&E SEC.

Maricel Azares Lawin 2nd Year YES A&E SEC.

Edna Son Pepito Grade 7 YES A&E SEC.

Jenny Sanay Son Grade 7 YES A&E SEC.

Lody Rapsing Son Grade 5 NO

ancedel Latiaga Cantonjos Grade 7 YES A&E SEC.

Marlyn Azares Ebazsabal Grade 6 YES A&E SEC.

orennce Albao Ebazsabal Grade 7 NO

Beverly Bantiling Albao Grade 7 YES A&E SEC.

Linda Tembal Verallio 2nd Year YES A&E SEC.

Marilyn Rapsing Pepito 2nd Year YES A&E SEC.

Margaritoc Punay Pepito Grade 7 NO

Judith Cortes Contabo Grade 2 YES A&E SEC.

Lorna Columna Mahinay Grade 3 YES A&E SEC.

Glora Dejito Tubiero 2nd Year YES A&E SEC.

Liza Cantoba Detablan Grade 7 NO

Janeta Regala Arizala Grade 7 YES A&E SEC.

Mancia Codilla Tulda Grade 7 NO

Jenny Atnas Almiñe Grade 7 NO

Gina Collibar Amatos Grade 5 YES A&E SEC.

Lorna Doria Cabrias Grade 7 NO

Nora Cortes Almiñie Grade 5 YES A&E SEC.

Signature of Facilitator over Printed Name

Signature of PSDS over Printed Name

SFRT 2017
AF2 Republic of the Philippines
Department of Education
ALTERNATIVE LEARNING SYSTEM
ALS ENROLMENT FORM (AF2)
Learner's Basic Profile

Date : January 25, 2019 LRN (if available) :

Personal Information (Part I)

ABRENICA ARCHIE PABILANDO
First Name Middle Name Name Extension

• Address: Manggahan Boca-Engaño Claveria Masbate

House No./Street/Sitio Barangay Municipality/City Province
• Birthdate (mm/dd/yyyy):07/25/2000 Place of Birth (Municipality/City)

• Sex: □Male □Female • Civil Status: □Single □Married □Widow/er □Separated □Solo Parent
• Religion: Roman Catholic• IP (Specify ethnic group) : ______________ • Mother Tongue : Cebuano PWD: □Yes □No
• Name of Father/Legal Guardian

Last Name First Name Middle Name Occupation

• Mother's Maiden Name
PABILANDO ROSALIE
Last Name First Name Middle Name Occupation

Educational information (Part II)

• Last grade level completed
Elementary : □K □G-1 □G-2 □G-3 □G-4 □G-5 □G-6
Secondary : □G-7 □G-8 □G-9 □G-10
• Why did you drop out of school? (For OSY only)
□No school in Barangay □School too far from home □Needed to help family
□Unable to pay for miscellaneous and other expenses Others:

• Have you attended ALS learning sessions before? □YES □NO

If Yes:
Name of the Program: _____________________________________________ Level of Literacy: □Basic □Elem. □Sec. □InfEd
Year Attended: ___________ Have you completed the Program? (Yes/No) _______
If NO, state the reason:

Accessibility and Availability (Part III)

• How far is it from your home to your Learning Center? in kms in hours and mins.
• How do you get from your home to your Learning Center? □Walking □Motorcycle □Bicycle □Others (Pls. Specify) ___________
• When can you attend your Learning Session?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday

What specific time

can you be at your
Learning Center?

HERMES M. ARIZALA _____________________________

Facilitator: Signature and Date Learner: Signature and Date

SFRT 2017
\
AF2 Republic of the Philippines

Department of Education

ALTERNATIVE LEARNING SYSTEM

ALS ENROLMENT FORM (AF2)
Learner's Basic Profile

Date : LRN (if available) :

Personal Information (Part I)

Family Name First Name Middle Name Name Extension

• Address:
House No./Street/Sitio Barangay Municipality/City Province

• Birthdate (mm/dd/yyyy):________________ Place of Birth (Municipality/City) _

• Sex: □Male □Female • Civil Status: □Single □Married □Widow/er □Separated □Solo Parent

• Religion: _____________________ • IP (Specify ethnic group) : ______________ • Mother Tongue :________________ PWD:

• Name of Father/Legal Guardian

Last Name First Name Middle Name Occupation

• Mother's Maiden Name

Last Name First Name Middle Name Occupation

Educational information (Part II)

• Last grade level completed

Elementary : □K □G-1 □G-2 □G-3 □G-4 □G-5 □G-6

Secondary : □G-7 □G-8 □G-9 □G-10

• Why did you drop out of school? (For OSY only)
□No school in Barangay □School too far from home □Needed to help family

□Unable to pay for miscellaneous and other expenses Others:

• Have you attended ALS learning sessions before? □YES □NO

If Yes:
Name of the Program: _____________________________________________ Level of Literacy: □Basic □Elem. □Sec.
Year Attended: ___________ Have you completed the Program? (Yes/No) _______
If NO, state the reason:

Accessibility and Availability (Part III)

• How far is it from your home to your Learning Center? in kms in hours and mins.
• How do you get from your home to your Learning Center? □Walking □Motorcycle □Bicycle □Others (Pls. Specify) ___________
• When can you attend your Learning Session?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday

What specific time

can you be at your
Learning Center?

