Renewal Forms Aster

RENEWAL FORM
Association of
Students in Teacher
Education in Region I
(ASTER)
S.Y. 2012-2013
SSD-SOP Form No. 1
MARIANO MARCOS STATE UNIVERSITY
STUDENT SERVICES & DEVELOPMENT OFFICE

City of Batac 2906
.(63) 077 792-2569 to 148 Telefax No. (63) 077 792-3191
e-mail: ssd@mmsu.edu.ph
APPLICATION FOR RECOGNITION/RENEWAL OF ORGANIZATION

SY 2012-2013_
__Old Returning __Renewal
July 30, 2012
Date
The Director
SSD
This University
Madam:
I Edward Almazan Jr, President of the Association of Students in Teacher
Education in Region I (ASTER) for and in behalf of the said organization, am
applying for the organizations renewal of recognition for the school year 2012-2013.
.
I, together with the adviser/s of the organization, be held accountable and
responsible for the organization in accordance with the provisions of the Rules and
Regulations Governing Student Organizations of the Mariano Marcos State
University, City of Batac, Ilocos Norte.
Dr. Maria Eliza Lopez / Prof. Estrella Luiz
Adviser
Recommending Approval:
_____________________________
Dean/Director/Principal
Approved:
HENEDINE A. AGUINALDO
Director
Edward Almazan Jr
President Name and Signature
of President
Prof. Jahnese D. Asuncion
Student Affairs Coordinator
SSDO-SOP (OSA) Form #2

Republic of the Philippines
MARIANO MARCOS STATE UNIVERSITY
Batac, Ilocos Norte
STUDENT SERVICES AND DEVELOPMENT
School Year 2012-2013
COLLEGE OF TEACHER EDUCATION
Name of College/Unit
ASSOCIATION OF STUDENTS IN TEACHER EDUCATION IN REGION I (ASTER)
Name of Club/Organization
Date
Title of Activity
Description
Place of Beneficiaries
June 16, 2012
General Orientation for Student Teaching (1st

Sem.)
Action Research Seminar
The activity aims to orient the students who will have their
practice teaching on the 1st semester of the school year.
The seminar aims to help the 1st semester student teachers in
making their action research.
The activity aims to give pieces of advice, rules, and
regulations to the out campus student teachers of the 1st sem.
The activity aims to orient the students who will have their
practice teaching on the 2nd semester of the school year.
The seminar aims to help the 2nd semester student teachers in
making their action research.
The activity aims to give pieces of advice, rules, and
regulations to the out campus student teachers of the 2nd sem.
This activity aims to broaden the knowledge of the students
about the world of teaching.
This activity aims to know how knowledgeable are the students
taking up teaching as their profession.
This program aims to help the out of school youths gain more
knowledge.
MMSU-CTE Social Hall
July 7, 2012
August 11,
2012
October 26,
2012
November 11,
2012
January 6,
2013
February 8,
2013
February 23,
2013
March 9, 2013
Briefing for the Out Campus Student Teachers

General Orientation for Student Teaching (2nd
Sem.)
Action Research Seminar
Briefing for the Out Campus Student Teachers
Student Congress
PAFTE Quiz Bee
Outreach Program for the Out of School
Youths
MMSU-CTE
2ND Floor, SAC Building
MMSU-CTE
2ND Floor, SAC Building
San Fernando, La Union
San Fernando, La Union
Vintar, Ilocos Norte
Prepared by:
EDWARD ALMAZAN JR
President
Type of Activities:
Academic-Symposium, quiz contest, etc
Fund raising-Dance/Disco Party, Raffle Draw, Sales, etc.
Cultural-Singing contest, concert, play, poster making, etc.
Sports fest- indoor/outdoor sports competition
Community service any service beneficial to the community
Noted:
DR. ELIZA LOPEZ / PROF. ESTRELLA LUIZ
Advisers
SSD-SOP Form No. 3
Mariano Marcos State University
STUDENT SERVICES & DEVELOPMENT OFFICE

City of Batac 2906
.(63) 077 792-2569 to 148 Telefax No. (63) 077 792-3191
e-mail: ssd@mmsu.edu.ph
July 30, 2012

Date
The Director
SSD
This University
Madam:
The Association of Students in Teacher Education in Region I (ASTER) has applied for
recognition as a university-based student organization.
I, a full time faculty, have consented to serve as the organizations adviser for the school
year 2012-2013, and, therefore assume full responsibility for it. I am aware that my presence or
that my representative is necessary during all their activities. I am also willing to cooperate and
participate in all endeavors of SSD.
Furthermore, I certify to the correctness and completeness to the documents attached to
the organizations application for recognition.
Signature
____________________________________
Adviser
Printed Name :
DR. ELIZA LOPEZ / PROF. ESTRELLA LUIZ

Adviser
College
Tel. #

____________________________________
:
:
Home Address:
Cel. #
:
Brgy. 9 Laoag City / San Nicolas

09205264243 / 09154855683
Consultation Hrs..:
3-4 pm M-W-F
SSD-SOP (OSA) FORM #4

Batac, Ilocos Norte
LIST OF ELECTED OFFICERS
SY 2012-2013
Name of College/Unit
ASSOCIATION OF STUDENTS IN TEACHER EDUCATION IN REGION I (ASTER)
Name of Organization/Club
NAME
Edward Almazan Jr
POSITION
Jade Raquio
V-President
Princess Raihanie Salleh
Secretary
Cherry Agustin
Sub-Secretary
Marc Paul Calzada
Treasurer
Raymart Ballesteros
Sub-Treasurer
Anbert Layus
Cyrus Castro
Auditor
Business Manager
Anna Marie Cautal
P.I.O.
Dave Cajigal
Alvin Peralta
3rd Year Rep.

