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National School Deworming Day July 29, 2016

ANNEX C: Form 1 MODIFIED deworming checklist


Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 23
Grade Level and
KINDER - RIZAL
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ACABADO, JOAQUIN INIGO Q.

ARANZA, JAYMARK R.

DE SILVA, SETH ANDREW M.

DEANGKINAY, MARK STEVEN C.

LAYNO, NIGEL C.

INDICO, JL SHON T.

MANILAG JAYCLO S.

MONTERO, ALVIN S.

OROGA, RAINIER K.

10

PASCUAL, JOMARI Q.

11

QUILLOY, CHRISTIAN H.

12

SALIVIA, JOHN VINCE S.

13

VASQUEZ, NIGEL C.

14

VILLAREZ, STORM PAUL A.

15

AGUDA, AKHEISHA G.

16

ALINSUNURIN, JHENICA L.

17

BATUCTOC, JHEZYREE J.

18

BUTED, PRECIOUS HANNA M.

19

DOMINGO, SOFIA C.

20

ESPINOSA, LAIZA CHRISTINE B.

21

FRIANEZA, SHEYLA YLLIZ M.

22

ILAGAN, KATE DIANNE L.

23

LAYNO, QUENNILYN FRITZ S.

24

LOPEZ, ABEGAIL NICOLE A.

25

MALAGUEO, JHARHEN B.

26

MIRABITE, PRINCESS JANE P.

27

SORIA, FRYSTELL FIONA O.

28

TAMBAN, JHENNISIS V.

29

TANDANG, CHLOE DENISE L.

29
Accomplished
by:

29

Class Adviser
(Name and
Signature)
Date Accomplished

SARAH J. MISALUCHA
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1

1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1

28
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 28
Grade Level and
KINDER - MABINI
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ACEBEDO, JACOB E.

ADORDIONISIO, MERWIN D.

ANDES, SHERWIN A.

DICTADO, ARMAN I.

GABALES, GIAN M.

GASULAS, CHRISTIAN N.

LAWOG-LAWOG, ACE JEXEL B.

MANILAG, EZEKIEL S.

MOLDEZ, PAUL JOHN

10

MULIMBAYAN, CHRIS ANDREI T.

11

OBIN, JOHN RONIO D.

12

PAMULAKLAKIN, ALJON T.

13

SEQUITO, MARKEN L.

14

YANEZA, BRIAN JAMES Y.

15

MAJIAS, ERLJOHN

16

ADA, JASMIN NICOLE N.

17

ALVARES, ANNE LORAINE T.

18

BANASIHAN, REALYN S.

19

BELANO, JHAERA MAE

20

BENAVENTE, CASSANDRA S.

21

BERTILLO, RHOSELHY O.

22

BUNYI, ANN ROSE M.

23

GONZALES, ROANN MAE F.

24

MANAMBIT, JEE ANN EUNICE L.

25

PAMULAKLAKIN, VHEA MAE E.

26

PARAHINOG, MERIECRIS T.

27

ROBRIGADO, ANGEL A.

28

VIVAS, QUELIANNE B.

28
Accomplished
by:

28

Class Adviser
(Name and
Signature)
Date Accomplished

ARLENE B. TALAMBAYAN
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1

28
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 23
Grade Level and
KINDER - BONIFACIO
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ALVAREZ, JUSTIN P.

BIENES, OMAR M.

DE VILLA, ALDRIC MARCIN V.

DECENA, JON ECHO C.

DELMINGUEZ, REYNIT M.

GUILING, JERICHO J.

JASARENO, VINCENT M.

LAPIE, ALEXANDER J.

LAPITAN, MATT ABRAHAM F.

10

LUBATON, NIO RAILEY L.

11

PAMULAKLAKIN, EXEKIEL B.

12

PASCUAL, JUSTINE LOUIE B.

13

RAMOS, MARK ALEXANDER G.

14

VILLAVER, GHION ARKIE A.

15

ALDAVE, CRISTA ANN MAE T.

16

BAUTISTA, JULIA A.

17

DE BORJA, ANGEL A.

18

DIZON, AL-JHIE L.

19

ELAYBA, RHEIN HEART

20

HINTURAL, ALEXANDRA V.

