House #/

Street/ Sitio/
Purok
Relationship
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
RELATIVE
M
Christiani
ty
School Form 1 (SF 1) School Register
(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)
School ID 120637 Region VII Division Negros Oriental District Vallehermoso
School Name Pinucauan ES School Year 2014 - 2015 Grade Grade 5 Section POMELO
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)
120637120027. ABADANO, JUNREY ONDING 09-17-2000 13. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
ABADANO,
JUVY SR
ONDING,
ANECIA
SABELLANO
120637070004. ABUNDIENTE, RITCHIE EBEZA 06-09-2000 13. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
ABUNDIENTE,
PORFERIO
BACALSO
EBEZA,
LEONIDA
FLORES
120637090009. AZUCENAS, NEKCHEL LAPERA 09-10-2003 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
AZUCENAS,
FEIX
LAPERA,
ANICETA
SABELLANO
120637090017.
CAASARES, JOSELITO
MORALES
08-13-2003 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
CAASARES,
JOSE
MORALES,
ANITA
CORDOVA
120637070020. CANOY, JOMAR PLACER 10-12-1997 16. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
CANOY,
FLORENCIO
MARTINEZ SR
PLACER,
EDITHA
ESPARAGOSA
120637090019.
CAPARIDA, RAMIL
CONCEPCION
01-20-2003 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
CAPARIDA,
DANILO LAPIZ
SR
CONCEPCION,
ROSALIA
MAGHARI
120637080026. COBOL, JOHNNY TRAYA 04-16-2000 14. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
COBOL,
EUFEMIO
ARCALA
TRAYA,
DEMOSTHENE
SA ABADANO
120637090022. ELLADORA, JESSIE PITOS 12-25-2002 11. Cebuano BAGAWINES
VALLEHERM
OSO
NEGROS
ORIENTAL
ELLADORA,
EUSTAQUIO
ARCALA JR
PITOS,
EVANGELINE
ELECCION
120637080032. ELLANES, ERNAN N-A 08-15-2002 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
GABRINA,
ROLANDO
TALARA
ELLANES,
ESTER
CEPADA
120637080037. GABUYA, LASTE STA ANA 04-10-2001 13. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
GABUYA,
ELMER
STA ANA,
JUANITA
NAVARRO
120637090031. GEORPE, RIGGIE ARANCES 12-15-2003 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
GEORPE,
LEONCIO
DAULONG
ARANCES,
RITA
FACULTAD
120637080055. LICAYAN, NILO MIRASOL 09-08-2001 12. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
LICAYAN,
VIRGILIO
VILLAREN
MIRASOL,
LEONILA
AMBROCIA
120637090051.
MAQUIPOTEN, ROBERT
CABALUNA
04-25-2003 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
MAQUIPOTEN,
JAIME FAT
CABALUNA,
JULIA
ARQUILITA
120637090053. MORALES, LOUIE PASTEDIO 04-07-2004 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
MORALES,
ANTONIO
CORDOVA
PASTEDIO,
VICENTA
BARNAYHA
120637080064. MORALES, ROYMIE MISTERIO 01-28-2001 13. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
MORALES,
ROBERTO
CORDOVA JR
MISTERIO,
GERMANA
ZAMORA
120637090057. NAVARRO, JAKE ABADANO 09-03-2002 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
NAVARRO,
TERESITO
PANTILANAN
ABADANO
ROSALINDA
TANIESA
120637080075. PANSOY, MIKE JUMARY N-A 01-29-2003 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
,
PANSOY,
JUDTH TRAYA
PANSOY
AURELLA
TRAYA
120637090061. PANTILANAN, JOVEN AQUINO 03-05-2001 13. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
PANTILANAN,
NARCISO
VILLAJUAN
AQUINO,
EVELYN
GONZALES
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
M
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
RELATIVE
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
F
Christiani
ty
120637080083. PITULAN, DANTE TUMACMOL 07-14-2002 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
PITULAN, FELIX
MAYONILA
TUMACMOL,
GORGONIA
CALAGO
120637090082. TANJAY, ARNOLD BASCON 01-03-2003 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
TANJAY,
AMELITO
CANDADO
BASON,
PRIMITIVA
MORALES