4th Year Rep
President
HOME ADDRESS
Don E. Ruiz St., Brgy. 17,
Laoag City, Ilocos Norte
Brgy. 20-A, Gabut Norte,
Badoc, Ilocos Norte
Brgy. 19, Nambaran,
Bacarra, Ilocos Norte
Brgy. 14, Bungon, Batac
City, Ilocos Norte
Don E. Ruiz St., Brgy. 17,
Brgy. #4 Solsona, Ilocos
Norte
Brgy. Utol, Bangui, Ilocos
Norte
Brgy. 7, P. Gomburza St.,
Badiu, Pinili, Ilocos Norte
Brgy. 19, Laoag City, Ilocos
Norte
C.P NUMBER
09215661587
09298426614
09399082713
09262439012
09099734792
09089654883
09487940326
09105142835
09305556406
09471711378
SSD-SOP(OSA) FORM # 5
2X2
ID
PICTURE

Batac, Ilocos Norte
BIO-DATA OF OFFICER
SY 2012-2013
NAME:
ALMAZAN
EDWARD JR
ORBOSIS
Family Name
Given Name
Middle Name
POSITION: PRESIDENT
ORGANIZATION: ASSOCIATION OF STUDENTS IN TEACHER EDUCATION IN REGION I (ASTER)
Nickname: ED
Age: 19 Sex: MALE Religious Affiliation: CATHOLIC
Nationality: FILIPINO
Birth Date: MAY 3, 1993 Birthplace: STA. LINA LUNA APAYAO
Campus Address: A. CASTRO AVENUE, LAOAG CITY
Telephone No. : ____________
Home Address: DON E. RUIZ ST., BRGY. 17 LAOAG CITY Telephone No. : _______________
Students Classification:
A. Undergraduate
Freshman
Sophomore
Junior
Senior
B. Graduate: Full Time
Part Time Employee
Source of Financial Support:
Others
Parents
Scholarship (specify) COLLEGE SCHOLAR, NCIP SCHOLAR
Assistantship
Special Talents/Skill: DANCING, SINGING, ACTING, DESIGNING,

College: MARIANO MARCOS STATE UNIVERSITY- COLLEGE OF TEACHER EDUCATION
Course: BACHELOR OF SECONDARY EDUCATION Major: ENGLISH
Educational Attainment:
Level
Elementary
School Last Attended

Sta. Lina, Elem. Sch.
Inclusive Years
1999-2005
Honor/Award
With honor
High School
ASC-LAB. HIGH
2005-2009
With honor
College/University MMSU-CTE
2009-present
CLASS SCHEDULE:
Subject
ENG. ED. 105
Time
7:30-8:30
Day
MWF
Room
207
Professor
MINA, SB
EDUC. 126
PI 1
EDUC 133
EDUC 135
EDUC 193
PHILO 1
ENGED 106
ENGL. 108
ENGL. 107
8:30-9:30
1-2
2-3
2-3
4-5
7:30-9:00
10:30-12
1-2:30
4-5:30
MWF
MWF
M
W
W
TTH
TTH
TTH
TTH
208
DORM
SOC HALL
SOC HALL
202
203
SPCH. LAB
103
SPCH. LAB
MINA, SB
NAJORDA, IL
MARTIN, AR
DEUS, IF
SANTOS, EB
MARTIN, AR
MINA, SB
MINA, SB
LASATEN, RCL
Membership in other student organization(s):

Name of Organization(s): MENS CLUB, SENIOR CLASS ORGANIZATION
Position: SUB-SECRETARY, PEACE OFFICER
Reason(s) for joining the organization(s): I want to serve my fellow students. I want to be
involved in the different activities of the club.___________________________________
FAMILY BACKGROUND:
Name of Father:
EDWARD
GUILLERMO
ALMAZAN SR.
Given Name
Middle Name
Family Name
Age: 52
Highest Educational Attainment: HIGH SCHOOL GRADUATE
Occupation: LABORER
Name of Mother:
VILMA
VALDEZ
ORBOSIS
Given Name
Middle Name
Family Name
Age: 49
Occupation: BARANGAY NUTRITIONIST
Number of Children in the Family: 7
How many of your brother(s)/sister(s) are still studying? 2
How many of your brother(s)/sister(s) are working now? 4
Sources of Family Income:
Salaries/ Wages Pension
Own Business
Others
___________________________
Signature of Student
None
(pls. specify)
July 30, 2012