21

LORENZO, JESSCEL E.

22

PARAISO, JILLIAN M.

23

VILLANUEVA, HAIDEE M.

23
Accomplished
by:

22

Class Adviser
(Name and
Signature)
Date Accomplished

SARAH J. MISALUCHA
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1

21
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I.PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 26
Grade Level and
KINDER - MALVAR
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ADO-AN, JOHNZEL MARK

BALAHADIA, DUAN ZUES

DEANGKINAY, JOHN ERIC S.

DICTADO, ARMAN I.

GIBAS, NHIEL ALLEN A.

HINTURAL, MICOS C.

IMBEIN, EMMANUEL M.

LAPITAN, NEHJ NIGEL G.

MACAPUA, ALDWIN C.

10

MANCERAS, JOHN HENRIX B.

11

OGALIN, CYRUS

12

POMENDIA, JERICK B.

13

TABACO, LANCE LAWRENCE

14

VALERIO, REYNOLD JR. N.

15

BANASIHAN, CLARISSA M

16

BARCALA, RHIANA MIEL B.

17

BERDINE, JANE ANGELINE A.

18

CHAVEZ, FRANCINE MAE

19

DELMINGUEZ, SHENELLE D.

20

EVANGELISTA, JAMILLE Q.

21

GALERO, SYLEIDY ZHUBEL T.

22

LEONES, XYRA MAE P.

23

PAMULAKLAKIN, ZOPIA D.

24

REBOLTAN, RHAYN ANNE D.

25

SIGUE, RICA MAE

26

VALLERIO, SHIELA MAE N.

26
Accomplished
by:

26

Class Adviser
(Name and
Signature)
Date Accomplished

ARLENE B. TALAMBAYAN
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1

25
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 34
Grade Level and
GRADE ONE-RIZAL
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

AGRISOLA, JHON KELVIN M.

AMOLOZA, EVAN DALE Q.

ARNESTO, JOHN LAWRENCE V.

BALLESTEROS, RAY ANTHONY C.

BANASIHAN, RUI K.

BARRIOS, MARK JOHN CHRISTOPHER

BESA, DARWIN KLEIN E.

CRISPINO, JOHN MATTHEW H.

LAINEZ, JASFHER VINCENT L.

10

LECHUGA, KARL MICHAEL R.

11

LOPEZ, GREG DELA C.

12

MEDENILLA, ALEX EVIA

13

ORENCIA, MARC LORENCE E.

14

PAMULAKLAKIN, KENNETH D.

15

PANER, RON JUSTIN F.

16

RAMIREZ, CZARED V.

17

ROBLES, SHAN RHAMIEL F.

18

TAMAYO, KEVIN C.

19

VASQUEZ, JOHN MATTHEW GAINUS A

20

ABEJAR, JHAZHIELLE A.

21

BAUTISTA, ANGELA C.

22

BIENES, ROSE PRINCESS J.

23

BUNYI, SARAH JOY L.

24

CELSO, AIYESHA G.

25

CERERA, PRINCESS NICOLE D.

26

DELA CRUZ, RISSA NAZ

27

CRUZ, CASSANDRA DENISE A.

28

DIMAPILIS, ANGELICA T.

29

FORTE, ROLAINE P.

30

LANGUNDINO, ASHLEY T.

31

MONDRAGON, CLARISSE A.

32

QUILLOY, LANARINE H.

33

TANDANG, MARIA JENICA LAIZA A.

34

VALENZUELA, ELIEZA JOY G.

34
Accomplished
by:

34

Class Adviser
(Name and
Signature)
Date Accomplished

GUADLUPE OFELIA A. BOBILA


7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

33
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 40
Grade Level and
GRADE ONE-MABINI
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

AVELINO, KENDRICK C.

ARQUILITA, JIM CALEB A.

CACHOLA, JOHNWILLE M.

CALLEJA, JEMAR V.

CANGYON, JHON LOYD C.

DELA PEA, REYNAN U.

DE VILLA, JOHN MARLON P.

ERASGA, LUCAS T.

GONZALES, JHAYRON F.

10

LAPIE, JOHNZELLE JOHN T.

11

LAPITAN, DENVER Y.

12

LAPITAN, KENT REIN D.

