Form A

SCHOOL REPORT ON KINDERGARTEN

Children who Are 5 Years Old by June 1, 2016 or Earlier
School Year ______________
Region
__________________________
___________________

Division

School
__________________________
___________________

District

NAME OF PUPIL

GENDER
DATE
OF
BIRTH

Last Name

First Name

Middl
e
Initia
l

Male

AG
E

REMAR
KS

Fema
le

Note: Use additional sheet if necessary.

Prepared by :
Correct:

Certified true and

______________________________
Teacher

________________________
Principal / School

Head
Signature over Printed Name
Printed Name

Signature

over

Date: ___________________
Cc: District Office
Division DepEd Office electronic file in excel format thru kindergarteniloilo@yahoo.com.ph

Form B
SCHOOL REPORT ON KINDERGARTEN
Children Who Will Turn 5 Within the Month of June, 2016
School Year ______________
Region
__________________________
___________________

Division

School
__________________________
___________________

District

NAME OF PUPIL

GENDER
DATE
OF
BIRTH

Last Name

First Name

Middl
e
Initia
l

Male

Fema
le

AG
E

REMAR
KS

Note: Use additional sheet if necessary.

Prepared by :
Correct:
______________________________
Teacher

Certified true and

________________________
Principal / School

Head
Signature over Printed Name
Printed Name

Signature

over

Date: ___________________
Cc: Cc: District Office
Division DepEd Office electronic file in excel format thru kindergarteniloilo@yahoo.com.ph

Form B.1
DISTRICT REPORT ON KINDERGARTEN
Request Permission to Recommend and Admit Children Who Will
Turn 5 Within the Month of June, 2016 into Kindergarten Program
School Year 2016-2017

Prepared by:
RIGARDO G. GIRADO,MPA
District Supervisor
Approved:
MYRNA S. CASTILLO,
Ph.D., CESO V
Schools Division
Superintendent