Date
2X2
ID
PICTURE

Batac, Ilocos Norte
BIO-DATA OF OFFICER
SY_2012-2013_
NAME: ______PERALTA________________ALVIN_________________MATEO_________
Family Name
Given Name
Middle Name
POSITION: FOURTH YEAR REPRESENTATIVE
Nickname: OTS-OTS Age: _19_ Sex: _MALE_ Religious Affiliation: PENTECOST
Nationality: FILIPINO Birth Date: OCT. 11, 1992 Birthplace: SOLSONA, ILOCOS NORTE
Telephone No.: ____________
Home Address: BRGY. CATANGRAAN, SOLSONA , I.N.
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee
Others
Parents
Scholarship (specify) ISKOLAR NI MANANG IMEE
Assistantship
Special Talents/Skill: DANCING, SINGING, BAKING, ACTING, COOKING_____________

College: COLLEGE OF TEACHER EDUCATION
Course: BACHELOR OF SECONDARY EDUCATION Major: PHYSICAL SCIENCES
Level
ELEMENTARY
SECONDARY
TERTIARY

Inclusive Years
CATANGRAAN ELEMENTARY
1999-2005
SCHOOL
SOLSONA NATIONAL HIGH
2005-2009
SCHOOL
MMSU-CTE
2009-present
Honor/Award
VALEDICTORIAN
RANK 16
CLASS SCHEDULE:
Subject
PHYS 141
Time
7:30-8:30
Day
MWF
Room
PHYS. RM.
Professor
VV ANTONIO
EDUC 126
PHYSCED 121
PHYSCED 122
EDUC 193
EDUC 133
EDUC 135
PI 1
PHILO 1
10:30-11:30
1-2
3-4
4-5
9-10
9-10
1-2:30
230-4
MWF
MWF
MWF
FRI
TUES
THURS
TTH
TTH
GEN. SCI. RM.

GEN. SCI. RM.
PHYS. RM.
SOC. HALL
PHYS. RM.
205
209
AR MARTIN
F GALLARDO
VJ AURELIO
EB SANTOS
AR MARTIN
VV ANTONIO
IL NAJORDA
SR FERNANDO

Name of Organization(s): UNESCO
Position: VICE-PRESIDENT
Reason(s) for joining the organization(s): I want to contribute for the attainment of an excellent
way of leadership here in our college and I want to develop more my leadership qualities because
these would be important to me as a future teacher.
FAMILY BACKGROUND:
Name of Father: _____NORBEL__________GABRIEL______________PERALTA SR._____
Given Name
Middle Name
Family Name
Age: _49_ Highest Educational Attainment: ELEMENTARY GRADUATE
Occupation: FARMING
Name of Mother: ____ ANITA____________MANUEL________________MATEO_______
Given Name
Middle Name
Family Name
Occupation: HOUSEKEEPING
Number of Children in the Family: _4_
How many of your brother(s)/sister(s) are still studying? _2_
How many of your brother(s)/sister(s) are working now? _1_
Salaries/Wages Pension
None
Own Business
(pls. specify)
Others
___________________________
July 30, 2012

Date
2X2
ID
PICTURE

Batac, Ilocos Norte
BIO-DATA OF OFFICER
SY_2012-2013_
NAME: ______CAUTAL
ANNA MARIE
SIMEON
Family Name
Given Name
Middle Name
POSITION: P.I.O
Nickname: ANNA Age: 19 Sex: _FEMALE_ Religious Affiliation: CATHOLIC
Nationality: FILIPINO Birth Date: AUGUST 12,1993 Birthplace: LAOAG CITY
Home Address: BRGY. 3, P. GUMBURZA ST., LAOAG CITY Telephone No.: ____________
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee
Others
Parents
Scholarship (specify) CHED SCHOLAR
Assistantship
Special Talents/Skill: DANCING, ACTING, COMPUTER LITERATE_____________

Course: BACHELOR OF ELEMENTARY EDUCATION Major: GENERALIST
Level
ELEMENTARY

Shamrock Elem. Sch.
SECONDARY
INCAT
TERTIARY
MMSU-CTE
Inclusive Years
1999-2005
Honor/Award
2005-2009
2009-present
CLASS SCHEDULE:
Subject
SS 143
Time
7:30-8:30
Day
MWF
Room
102
Professor
LUIS
PI 1
EDUC 126
EDUC 193
EDUC 129
LIT. 105
LIT. 2
POL SCI 1
EDUC 135
EDUC 133
9:30-10:30
10:30-11:30
1-2
3-4
7:30-9
10:30-12
1-2:30
2:30-3:30
2:30-3:30
MWF
MWF
M
MWF
TTH
TTH
TTH
T
TH
207
GEN. SCI. RM.
SOC. HALL
SOC. HALL
203
209
ED TECH RM.
SOC HALL
GEN. SCI RM.
NAJORDA
GALLARDO
AURELIO
STA. MARIA
J. ASUNCION
LASATEN
BLANCO
V. ANTONIO
GALLARDO