13

MAGINOO, JAHN ERVIN V.

14

MAZO, GIMZ RALVY J.

15

MICOSA, ADRIAN

16

NABATA, RAFAEL N.

17

NORIEL, JOHN GABRIEL

18

QUILLOY, MARK ANGELO D.

19

TOLENTINO, SHAN LAWRENCE B.

20

TABUETE, CHRIS XANDER

21

ZAYAS, BILLY JAMES T.

22

BAJA, AILEEN

23

GARAB, JELLA JANE R.

24

GULAY, STEPHANIE D.

25

HINTURAL, LHIAN ANGELA P.

26

LADJAHASAN, JHANA YESSAMIN

27

LAGANZON, RICA B.

28

LAPITAN, ERICKA C.

29

LATORRE, ALYSHA MAE C.

30

MANCIO, NIZZETH ANGEL C.

31

MANIBOG, MAFEA T.

32

ORDANZA, IRISH MIELLE S.

33

REY, YANIE SHANELLE R.

34

SALANATIN, DANIELA CORAZON S.

35

SOLINAP, KHIANNE T.

36

SY, JIHAN

37

TANDANG, CARMELA EZRA L.

38

TANDANG, MARIANE E.

39

YANEZA, FRANCHESCA E.

40

VALENZUELA, DENNIE PEARL I.

40
Accomplished
by:

40

Class Adviser
(Name and
Signature)
Date Accomplished

LUCINDA T. HIDALGO
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
37
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 38
Grade Level and
GRADE ONE-BONIFACIO
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

BARBA, AIAN D.

CARACUEL, CALVIN V.

CHAVEZ, MARK

ELLEC, KYLE ESZEKIEL

DE LOS REYES, JOSH SANIELLE A.

ESCOBIN, JOHN R.

ESQUILONA, ALJON A.

FERNANDO, JOHN MATHEW L.

GALVEZ, ALDEN CRIS

10

GARCIA, BRENDAN RICARDO ANDRIE M.

11

GRICALDA, BRENT JOZZWELL B.

12

LANUANG, LLOYD D.

13

MIEL, JAMIR M.

14

MOLDEZ, JOHN CHRISTOPHER

15

NOEL, JAY ALFRED M.

16

OIRA, JOHN JOHN G.

17

PANISALES, PRINCE KYLE L.

18

PETRAS, CHRISTIAN A.

19

RESQUITES, KIAN ALAIN V.

20

SAN PEDRO, JOHN PATRICK M.

21

SERRANO, ADRIAN JASKIE A.

22

TOLENTINO, JOEL JR. B.

23

UMALI, MARK JOSEPH M.

24

ALVARADO, MICHAELA L.

25

DIMAPILIS, RHEILYN B.

26

ELLAS, JHANETH TUD

27

FLORES JEN MARIE O.

28

LALAP, PRINCESS SHAIRA E.

29

MACAPUA, DENISE H.

30

MACAPUA, MAYAN E.

31

MALIHAN, LHARA MAE I.

32

MERCADO, CHYNNA MAE H.

33

MULIMBAYAN, ANGEL H.

34

PAMULAKLAKIN, CHRISTINE MAE C.

35

PAMULAKLAKIN, LIANNE D.

36

RANCES JOVIELYN P.

37

VIERNEZA FERLYN M.

38

VILORIA, RHIAN E.

38
Accomplished
by:

38

Class Adviser
(Name and
Signature)
Date Accomplished

JEAN Q. TOLENTINO
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

36
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 44
Grade Level and
GRADE TWO-RIZAL
Section

Number
Enrolled

Name of Child

with consent

ARGONCILLO, MAURITONIE ANGELO A.

CASTILLO, JOHN CHRISDEL R.

DAYAG, DARYL M.

DEANGKINAY, PTEROCHRIST R.

DE VILLA, ADRIEL MC GILLIAN V.

JIMENEZ, KNIGHT B.

LAGUERTA, JERWYN T.

MANTALA, JAYVEE B.

MAQUILING, VICENTE III T.

10

MOJICA, JUAN CARLOS B.

11

MURIN G, KAYDEN JADE L.

12

PADILLA, KIETH ANDRIED B.

13

PARAMIO, ELIJAH CHRISTOF C.

