School Form 3 (SF3) Books Issued and Returned

(This replaces Form 1 & Inventory of Textbooks)

108480

School ID

Santa Rosa Elementary School Central I

School Name
Subject Area & Title

N
o.

NAME
(Last Name, First Name,
Middle Name)

Date
Issued

ADANTE, MARKUS KAYLEB

1
VALERIANO
2 ALINSOD, DAVE LEMUEL USI
3

ALMARINEZ, NICOLAS
REDONDO

ALMIE, KENNETH
AMARANTE

BABASANTA, OSWALD
SELWYN ACUA

BARTOLAZO, RONALD
ZOREN BABILONIA

7 BEATO, JUSTINE REYES

8

CARAIT, ADRIAN BENEDICT

MAGAT

9 EBESATE, KYLE DANHIL BAYA

10

GOMEZ, LEI GION PAUL

NACIONAL

11

GUEVARA, ANTON LUIS

DIANASAS

12

LASERNA, GIAN ANDREI

CAPUL

13 LAZO JR, OLIVER ASUNCION

14

NAVORA, SHAWN ZEDRIC

MOOG

15 OLIMPIADA, JAHRED ORBAA

16

PUNZALAN, JOSHUA JOVICH

ALMODOVAR

17 REAL, JHON ROGHIE MUNDA

18 SALIDO, JERVIN YAMBAO
19 SANTOS, JONARD MARFIL
19

<=== TOTAL FOR MALE |

TOTAL COPIES ===>

2014 - 2015

School Year

Returned

Subject Area & Title

Date
Issued

Returned

Subject Area & Title

Date
Issued

Returned

Subject Area & Title

Date
Issued

Returned

Grade 2

Grade Level
Subject Area & Title

Date
Issued

Returned

Subject Area & Title

Date
Issued

Returned

Subject Area & Title

Date
Issued

Returned

Subject Area & Title

Date
Issued

STARGAZER

Section

Returned

Subject Area & Title

Date
Issued

Returned

Subject Area & Title

Date
Issued

Returned

REMARKS/ACTION TAKEN
(Please refer to the legend
on last page)

ALITAGTAG, JILLIAN ROSE

LAZO

ALZONA, VALERIE GAYLE

DIZON

AMOR, ANGEL EUNICE

TORRES

BAAO, NEZEL MAE DE

GUZMAN

5 BUENO, SAICY JOY MONTERO

6

CATINDIG, RHOVILYN
DIMAPILIS

CUA, SABRIAH YVONNE

CLEWIN BELICANO

DE RAMOS, KASHNEIAH
PATERNO

DICHOSO, KLOWIE SHAYNE

MAGBATO

10

FABIOSA, MARIE BEATRICE

SOLIS

11

FERRER, ROSE MAE

MENDOZA

12

GABAYAN, SAMANTHA
MALABONGA

13

GONZALES, CHRISTINE
JOYCE CORRALES

14 MANGAHIS, ALTHAEA SISON

15

MIRANDA, CLARISSA
MIRANDA

16

MORALES, ROMEENEIA
EGAMINO

17

MUGAR, CLARICLYN IVON

MASCARINAS

18

OLASO, CRISTINE JOY

PRIMAVERA

19

ONOYA, YVESS LEINN

ENCINA

20 PRIETO, EUNICE DELA CRUZ

21

RAGASA, FRANCESCA
SHAMELLE BELICANO

22

SAMONTE, ALLISON MAE

MEDALLA

23

STO TOMAS, ROSE ANN

GUSTILO

24 TIBAY, REIN BELEN

24

<=== TOTAL FOR FEMALE |

TOTAL COPIES ===>

43

<=== TOTAL LEARNERS |

TOTAL COPIES ===>

GUIDELINES:

In case of lost/unreturned books, please provide information with

the following code:

Prepared By:

1. Title of Books Issued to each learner must be recorded by the class

adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the
form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be
reflected in the form.
5. All textbooks being used must be included. Additional copies of

A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout,

NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly
signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted
by School Head for submission to School Property Custodian (for code TDO), PTL=Paid by
the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14,
2.2012.

MA LOTIS NACIONAL LAGUERTA

(Signature of Adviser over Printed Name)

Date of BoSY:___/___/_____ Date of EoSY: ___/___/_____