Name of Organization(s): UNESCO, RCYC
Position: PEACE OFFICER, PRESIDENT
Reason(s) for joining the organization(s): As a student I want to enhance my leadership skill and
this serves as my experience in handling an organization as a future teacher.
FAMILY BACKGROUND:
Name of Father: _____CLEOFE
UNDECIMO
CAUTAL
Given Name
Middle Name
Family Name
Age: _45 Highest Educational Attainment: HIGH SCHOOL GRADUATE
Occupation: TRUCK DRIVER
Name of Mother: ____ ROSITA
LEAO
SIMEON
Given Name
Middle Name
Family Name
Age: _43_ Highest Educational Attainment: HIGH SCHOOL GRADUATE
How many of your brother(s)/sister(s) are still studying? _2_
How many of your brother(s)/sister(s) are working now? __
None
Own Business
(pls. specify)
Others
___________________________
July 30, 2012

Date
2X2
ID
PICTURE

Batac, Ilocos Norte
STUDENT SEVICES AND DEVELPOMENT
BIO-DATA OF OFFICER
SY 2012-2013
NAME:
CASTRO,
CYRUS
ARZAGA
Family Name
Given Name
Middle Name
POSITION: BUSINESS MANAGER
Nickname: SAICY Age: 19
Sex: M
Religious Affiliation: PROTESTANT-UCCP
Nationality: FILIPINO Birth Date: JANUARY 10, 1993 Birthplace: MMMH-BATAC I.N.
Campus Address: A. CASTRO AVENUE, LAOAG CITY Telephone No. : _______________
Home Address: # 15 UTOL, BANGUI, ILOCOS NORTE
Telephone No. :09061305901
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee
Parents
Others
Assistantship
Others
Assistantship
Scholarship (specify) COLLEG SCHOLAR
Special Talents/Skill:
Course: BACHELOR OF SECONDARY EDUCATION Major: ENGLISH
Level
Elementary
Baruyen Elementary School
High School
Bangui national High

School (Banban Campus)
CLASS SCHEDULE:
Inclusive Years
1999-2005
2005-2009
-
Honor/Award
Subject
Time
Day
Room
Professor
ENGED 105
7:30-8:30
MWF
Speech Lab
SB Mina
P.I. 1
1-2
MWF
208
I Najorda
FS 4
2-3
M
Bio Rm
A Martin
EDUC 126
3-4
MWF
Bio Rm
A Martin
EDUC 193
4-5:30
M
208
EB Santos
PHILO 1
7:30-9:00
TTH
202
SR Fernando
ENGL 104
9-10:30
TTH
Speech Lab
SB Mina
ENGED 108
2:30-4
TTH
Speech Lab
SB Mina
ENGED 107
4-5:30
TTH
103
RL Lasaten
EDUC 135
2-3
W
FI Deus
Name of Organization(s): GUMIL
Position: PIO
Reason(s) for joining the organization(s):____________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
__
FAMILY BACKGROUND:
Name of Father:
REMIGIO
GOKEN
Given Name
Middle Name
Age: 52
Highest Educational Attainment:
Occupation: FARMING/ GOVT EMPLOYEE
CASTRO
Family Name
Name of Mother:
CASTRO
Family Name
MAVELYN
ARZAGA
Given Name
Middle Name
Age: 50
Highest Educational Attainment: BACHELOR
Occupation: TEACHING
Salaries/ Wages Pension None
Own Business
Others
___________________________
(pls. specify)
July 30, 2012

Date
2X2
ID
PICTURE

Batac, Ilocos Norte
BIO-DATA OF OFFICER
SY 2012-2013
NAME: ____SALLEH__________PRINCESS RAIHANIE_____________SUGUITAN______
Family Name
Given Name
Middle Name
POSITION:SECRETARY ______________________________________________________
ORGANIZATION:ASSOCIATION OF STUDENTS OF TEACHER EDUCATION IN______ REGION 1 (ASTER)
Nickname:__CES, RAI Age19 Sex:FEMALE Religious Affiliation:ROMAN CATHOLIC
Nationality:_FILIPINO_ Birth Date: AUGUST 20, 1992 Birthplace:_LAOAG CITY_________
Home Address: # 19, BACARRA, ILOCOS NORTE
Telephone No. : _______________
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee

Parents
Others
Scholarship (specify): CHED SCHOLAR
Assistantship
Special Talents/Skill: PUBLIC SPEAKING, COMPUTER LITERATE

____________
College: COLLEGE OF TEACHER EDUCATION____________________________________
Course:BACHELOR IN SECONDARY EDUCATION Major: ENGLISH
Level
Elementary
Nambaran E/S
Inclusive Years
1999-2005
Honor/Award
Valedictorian
High School
2005-2009
With Distinction
Bacarra Natl Comp H/S
CLASS SCHEDULE:
2009-present
ENG. ED. 105