14

REGONDOLA, ROAN M.

15

SAGADO, RENZ WILSON S.

16

SAMADAN, CHEZTER XAVIERY E.

17

SUMBINGCO, GABRIEL C.

18

TANDANG, FRANZ ASIS M.

19

TANDANG, LON RAILEY F.

20

TOLENTINO, RALLEN O.

21

ALMONTE, PRECIOUS LEA JEAN M.

22

ARANGO, ALTHEA DARLENE B.

23

BANASIHAN, TRIXZIE G.

24

BELTRAN, PRINCESS LYANA T.

25

DEANGKINAY, MARY JANE CARLA C.

26

DELMINGUEZ, DANIELA MAE A.

27

DIJAN, RHAYZELLE MAY D.

28

DUMAGCO, STHEACY EHRA S.

29

EMOLAGA, BERNADETH M.

30

ESPADILLA, CASSANDRA S.

31

ESPINOSA, JENNIFER B.

32

GARCIA, JANISABEN SAI M.

33

LAPINID, KAYMAE JAN LIAN M.

34

MOLDEZ, PRINCESS APRIL M.

35

PELOBELLO, PRECIOUS MAE P.

36

PONDIVIDA, RICA MAE R.

37

QUILLOY, ARIANNE H.

38

RETUERTO, SAMANTHA MAE L.

39

RIVERA, CHRISTINE GAILE D.

40

SEDIEGO, MARHJIE C.

41

TANDANG, ALEKRISH RAIN L.

42

TANDANG, ROMAY G.

43

TOLENTINO, ANNE LORAIN Q.

44

VALENZUELA, AUDREY E.

44

44

Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

AIDA C. LITARGO
7/8/2016

NA

Remarks for not being dewormed


dewormed
(June 1-July 29)

4P's

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

Ineligible
deferred
(dewormed
Refused
due to
before June deworming prevalence
1)
survey

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2

42

Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

eing dewormed
Precautionary Measure
(seriously ill, with
abdominal pain,
diarrhea, who has
previous
hypersensitivity with
deworming drug
( annex B MDAP
Guide #1 page 14)

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 46
Grade Level and
GRADE TWO-MABINI
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ABARQUEZ, MARK ANTHONY P.

ADOLFO, JHON CYRILL P.

BANASIHAN, JOHN HOMER A.

CACHOLA, PAULO M.

CENAJO, MICO PRINCE V.

FABIAN,JOHN PAUL C.

GARDOCE, JOHN EZEKIEL P.

GANZALAO, CYRELL ALLEN L.

ILAGAN, JHAREL M.

10

LANTE, ENZO C.

11

LAPIE, ALEXIS DERICK J.

12

LAPITAN, WARREN I.

13

LAYNO, JURRY R.

14

MONILLA, MARK JAYDEN C.

15

PEREJA MHART JHAY A.

16

REPLAN, JOHN ALLEN D.

17

REYES, DAVE CONNON Q.

18

RODICO, MARK JHON C.

19

TANDANG, JAZZ C.

20

TANDANG ZYRUS E.

21

TERROBIAS, RALPH JUSTNIE D.

22

VASQUEZ, JHONZEL

23

VICTORIA, JAMES CARLO E.

24

ALVAREZ, RACHEL C.

25

ARMECIN, LEA MAY M.

26

BANASIHAN, CHASELYN A.

27

BANASIHAN, JENICA T.

28

BARCALA, DARLENE JOY A.

29

BARAYANG, CHRISTNEIL S.

30

BAYANI, HAYLEY C.

31

BERDIN, IRISH JANE A.

32

CAPITAN, GLYDALLE M.

33

CORTEZ, KYLE NATHALIE A.

34

DELA CRUZ, RAIZA JOI C.

35

DELOS REYES, SOPIA E.

36

DE LUNA, JHOSA MAE I.

37

EVANGELISTA, MA. CAMILLE Q.

38

FABIAN, CHAMIQUE JHADE Q.

39

GONZALES,, MA. STEPHANIE D.

40

JUEGO, JOANA MAY R.

41

LAYNO, KRISTNE CASSANDRA

42

MOLDEZ, YSSHA FAE M.

43

SILO, JHENIAH V.

44

VASARINO, VANESSA M.

