House #/

Street/ Sitio/
Purok
Relationship
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
M
Christian
ity
F
Christian
ity
F
Christian
ity
RELATIVE
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
F
Christian
ity
Indicator Code BoSY
School Form 1 (SF 1) School Register
(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)
School ID 189527 Region VII Division Negros Oriental District Vallehermoso
Section MULTIGRADE K-2
LRN
NAME
(Last Name, First Name, Middle Name)
S
e
x

(
M
/
F
)
BIRTH DATE
(mm/dd/yyyy)
AGE as
of 1st
Friday
June
MOTHER
TONGUE
(Grade 1
to 3 Only)
IP
(Ethnic
Group)
RELIGION
School Name Bairan Primary School School Year 2014 - 2015 Grade Grade 1
ADDRESS PARENTS
GUARDIAN
(if Not Parent)
Contact
Number of
Parent or
Guardian Barangay
Municipality/
City
Province
Father's Name
(Last Name, First
Name, Middle
Name)
Mother's Maiden
Name (Last Name,
First Name,
Middle
Name
189527130001.
CATIPAY, JAMES PATRICK
PATALANDO
11-27-2007 6. Cebuano BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
CATIPAY, JUAN
PATALANDO,P
ONCIANA
189527130002. ESCOZAR, CHRISTIAN PUERTO 05-17-2008 6. Cebuano
189527130003. LANGUIDO, JERALD POCONG 11-30-2007 6. Cebuano
BULUANGA
N
SAN
CARLOS
CITY
NEGROS
OCCIDENTAL
BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
ESCOZAR,
CHRISTOPHER
PUERTO,GEM
MA
,
POCONG,HELE
N
189527130004. LARIOSA, ALVIN ALQUISOLA 11-18-2007 6. Cebuano
189527130005. TRAYA, ELJAY CANTUTAY 03-03-2008 6. Cebuano BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
BULUANGA
N
SAN
CARLOS
CITY
NEGROS
OCCIDENTAL
LARIOSA,
ANGELO
ALQUISOLA,M
ARIA LORENA
TRAYA, JUAN
MARCELLANA
JR
CANTUTAY
LIEZEL
DISCARTIN
5 <=== TOTAL MALE
189527130006. CABALLERO, MIRA SACASAN 03-03-2008 6. Cebuano BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
CABALLERO,
EDUARDO
SACASAN,PON
CIANA
189527130007. CASTRO, MARIVIC SIBAN 10-29-2008 5. Cebuano
120218130041. GUTANG, JORELYN DIAZ 12-08-2007 6. Cebuano BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
BULUANGA
N
SAN
CARLOS
CITY
NEGROS
OCCIDENTAL
CASTRO,
ROGELIO
DELUBIO
SIBAN,
MARILOU
CAGATIN
ERLINDA
DELUBIO
,
GUTANG,REM
EDIOS DIAZ
189527130009. HERMINO, JONALYN TANION 06-22-2008 5. Cebuano
189527130010.
LARIOSA, CHERRY ANN
GUTANG
05-19-2008 6. Cebuano BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
HERMINO,
FRANCISCO
TANION,JOVIT
A
LARIOSA,
DINDO
GUTANG,DIOS
CORA
189527130011. LARIOSA, KATHLEEN DAAROL 12-03-2007 6. Cebuano
189527130013.
PATIGA, CHERRY ANN
LICANDA
03-19-2008 6. Cebuano BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
LARIOSA,
EDUARDO
DAAROL,MIRA
PATIGA, MARIO
LICANDA,DAIS
Y ENCLONAR
189527130014.
SELMA, CHARLENE
BATOMALAQUE
11-22-2007 6. Cebuano
8 <=== TOTAL FEMALE
BAIRAN
VALLEHERM
OSO
NEGROS
ORIENTAL
SELMA, EDWIN
BATOMALAQU
E,TEODORA
13 <=== COMBINED
List and Code of Indicators under REMARKS column
Code Required Information Indicator Required Information REGISTERED EoSY
Prepared by; Certified Correct:
School Form 1 (SF 1) School Register
(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)
Vallehermoso
MULTIGRADE K-2
REMARKS
(Please refer to
the legend on last
page)
Certified Correct:
5.
8
13
Transfered Out
Transfered In
Dropped
T/O
T/I
DRP
LE
Name of Public (P) Private (PR) School &
Effectivity Date
Name of Public (P) Private (PR) School &
Effectivity Date
Reason and Effectivity Date
Reason (Enrollment beyond 1st Friday of
CCT Receipient
Balik Aral
Learner With
Disability
Accelerated
CCT
B/A
LWD
ACL
Revision 4
BoSY Date: EoSY Date: BoSY Date: EoSY Date:
Generated on: Wednesday, August 13, 2014 8:48:19 AM
CCT Control/reference number & Effectivity Date
Name of school last attended & Year
Specify
Specify Level & Effectivity Data
MALE
HYACINTH MYVON ENGARCIAL CALAGO JENEFFER LAYAN SALADO
FEMALE
(Signature of Adviser over Printed Name) (Signature of School Head over Printed Name)
TOTAL
EoSY Date:
Generated on: Wednesday, August 13, 2014 8:48:19 AM
JENEFFER LAYAN SALADO
(Signature of School Head over Printed Name)