7:30-8:30
MWF
207
MINA, SB
EDUC. 126
8:30-9:30
MWF
208
MINA, SB
PI 1
1-2
MWF
DORM
NAJORDA, IL
EDUC 133
2-3
M
SOC HALL
MARTIN, AR
EDUC 135
2-3
W
SOC HALL
DEUS, IF
EDUC 193
4-5
W
202
SANTOS, EB
PHILO 1
7:30-9:00
TTH
203
MARTIN, AR
ENGED 106
10:30-12
TTH
SPCH. LAB
MINA, SB
ENGL. 108
1-2:30
TTH
103
MINA, SB
ENGL. 107
4-5:30
TTH
SPCH. LAB
LASATEN, RCL
Membership in other student organization(s): Womens Club, CAG, PCC, SSC, ASTER
Name of Organization(s):_SeCO _________________________________________________
Position: ____VICE GOVERNOR________________________________________________
Reason(s) for joining the organization(s):_____I joined these clubs to extend my services as a
student leader and to be acquired with the necessary experiences needed for my personal growth
and development.
_______________________________________________________
FAMILY BACKGROUND:
Name of Father: ____HADJI NUR_______ AMPAOA_____________
_SALLEH________
Given Name
Middle Name
Family Name
Age: (deceased)
Highest Educational Attainment: High school graduate_______________
Occupation: ___________________________
Name of Mother: __
NORMA_________CADIENTE_____________ SUGUITAN_
__
Given Name
Middle Name
Family Name
Age: ___55____
Highest Educational Attainment: __2nd year college
_______
Occupation: FARMING_____________
Number of Children in the Family:_Five_(5)____
How many of your brother(s)/sister(s) are still studying? none_
How many of your brother(s)/sister(s) are working now? Three (3)
Salaries/ Wages Pension None
Own Business
Others
___________________________
(pls. specify)
July 30, 2012

Date
2X2
ID
PICTURE

Batac, Ilocos Norte
STUDENT SEVICES AND DEVELPOMENT
BIO-DATA OF OFFICER
SY 2012-2013
NAME:
CAJIGAL,
CHRISTIAN DAVE
PASCUA
Family Name
Given Name
Middle Name
POSITION: 3rd YEAR REPRESENTATIVE
___
ORGANIZATION: ASSOCIATION OF STUDENTS OF TEACHER EDUCATION IN______ REGION 1 (ASTER)
Nickname: KADJANG Age 18 Sex: M Religious Affiliation: JEHOVAH;S WITNESS
Nationality: FILIPINO Birth Date: SEPTEMBER 11, 1993
Birthplace: PINILI, I.N.
Home Address: BRGY. BADIO, PINILI, ILOCOS NORTE Telephone No. :
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee
Others
Parents
Scholarship (specify) COLLEGE SCHOLAR
Assistantship
Special Talents/Skill:WRITING, SINGING, ACTING

Course:
BSED
Major:
Level
ENGLISH
Inclusive Years
Honor/Award
Elementary
Badio Elementary School
High School
Pinili National High School
CLASS SCHEDULE:
Subject
EDUC 124
HUM 1
ENGL 106
LIT 106
EDUC 122
EDUC 121
EDUC 131
LIT 105
EDUC 191
Time
8:30-9:30
9:30-10:30
10:30-11:30
1-2
3-4
4-5
9-10
2:30-4
9-10:30
2000-2006
2006-2010
-
Day
MWF
MWF
MWF
MWF
MWF
TTH
TUES
TTH
TTH
Room
202
205
DORM
Speech Lab
206
203
204
Speech Lab
209
Valedictorian
Valedictorian
Professor
Dr. E. Samson
Dr. C. Sanchez
Dr. R. Lasaten
Prof. J. Asuncion
Prof. V. Antonio
Dr. J. Aragon
Dr. L. Abrogena
Ms. C. Balantac
Prof. V. Antonio

Name of Organization(s):CAG; GUMIL; CTE BULLETIN
Position: VICE PRESIDENT; SUB-TREASURER; CHIEF CORRESPONDENT
Reason(s) for joining the organization(s):To enhance more my leadership skills as a teacher in
the future.
FAMILY BACKGROUND:
Name of Father:
CRISOLOGO
WATAN
CAJIGAL
Given Name
Middle Name
Family Name
Age: 54
Highest Educational Attainment: HIGH SCHOOL UNDERGRADUATE
Occupation: FARMING
Name of Mother:
EVANGELINE
PAYALA
PASCUA
Given Name
Middle Name
Family Name
Age: 56
Highest Educational Attainment: COLLEGE GRADUATE
None
Own Business
(pls. specify)
Others
___________________________
July 30, 2012

Date
2X2
ID
PICTURE

Batac, Ilocos Norte
BIO-DATA OF OFFICER
SY_2012-2013_
NAME: ______CALZADA
MARC PAUL
TUNAC _________
Family Name
Given Name
Middle Name
POSITION: TREASURER
Nickname: MAHKIE Age: _19_ Sex: _MALE_ Religious Affiliation: CHURCH OF GOD
Nationality: FILIPINO Birth Date: OCT. 11, 1992 Birthplace: #25 VINTAR, ILOCOS NORTE
Home Address: 25 TAMDAGAN, VINTAR, ILOCOS NORTE Telephone No.: ____________
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee

Parents
Others
Scholarship (specify) VINTARINIANS OF CALIFORNIA SCHOLARSHIP
Assistantship
Special Talents/Skill: DANCING, COMPUTER LITERATE