45

VASQUEZ, FERSYBEL A.

46

VASQUES, JEANZEL L.

46

45

Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

ETHELWINDA L. SIANO
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1

1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

40

Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD

Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 40
Grade Level and
GRADE TWO-BONIFACIO
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

AGRISOLA, KIAN LEI B.

ALVAREZ, CHESTER LUIS A.

BAUTISTA, BJ M.

CIRIACO, JHON MHYCO L.

CRUZ, JERWIN A.

DALGUNTAS,KING C.

IMPERIAL, PRINCE C.

IPOSADA, ACE R.

LAPITAN, JHON ANDREI B.

10

MALIHAN, CARL LUIS M.

11

MANUEL, PRINCE ARLO F.

12

MENIA, ADRIAN V.

13

MONTANO, JADE M.

14

OGALIN, JHON PRANCIS,V.

15

PALCONIT, JERICO P.

1
1

16

RIVERA, ARMAN P.

17

SUENO, BEJAY D.

18

SULTAN, AEDRIAN P.

19

TANDANG, JOHN PAOLO J.

20

TANDANG, KENT BRYAN P.

21

VIBAL, AARON C.

22

ALDAVE, CHANTELLE JANE T.

23

BARRAMEDA, ATHENA RAINE V.

24

CASTILLO DOROTHY KEI T.

25

ESCOBIN, CRISTEL T.

26

FERNANDEZ, KATE HAIDEE Y.

27

LLOSIS, RINA JANE D.

28

LONTOC, PRINCESS S.

29

LUBATON, RHIAN NICOLE L.

30

MACAPUA, ZIDJANE B.

31

MARTINEZ, PRINCESS VIONALYN A.

32

MONTANO, JISSEL C.

33

MUDLONG, JAZMINE L.

34

NIVAL, ALYZZA L.

35

PUPA, LYRA MAE L.

36

RIVERA, AYA FRANCHESKA B.

37

SANTONIA, CHE CHE M.

38

TANDANG, GENCEL L.

39

TOBIAS, CEANA B.

40

VASQUEZ, MA. AGNES R.

40
Accomplished
by:

32

Class Adviser
(Name and
Signature)
Date Accomplished

ALONA L. LONTOK
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
30
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 40
Grade Level and
GRADE TWO-MALVAR
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ALANO, RENZ MICHAEL B.

BARNIDO, KIAN CLEIN L.

BUNDALIAN, CARL JAVIN S.

BUNDALIAN, JEAN CLAUDE S.

CABRAL, JOHN LERICK A.

CHUA, JUSTINE

DE DIOS, JOHN LENARD T.

FLORES, TROY ANDREI C.

GIBAS, JOHN TEDDY P.

10

GUILING, AR-JAY J.

11

LIWANAGAN, MIGZ ANTON L.

12

MENIA, JAMES R.

13

NATIVIDAD, JR. LOUIE M.

14

NAVASERO, ARON H.

15

PASCUAL, JOHN LAWRENCE B.

16

ROBRIGADO, OWEN A.

17

TENORIO, JOHN LAWRENCE B.

18

TOLENTINO, GERWIN P.

19

VILLAREZ, WINTER PAUL A.

20

VILLORIA, JAMES ROBERT B.

21

ACOSTA, TRIXIA L.

22

ANDES, SHERAIN A.

23

ALVAREZ, KEYSHIA N.

24

CARILLAGA, FATIMA M.

25

CARIO, ROXANNE V.

26

CASILAO, AYCEL A.

27

CILLS, CHRISTAL C.

28

DIZON, SHUNELA THERESE T.

29

GALIMBA, JOANA JOYCE

30

GARCIA, JACKIE RICE O.

31

MANARIN, LOUGIE M.

32

MARCELO, AIRA MAY

33

MORRON, APRIL JOYCE P.

34

PAMULAKLAKIN, RHIAN D.

35

PATOTOY, CZHARLENE ANNE M.

36

RIMAS, MARY JANE RAFAEL

37

SURETA, ANGEL CEREI A.

38

SY, KRISHIA P.

39

VALENCIA, SHEILA MAE C.

40

VILLA, CHRISTINA R.

