House #/

Street/ Sitio/
Purok
Relationship
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
M Christianity
F Christianity
F Christianity
F Christianity
F Christianity
F Christianity
F Christianity
Indicator Code BoSY
14.
6
School Form 1 (SF 1) School Register
(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)
School ID 120640 Region VII Division Negros Oriental District Vallehermoso
School Name Tolotolo ES School Year 2014 - 2015 Grade Grade 4 Section GLORIA
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
ADDRESS PARENTS
GUARDIAN
(if Not Parent)
Contact Number
of Parent or
Guardian
REMARKS
Barangay Municipality/ City Province
Father's Name
(Last Name, First
Name, Middle
Name)
Mother's Maiden
Name (Last Name,
First Name, Middle
Name
(Please refer to the legend
on last page)
120640100002.
ARELLANO, ROSEVELLE
YARES
09-07-2004 9. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
ARELLANO,
ISAIAS
PARADERO
MARIA
MANCAO
YARES
120640100003.
ATACA, ZERAHIAH JAMES
BANCOG
05-07-2005 9. Cebuano TAGBINO VALLEHERMOSO
NEGROS
ORIENTAL
ATACA,
ZEZZIER
ACERON
TEODORA
MENDOZA
BANCOG
120640100006. DOLOSA, ANGELO ROMA 08-01-2005 8. Cebuano TAGBINO VALLEHERMOSO
NEGROS
ORIENTAL
,
MARY JANE
ROMA DOLOSA
MARY JANE
ROMA
DOLOSA
120640100008.
HERMOSO, NOLIBERT
DIONSON
05-19-2005 9. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
HERMOSO,
HESAEL NOLI
BASCONES
CHRISTI MAE
DIVINAGRACIA
DIONSON
120640100013.
ORTIZ, RAYQUIL JAMES
DAMALERIO
01-29-2005 9. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
BERBO, ROGER
HERALDA
DAMALERIO
ORTIZ
120640130025. ORTIZ, ROMEO PATIGA 03-15-2005 9. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
ORTIZ, JAIME
BABOR
MILA
ARQUILOS
PATIGA
120640100015. PARAGOSO, RYAN ANTONIO 07-27-2005 8. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
PARAGOSO,
RONINO
SUMILAO
NERISA
EMPINADO
ANTONIO
120640130026. SEBIAL, ALVIN CUEVAS 05-30-2005 9. Cebuano TAGBINO VALLEHERMOSO
NEGROS
ORIENTAL
SEBIAL, ELMER
PARRA
ADELAIDA
LERASAN
CUEVAS
120640130027. SEBIAL, MARK CUIZON 06-12-2005 8. Cebuano TAGBINO VALLEHERMOSO
NEGROS
ORIENTAL
SEBIAL,
MICHAEL
ANTONIO
AURORA
MAHINAY
CUIZON
120640100018.
SOLLANO, KIEM JAY
CABONILAS
09-01-2005 8. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
SOLLANO,
PAULINO
ORTIMBAC JR
NIZA
DIACAMOS
CABONILAS
PAULINO
ORTIMBAC
SOLLANO JR
120640100019.
SONSONA, WENDELL
MAGTAGAD
04-18-2005 9. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
SONSONA,
MARK NOEL
EPE
MARIA
CRISTINA
POLOGON
MAGTAGAD
120640100020. SUARING, MINARD LAPAZ 05-19-2005 9. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
SUARING,
HILARIO
ENDONA
MONINA
SALDUA
LAPAZ
HILARIO
ENDONA
SUARING
120640130028.
TORTOR, CHRISTOPHER
OGHAYON
07-18-2005 8. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
TORTOR,
ALFREDO
MANGYAO
CRISANTA
DIONSON
OGHAYON
120640100021.
VILLASORDA, CHRISTIAN
DOLOSA
09-10-2005 8. Cebuano TAGBINO VALLEHERMOSO
NEGROS
ORIENTAL
VILLASORDA,
DANILO
DONABELLE
ROMA DOLOSA
14 <=== TOTAL MALE
120639100011. BAGUIO, KAREN SANDOT 04-16-2004 10. Cebuano TAGBINO VALLEHERMOSO
NEGROS
ORIENTAL
BAGUIO,
MELCHOR F
JUDITHA
SANDOT
120640100007. ESGUERRA, KISSY PACUNLA 08-17-2005 8. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
ORTIZ,
ENRIQUE
DAMALERIO
MARY ANN
PACUNLA
ESGUERRA
120640100009. JAKOSALEM, REYNABEL LAPAZ 01-20-2005 9. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
JAKOSALEM,
LEONEDES
MANGYAO
MAGIN
SALDUA
LAPAZ
LEONEDES
MANGYAO
JAKOSALEM
120640100011. LAPERA, JEMAIKA MOLLENA 04-30-2005 9. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
LAPERA,
MARIO
PASAGDAN
MYLENE
BUTAC
MOLLENA
MARIO
PASAGDAN
LAPERA
120640100012. NAYON, SHANE PAGAYANAN 02-08-2005 9. Cebuano ULAY VALLEHERMOSO
NEGROS
ORIENTAL
NAYON,
FERNANDO
PANO III
ANITA
PABILANDO
PAGAYANAN
120640130029. VILLACORA, GINA TEOFILO 04-22-2005 9. Cebuano TAGBINO VALLEHERMOSO
NEGROS
ORIENTAL
VILLACORA,
ALLAN
TEODORO
PACITA
PABILANDO
TEOFILO
6 <=== TOTAL FEMALE
20 <=== COMBINED
List and Code of Indicators under REMARKS column
Code Required Information Prepared by;
ADELA DIVINAGRACIA DIONSON
CCT Control/reference number & Effectivity Date
Name of school last attended & Year
Specify
Specify Level & Effectivity Data
MALE
Indicator Required Information REGISTERED EoSY Certified Correct:
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
MARISSA LEON EMPERADO
FEMALE
(Signature of Adviser over Printed Name) (Signature of School Head over Printed Name)
20
CCT Control/reference number & Effectivity Date
Name of school last attended & Year
Specify
Specify Level & Effectivity Data
BoSY Date: EoSY Date: BoSY Date:
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
EoSY Date:
Generated on: Wednesday, August 13, 2014 1:11:39 PM
Revision 4
TOTAL