_____________
Course: BACHELOR OF SECONDARY EDUCATION Major: PHYSICAL SCIENCES
Level
ELEMENTARY

Tamdagan Elem. Sch.
SECONDARY
Vintar National High Sch.
TERTIARY
MMSU-CTE
Inclusive Years
1999-2005
2005-2009
2009-present
Honor/Award
First Honorable
Mention
First Honorable
Mention
CLASS SCHEDULE:
Subject
Time
Day
Room
Professor
PHYS 141
7:30-8:30
MWF
PHYS. RM.
VV ANTONIO
EDUC 126
10:30-11:30
MWF
GEN. SCI. RM.
AR MARTIN
PHYSCED 121
1-2
MWF
GEN. SCI. RM.
F GALLARDO
PHYSCED 122
3-4
MWF
PHYS. RM.
VJ AURELIO
EDUC 193
4-5
FRI
SOC. HALL
EB SANTOS
EDUC 133
9-10
TUES
AR MARTIN
EDUC 135
9-10
THURS
PHYS. RM.
VV ANTONIO
PI 1
1-2:30
TTH
205
IL NAJORDA
PHILO 1
230-4
TTH
209
SR FERNANDO
Name of Organization(s): UNESCO
Position: VICE-PRESIDENT
Reason(s) for joining the organization(s): I want to contribute for the attainment of an excellent
way of leadership here in our college and I want to develop more my leadership qualities because
these would be important to me as a future teacher.
FAMILY BACKGROUND:
Name of Father: _____PATERNO
AGBAYANI
Given Name
Middle Name
Age: _62_ Highest Educational Attainment: GRADE 3 LEVEL
Occupation: FARMING
CALZADA
Family Name
Name of Mother: ____ ROSALINDA

TUNAC
CALZADA
Given Name
Middle Name
Family Name
How many of your brother(s)/sister(s) are still studying? ___
How many of your brother(s)/sister(s) are working now? _1_
None
Own Business
(pls. specify)
Others
___________________________
July 30, 2012

Date
2X2
ID
PICTURE
Batac, Ilocos Norte
BIO-DATA OF OFFICER
SY 2012 -2013
NAME:
LAYUS
ANBERT
PARAOAN
Family Name
Given Name
Middle Name
POSITION: AUDITOR
Nickname: ANJO
Age: 18
Sex: MALE
Religious Affiliation: CATHOLIC
Nationality: FILIPINO
Birth Date: OCTOBER 13, 1993
Birthplace: BATAC CITY
Campus Address: A. CASTRO AVE. LAOAG CITY Telephone No. : __________
Home Address: BRGY . 16 QUILING NORTE BATAC CITY Telephone No: 09102388990
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee

Parents
Others
Assistantship
Scholarship (specify) BATAC CITY SCHOLARSHIP
Special Talents/Skill: DANCING AND PLAYING GUITAR

Course: BEED
Major: SPECIAL EDUCATION
Level
Inclusive Years
Elementary
QUILING ELEM.
2000-2006
SCHOOL
High School
BATAC INSTITUTE
2006-2010
INC.
College/University
MARIANO MARCOS
2011-PRESENT
STATE UNIVERSITY
CLASS SCHEDULE:
Subject
Time
Day
Room
SPED 110
7:30-8:30
MWF
DORM
Honor/Award
VALEDICTORIAN
VALEDICTORIAN
Professor
MS. CASTRO
SPED 109
8:30-9:30
MWF
201
PROF. ACUNA
SPED 108
9:30-10:30
MWF
208
DR. ARAGON
EDUC 122
10:30-11:30
MWF
208
PROF. PACIS
SPED 119
1-2
MWF
101
DR. SAMSON
EDUC 121
7:30-9
TTH
DORM
MS. CASTRO
EDUC 128
1-2:30
TTH
206
PROF. DIALS
EDUC 124
2:30-4
TTH
201
PROF. ACUNA
EDUC 131
9-10
TH
DORM
MS. CASTRO
EDUC 191
4-5
TH
SOC. HALL
PROF. S. MINA
Name of Organization(s): EARLY CHILDHOOD EDUCATORS CLUB
Position: VICE PRESIDENT
Reason(s) for joining the organization(s):TO DEVELOP MY LEADERSHIP ABILITIES
_____________________________________________________________________________
_____________________________________________________________________________
__
FAMILY BACKGROUND:
Name of Father:
GILBERT
DOMINGO
LAYUS__
Given Name
Middle Name
Family Name
Age:52
Highest Educational Attainment: ELEMENTARY GRADUATE
Occupation: FARMING
Name of Mother:
EVANGELINE
PARAOAN
LAYUS________
Given Name
Middle Name
Family Name
Age: __________
Occupation: HOUSE KEEPING
How many of your brother(s)/sister(s) are working now? NONE
Own Business
Others
___________________________
None
(pls. specify)
JULY 30, 2012