40
Accomplished
by:

29

Class Adviser
(Name and
Signature)
Date Accomplished

IMELDA Q. SALAZAR
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)
1

1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
26
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 42
Grade Level and
GRADE THREE-RIZAL
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

AMPARO, BRENAN DERICK I.

BANASIHAN, ZEUS MAX G.

BAUTISTA, YGO KHELLE M.

CAO, RAM MARDI A.

CORDOVA, JHUDRIX A.

GALOSMO, NATHANIEL M.

GARCIA, RAVE ALVER R.

GEMINIANO, XARLET ASHEN L.

GIBE, AIKEE DENMARK V.

10

JIMENEZ, NEIL RAIZEN B.

11

LAPITAN, JOHN ARDEE G.

12

LUTAP, CEE-JAY C.

13

MEDALLON, REXTOR D.

14

MICOSA, GODWIN A.

15

MOLDEZ, JOHN KENNETH C.

16

MONDRAGON, CHRIS JERICO A.

17

NABIA JR., MELDIN J.

18

ORENCIA, MARC LENARD E.

19

QUILLOY, FRANCIS BON R.

20

SAN PEDRO, PRINCE LEN MAR M.

21

SURETA, KURD TRISTAN A.

22

AGBAY, JOSHIELIN FRANCES R.

23

ALIPIO, HERSHEY A.

24

ALVAREZ, RAIN P.

25

BUTED, CHEENINIE

26

DEANGKINAY, RHIANNE D.

27

DELMIGUEZ, IVY JANE D.

28

ESPINOSA, CLAIRE LARRA PERRETTE

29

HINTURAL, BERNALYN M.

30

JAVIER, ANREY NICOLE S.

31

LAPINID, IONAH VALEA M.

32

LOPEZ, SHANE D.

33

MONDRAGON, MARIZZ A.

34

MONTEJO, VERONICA JANE A.

35

PARAISO, FRANCHESCA DENISE

36

RAMBOYONG, MAXIME JOY O.

37

REYES, AKIRA GHAZEL L.

38

ROMERO, RHIAN VENICE B.

39

TANDANG, MYLEEN B.

40

TARZONA, CAIZEL ANGELIQUE D.

41

TIMOSAN, ALEICIA SZHANE S.

42
42

VIVAS, JHONA T.

1
42

Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

TEODORA D. GABRILLO
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
40
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2015


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEMENTARY SCHOOL
School Address TAGPUAN BAYOG LOS BAOS LAGUNA
Total Enrolment 42
Grade Level and
GRADE III - MABINI
Section

Number
Enrolled

Name of Child

with consent

ALTICHE, ARCHIE O.

BANASIHAN, JHARRED A.

BANASIHAN, JOHN RYLLE L.

BENAVENTE, HANJIN S.

BUARAO, JHON FRANCIS O.

CENAJO, MATTHEW IVAN V.

DELA PEA. EUNIZICE A.

DEL ROSARIO, JOHN KERVIE S.

DIAZ, KLARENCE P.

10

DIZON, IAN MATHEWS C.

11

MACAPUA, DAVE CHRISTIAN H.

12

MACAPUA, ZIDJAN B.

13

MACARAIG, CHRIS ZYRIL M.

14

MANCIO, KERVY D.

15

NAVALES, JAMES CRAVEN P.

16

POMENDIA, JHON REM B.

17

QUILLOY, SHANGAIL ADENZEL C.

18

TRABOCO, JANH PAOLO A.

1
1

19

VALENCIA, JR. CELESTINO B.

20

ACLAO, MARY JOY A.

21

BAUTISTA, ALZEA NICOLE -

22

CRUZAT, JURIELIE G.

23

DE CASA, SOPHIA ALTHEA E.

24

DELMINGUEZ, YZABELLE C.

25

DORADO, DENISE D.

26

EBEC, NICOLE B.

27

LAAB, HANNAH VICTORIA H.

28

LERON, ESTHER JOICE H.

29

LORENZO, MARIAN E.

30

MANCIO, ISHIN D.

31

MANILAG, JASMINE M.

32

MAZO, GENESIS B.

33

MESA, DAICIRIE A.

34

MOLDEZ, DIANA LYN C.

35

MUDLONG ASHLEY D.

36

PAMULAKLAKIN, GRACIE ANN T.