120637080105. TUMACMOL, REYNALDO N-A 04-09-2002 12. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
TEMPERATURA
, RAMON
SAYSON
TUMACMOL,
MARCELINA
CALAGO
120637080110. ZAMORA, ARCINIO ABARICO 05-29-2002 12. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
ZAMORA, FELIX
SAROMINES
ABARICO,
ANNABELLE
ABAO
22 <=== TOTAL MALE
120637090012. BERDON, ANGELISA ABADANO 04-16-2003 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
BERDON,
SABINIANO
PARADERO
ABADANO,
JOCELYN
UNGRIA
120637090013. BUHAY, MARIANNE TOPIA 01-19-2004 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
BUHAY, MARIO
MAQUIPOTEN
TOPIA, MERRY
JOY
BALASABAS
120637080024. CANOY, MARY MAE NAVALES 05-15-2002 12. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
CANOY,
ROCILO
MARTINEZ
NAVALES,
NATIVIDA
CAPARIDA
119485090146. DAYON, IRISH ANNE N-A 08-04-2004 9. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
MALABAGO,
RITCHIE
DAYON,
LEONORA
PLACER
DAYON,
LEONORA
PLACER
120637090026. ENTIENZA, MARIAME SALCEDO 07-23-2003 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
ENTIENZA,
ERNESTO
CAPARIDA
SALCEDO,
MARICEL
NAVALES
120637090027. EPANTO, JINKY OBEDENCIO 02-05-2002 12. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
EPANTO,
FRANCISCO
RECABO
OBEDENCIO,
JULIANA
VILLEGAS
120637090030. GABUYA, EVERLY STA ANA 03-03-2004 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
GABUYA,
ELMER
STA ANA,
JUANITA
NAVARRO
120637080038. GEMINA, JENALIN CAPARIDA 02-02-2002 12. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
GEMINA,
BENITO
CAPARIDA,
EDITHA
MAGHARI
120637090039. JIMENEZ, ROWENA BACLA-AN 01-27-2004 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
JIMENEZ,
ROGELIO
TRAYA
BACLA-AN,
MEDINA
PASOIT
120637090041. LASPONIA, ANGELINE AMANCIA 10-22-2003 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
LASPONIA,
DEMLO
AMANCIA,
ELVIRA BABOR
120637090049.
MAQUIPOTEN, CATHERINE
CABALUNA
05-16-2001 13. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
MAQUIPOTEN,
JAIME FAT
CABALUNA,
JULIA
ARQUILITA
120637120048.
MORALES, APRIL JOY
MISTERIO
04-04-2003 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
MORALES,
ROBERTO
CORDOVA JR
MISTERIO,
GERMANA
ZAMORA
120637090060. PANSOY, MARISSA ALBIA 01-21-2000 14. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
PANSOY,
ROMULO
BANTOD
ALBIA,
ROSALINDA
BERTRAN
120637090064. PLACER, JERLIN N-A 11-18-2002 11. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
,
PLACER,
LETTY
ESPARGOSA
120637090071. SALCEDO, JANELL NAVALES 04-13-2003 11. Cebuano ULAY
VALLEHERM
OSO
NEGROS
ORIENTAL
SALCEDO,
TULDERICO
PALDAS
NAVALES,
CATALINA
PLACER
120637090077.
SENILLO, ANNIE ROSE
QUIRABO
09-08-2004 9. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
SENILLO, JUNIE
BOY ESCAPE
QUIRABO,
FLORA
CABANSAG
120637090083. TAO, CRISTINA HILARDEZ 08-19-2003 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
TAO,
PONCIANO
CANOY
HILARDES,
BONIFACIA
SOTERIO
120637090087.
TRAYA, GERA MHEA
CABALUNA
01-16-2004 10. Cebuano
PINOCAWA
N
VALLEHERM
OSO
NEGROS
ORIENTAL
TRAYA,
WILFREDO
EMINDO SR
CABALUNA,
EDITHA
ORALDE
18 <=== TOTAL FEMALE
Indicator Code BoSY
22.
18
40
40 <=== COMBINED
List and Code of Indicators under REMARKS column
Code Required Information
Prepared by;
STELLA MARIE ECUBE MALAHAY
CCT Control/reference number & Effectivity Date
Name of school last attended & Year
Specify
Specify Level & Effectivity Data
MALE
Indicator Required Information REGISTERED EoSY
BoSY Date: EoSY Date: BoSY Date:
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
EoSY Date:
Generated on: Wednesday, August 13, 2014 1:39:30 PM
Revision 4
MARIA THERESA M. ARRIETA
FEMALE
(Signature of Adviser over Printed Name) (Signature of School Head over Printed Name)
TOTAL