Date
2X2
ID
PICTURE
Batac, Ilocos Norte
BIO-DATA OF OFFICER
SY 2012 -2013
NAME: ____BALLESTEROS__________REYMART JAY_____________GANAL________
Family Name
Given Name
Middle Name
POSITION: SUB-TREASURER
Nickname:__________ Age_17_ Sex:_MALE__ Religious Affiliation:_AGLIPAYAN____
Nationality:_FILIPINO__ Birth Date:MARCH 13, 1994 Birthplace:_BRGY.4, SOLSONA, I.N.
Home Address: _________BRGY. 4 SOLSONA, I.N._____ Telephone No. : 09189654883____
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee
Others
Parents
Scholarship (specify)___________________
Assistantship
Special Talents/Skill: ______dancing and acting_______________________________

College:_COLLEGE OF TEACHER EDUCATION
Course:_____BEEd_____________________ Major: _______GEN. ED_______________
Level
Elementary
Santiago Elem. School
High School
Solsona National H/S
CLASS SCHEDULE:
Subject
Time
EDUC 136
8:30-9:30
EDUC 122
9:30-10:30
Inclusive Years
2000-2006
Honor/Award
Valedictorian
2006-2010
With Honors
2010-present
Day
MWF
MWF
Room
205
101
Professor
E. Nagtalon
N. Lorenzo
EDUC 121
10:30-11:30
MWF
101
E. Asuncion
MATH 125
2-3
MWF
203
A. Seatriz
VALED
3-4
MWF
201
R. F. Mina
EDUC 124
4-5
MWF
205
S. Sanchez
LIT 3
9-10:30
TTh
204
M. Arellano
CHEM 114
1-2:30
TTh
Chem Rm
L. Abrogena
EDUC 131
2:30-3:30
Tues
101
R. Mateo
EDUC 191
4-5
Th
205
E. Macugay
Name of Organization(s): _____SECTION ORGANIZATION
__________________
Position: ______________ MAYOR______________________________________
Reason(s) for joining the organization(s):____To impart my responsibility to my fellow students
and to experience the enjoyment in the said organization__________________
FAMILY BACKGROUND:
Name of Father: ____GERONIMO________DOMINGO
__
BALLESTEROS_____
Given Name
Middle Name
Family Name
Age: ___45_____
Highest Educational Attainment: _____ELEM. GRAD._______________
Occupation: ___FARMING_______________
Name of Mother: ____MARITES____________GANAL _________BALLESTEROS______
Given Name
Middle Name
Family Name
Age: ___44_____
Highest Educational Attainment: _____ELEM. GRAD._______________
Occupation: ___HOUSEKEEPING_________
Number of Children in the Family:_______3_______
How many of your brother(s)/sister(s) are still studying? _____3____
How many of your brother(s)/sister(s) are working now? ____none___
None
Own Business
(pls. specify)
Others
___________________________
July 30, 2012

Date
Batac, Ilocos Norte
BIO-DATA OF OFFICER
SY 2012-2013
NAME:
RAQUINO
JADE
DUMLAO
Family Name
Given Name
Middle Name
POSITION: VICE-PRESIDENT
Nickname: JEDA Age: 18 Sex: MALE Religious Affiliation: CATHOLIC
Nationality: FILIPINO Birth Date: JAN. 10, 1994 Birthplace: BADOC, ILOCOS NORTE
Telephone No. : ____________
Home Address: BGRY. 20-A GABUT NORTE, BADOC, ILOCOS NORTE Telephone No. : _____
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee
Others
Parents
Scholarship (specify) PROVINCIAL SCHOLAR
Assistantship
Special Talents/Skill: DANCING, _____________________________________________

Course: BACHELOR OF ELEMENTARY EDUCATION Major: GENERAL EDUCATION
Level
Elementary

Gabut Elem. Sch.
Inclusive Years
2000-2006
Honor/Award
Salutatorian
High School
Juan Luna Mem. Acad.

Inc.
2006-2010
Third Hon. Mention
2010-present
CLASS SCHEDULE:
Subject
VALED
MATH 125
Time
7:30-8:30
9:30-10:30
Day
MWF
MWF
Room
101
203
Professor
MINA, RE
SEATRIZ, AP
LIT 3
1-2
MWF
209
EDUC 124
EDUC 121
EDUC 136
2-3
4-5
7:30-9
MWF
MWF
TTH
101
101
203
EDUC 191
CHEM 114
9-10
1-2:30
Tues
TTH
209
CHEM. ROOM
EDUC 122
EDUC 131
2:30-4
9-10
TTH
TH
205
101
ARELLANO,
MR
SAMSON, ET
MATEO, RR
NAGTALON,
EC
ASUNCION, EB
GALLARDO,
FB
PACIS, E
MATEO, RR

Name of Organization(s): SECTION ORGANIZATION ________________
Position: TREASURER
__________________
Reason(s) for joining the organization(s): I want to serve my fellow students. I want to be
improved my leadership skills_____________________________________________________
FAMILY BACKGROUND:
Name of Father:
ALEX
RACILES
RAQUINO_
Given Name
Middle Name
Family Name
Age: 47
Occupation: FISHING
Name of Mother:
NIDALYN
SALAAN
DUMLAO
Given Name
Middle Name
Family Name
Age: 42
Own Business
Others
___________________________
None
(pls. specify)
July 30, 2012