_____________________________
Facilitator: Signature and Date Learner: Signature and Date
 Name Extension

Province

nt

□Yes □No

\
Occupation

Occupation

eded to help family

 □Sec. □InfEd

in hours and mins.

rs (Pls. Specify) ___________

Sunday

________________
nature and Date

SFRT 2017
 Republic of the Philippines
AF-3
Department of Education
ALTERNATIVE LEARNING SYSTEM
MASTERLIST OF ENROLLED LEARNERS WITH END OF PROGRAM/CY STATUS (AF-3)
District Division Region Calendar Year

Type of
Name of CLC Barangay City/Municipality
CLC

NON FORMAL EDUCATION

PROGRAM ENROLLED Assessment for Basic Literacy
Functional Literacy Assessment (FLT) Score
(ABL)

PIS Score
Sex (M/F)
NAME End of
Birthdate First Date of
LRN (Last Name, First Name, Middle Age Program/ Remarks
(mmddyyyy) Attendance

Basic Literate

Post Literate
Neo Literate
Name, Name Extension) CY Status
Type of Listening & Overall
Mode of Program Delivery Reading Numeracy Writing
Program Speaking Score

<=== TOTAL MALE

<=== TOTAL FEMALE

<=== COMBINED

Learners Enrolled
Learners Enrolled by Program Male Female Total
by Program Delivery
Male Female Total

BLP Face to Face Prepared By:

A&E Elem. Independent Learning
A&E Sec. Radio-based Instruction
InFED Computer-based Instruction Signature of Facilitator over Printed Name

Learners Enrolled in BLP

by Level
Male Female Total Enrolled Learners Male Female Total Certified Correct By:
Basic Literate Number of 4P's Learners
Neo Literate Percent of Enrolled 4P's Learners
Signature of PSDS over Printed Name
Post Literate
AF-3
 Republic of the Philippines
Department of Education
ALTERNATIVE LEARNING SYSTEM
MASTERLIST OF A&E REGISTRANTS (AF-4)
District Division Region

Place of Registration Center

(Name of School/Center, Barangay, Municipality)
(Testing Center) (Barangay) (Municipality/City)

CLC DETAILS

Sex (M/F)

Birthdate
NAME
A&E Test Level
LRN (Last Name, CLC Registered
Date Registered
First Name, Middle Name, Ext) CLC Name Barangay Municipal
Type

505051902634  AMICAN,GIOVANNI barangay hall 2 San Pascual North

50505051902980 BENIGNA, SARAD JOHN

113934080041 CORALDE, JOHNSON
505051902627 DARAS, JANET
505051902632 DAVID, JULIET
505051902633 DELA PENA , JENNIFER
505051902630 DELOS SANTOS , AILEN
505051902631 DELOS SANTOS , ROY
113920080027 FLORES , JOSHUA
505051902717 LAZARO , JUNDY
MACARARANGA , ARGIE

<=== TOTAL MALE

<=== TOTAL FEMALE

<=== COMBINED

Registered Male Female Total Prepared By:

Elementary Signature of Facilitator over Printed Name
Secondary
Taker Male Female Total Certified Correct By:
Elementary
Secondary Signature of PSDS/DC over Printed Name
 AF-4

y/City)

Date of
Examination

ed Name
ed Name
 Republic of the Philippines AF-5
Department of Education
ALTERNATIVE LEARNING SYSTEM

LEARNER'S PERMANENT RECORD (AF-5)

DISTRICT: DIVISION: REGION:

LEARNER'S INFORMATION LRN:_______________________

___
LAST NAME: FIRST NAME: _____________________ NAME EXTENSION: ______ MIDDLE NAME: _____________________

ADDRESS:
HOUSE NO./ SITIO / ST. BARANGAY MUNICIPALITY/CITY PROVINCE

BIRTHDATE: MONTH _____/ DATE__________ / YEAR______________ SEX: Male Female

LEARNER'S EDUCATIONAL STATUS

Program Enrolled : Program Enrolled :
Delivery Mode : Delivery Mode :
CLC Name : CLC Name :
CLC Address : CLC Address :
Name of Facilitator : Name of Facilitator :
Calendar Year : Calendar Year :

Score Score
ASSESSMENT RESULTS ASSESSMENT RESULTS
Pre Post Pre Post
PIS Score PIS Score
Assesment for Basic Literacy (ABL) Pre Post Assesment for Basic Literacy (ABL) Pre Post
Basic Literate Basic Literate
Neo Literate Neo Literate
Post Literate Post Literate
Functional Literacy Assessment Pre Post Functional Literacy Assessment Pre Post
FLT Score in Reading FLT Score in Reading
FLT Score in Numeracy FLT Score in Numeracy
FLT Score in Writing FLT Score in Writing
FLT Score in Listening & Speaking FLT Score in Listening & Speaking
Overall Score 0 0 Overall Score 0 0
InfEd Remarks InfEd Remarks

A & E STATUS Remarks A & E STATUS Remarks

Program Status Program Status
Test Taken Test Taken
Date of Examination Date of Examination
Testing Center Testing Center
Location of Testing Center Location of Testing Center
Accreditation and Equivalency (A&E) Test Result Accreditation and Equivalency (A&E) Test Result

Certificate of Transfer Certificate of Transfer

Eligible for Admission to : Eligible for Admission to :

Certificate of Good Moral Character Certificate of Good Moral Character

This is to certify that the above-named is a learner of good moral character. This is to certify that the above-named is a learner of good moral character.
This certification is issued upon request of the concerned individual due to This certification is issued upon request of the concerned individual due to
his/her desire to pursue formal schooling/other CLC or for employment. his/her desire to pursue formal schooling/other CLC or for employment.

Prepared By: Certified Correct By: Prepared By: Certified Correct By:

Facilitator PSDS/District Coordinator/EPSA Facilitator PSDS/District Coordinator/EPSA

F-5