Date
Batac, Ilocos Norte
BIO-DATA OF OFFICER
SY 2012-2013
NAME:
AGUSTIN
CHERRY
RUNGDUEN
Family Name
Given Name
Middle Name
POSITION: SUB-TREASURER
Nickname: CHERRY Age: 19 Sex: FEMALE Religious Affiliation: AGLIPAYAN
Nationality: FILIPINO Birth Date: JULY 24,1993 Birthplace: BATAC CITY I.N
Telephone No. : ____________
Home Address: BGRY. 14 BUNGON, BATAC CITY, ILOCOS NORTE Telephone No. : _____
A. Undergraduate
Freshman
Sophomore
Junior
Senior
Part Time Employee
Others
Parents
Scholarship (specify) :
Assistantship
Special Talents/Skill: DANCING_____________________________________________

Course: BACHELOR OF ELEMENTARY EDUCATION Major: GENERAL EDUCATION
Level
Elementary

Baay Elem. School
High School
Batac National High Sch.

(Bungon Campus)
Inclusive Years
2000-2006
Honor/Award
With Distinction
2006-2010
Salutatorian
2010-present
CLASS SCHEDULE:
Subject
VALED
MATH 125
LIT 3
Time
7:30-8:30
9:30-10:30
1-2
Day
MWF
MWF
MWF
Room
101
203
209
Professor
MINA, RE
SEATRIZ, AP
ARELLANO,
EDUC 124
EDUC 121
EDUC 136
2-3
4-5
7:30-9
MWF
MWF
TTH
101
101
203
EDUC 191
CHEM 114
9-10
1-2:30
Tues
TTH
209
CHEM. ROOM
EDUC 122
EDUC 131
2:30-4
9-10
TTH
TH
205
101
MR
SAMSON, ET
MATEO, RR
NAGTALON,
EC
ASUNCION, EB
GALLARDO,
FB
PACIS, E
MATEO, RR

Name of Organization(s): none________________
Position:
__________________
Reason(s) for joining the organization:_________________________________________
FAMILY BACKGROUND:
Name of Father:
ROLANDO
NAUPAL
AGUSTIN_
Given Name
Middle Name
Family Name
Age: 47
Occupation: FARMING
Name of Mother:
ADORA
REAL
RUNGDUEN
Given Name
Middle Name
Family Name
Age: 42
None
Own Business
Others
___________________________
(pls. specify)
July 30, 2012

Date

Renewal Forms Aster

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Renewal Forms Aster

Uploaded by

Copyright:

Available Formats

RENEWAL FORM

SSD-SOP Form No. 1

MARIANO MARCOS STATE UNIVERSITY

STUDENT SERVICES & DEVELOPMENT OFFICE

APPLICATION FOR RECOGNITION/RENEWAL OF ORGANIZATION

Dr. Maria Eliza Lopez / Prof. Estrella Luiz

SSDO-SOP (OSA) Form #2

June 16, 2012

General Orientation for Student Teaching (1st

MMSU-CTE Social Hall

Briefing for the Out Campus Student Teachers

SSD-SOP Form No. 3

Mariano Marcos State University

STUDENT SERVICES & DEVELOPMENT OFFICE

July 30, 2012

DR. ELIZA LOPEZ / PROF. ESTRELLA LUIZ

COLLEGE OF TEACHER EDUCATION

Brgy. 9 Laoag City / San Nicolas

SSD-SOP (OSA) FORM #4

Princess Raihanie Salleh

Marc Paul Calzada

Anna Marie Cautal

3rd Year Rep.

Republic of the Philippines

B. Graduate: Full Time

Part Time Employee

Source of Financial Support:

Scholarship (specify) COLLEGE SCHOLAR, NCIP SCHOLAR

Special Talents/Skill: DANCING, SINGING, ACTING, DESIGNING,

School Last Attended

Membership in other student organization(s):

Salaries/ Wages Pension

July 30, 2012

Republic of the Philippines

B. Graduate: Full Time

Part Time Employee

Source of Financial Support:

Scholarship (specify) ISKOLAR NI MANANG IMEE

Special Talents/Skill: DANCING, SINGING, BAKING, ACTING, COOKING_____________

School Last Attended

GEN. SCI. RM.

Membership in other student organization(s):

July 30, 2012

Republic of the Philippines

B. Graduate: Full Time

Part Time Employee

Source of Financial Support:

Scholarship (specify) CHED SCHOLAR

Special Talents/Skill: DANCING, ACTING, COMPUTER LITERATE_____________

School Last Attended

Membership in other student organization(s):

July 30, 2012

Republic of the Philippines

B. Graduate: Full Time

Part Time Employee

Source of Financial Support:

Scholarship (specify) COLLEG SCHOLAR

Bangui national High

Salaries/ Wages Pension None

July 30, 2012

Republic of the Philippines

B. Graduate: Full Time

Part Time Employee

Special Talents/Skill: dancing and acting_________________________