37

REBOLTAN, RHIANNE D.

38

RIGAY, LEA MAY M.

39

SUGASTE, LORIN MAY T.

40

TENORIO, JEANELLE MAE B.

41

TIGUE, ANTONETTE A.

42

VALERIO, NINALYN N.

42

Accomplished
by:

Class Adviser
(Name and
Signature)

SONIA M. ARLETA

1
1

1
1
25

Date Accomplished

7/8/2016

Remarks for not being dewormed


Ineligible
deferred
dewormed (June 1-July 29) (dewormed Refused
due to
before June deworming prevalence
1)
survey
4P's

non-4P's
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
3

22

17

Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

t being dewormed
Precautionary Measure
(seriously ill, with
abdominal pain,
diarrhea, who has
previous
hypersensitivity with
deworming drug ( annex
B MDAP Guide #1 page
14)

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 41
Grade Level and
GRADE THREE-BONIFACIO
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ARCINUE, JOHN ALBERT E.

AVELINO, HARVEY KENT C.

BARABA, DREW JASPER M.

CARACUEL, KENNETH V.

CUARTO, JAVIER B.

GONZALES, AARON JOHN F.

HINTURAL, NEIL ANDREI

HUINDA, CHRISTIAN JAMES V.

MANE, KENJI P.

10

MARIANO, BRIXIANIEL A.

11

MEDENILLA, ALEJANDRE E.

12

PAMULAKLAKIN, ALEXIS M.

13

PASCUAL, EDZELE E.

14

PETRAS, YURHIE A.

15

SANTONIA, JAYJAY M.

16

TANDANG, LORENZ B.

17

TEGALAO, JOHN MARK T.

18

TRIA, MICHAEL JR. V.

19

UGDIMAN, MC EDRO B.

20

ALAVARADO, MAYELLE L.

21

AVELINO, DENISE C.

22

BANASIHAN, RHYANNE S.

23

BAUTISTA, RONA SHEI S.

24

CABRAL, CHRISTINE P.

25

COMENDADOR, TRISHANNE P.

26

DELA CRUZ, NHELAINE G.

27

DELOS REYES, FHERCIE ANNE G.

28

ELIAS, PRINCESS YVONNE T.

29

GARCIA, JACKIE ROSE O.

30

HERALDO, GELLIE MARIE S.

31

LAPIZ, KYLEE O.

32

MANILAG, ELLA MARIE S.

33

MARANAN, GEMMARIE B.

34

MARANAN, MARICAR

35

NAVASERO, ANNALIZA H.

36

PASCUA, MIZHELL C.

37

QUIMBA, MA. CRISTINA T.

38

RAMOS, ZYRENE JOY L.

39

TABACO, EIZA MAE L.

40

TANDANG, HILLARY KHEANA J.

41

VILORIA, RINA JOY E.

41
Accomplished
by:

40

1
1

Class Adviser
(Name and
Signature)
Date Accomplished

HAZEL L. SAPIN
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
36
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD

Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 41
Grade Level and
GRADE THREE-MALVAR
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ALVARADO, SONNY S. JR.

ANDES, ARCHIE A.

BAYANI, RENZO T.

BESA, DARIUS GABRIELLE E.

CRUZ, DAVID ANGELO B.

DAMIAN, JAMIR LEE A.

HINTURAL, GIAN ANDREW

HOLANDA, REN-REN D.

LAPITAN, RAVEN S.

10

LERON IV, CATALINO KYLE H.

11

LONTOC, WILSON S.

12

MONTANO, JUSTINE T.

13

MONTERO, JOHN ALBERT S.

14

MULIMBAYAN, AR JAY JASTINE H.

15

NAVASERO, ANDROU H.

16

NUEZ, JASPER B.

17

OROGO, CHRISTIAN ALLEN C.

18

RANCES, CRIS JEMRIX P.

19

ROBLES, SHAN DAVE F.

20

TABUETE, JOHN PATRICK P.

21

TROLLANO, RODRIGO B.

22

VALEDEZ, MIGUEL S.

23

VASQUEZ, FRANCE DANIEL A.

24

VILLAREZ, RAIN PAUL A.

25

BANASIHAN, SHALLER ROSE P.

26

BARBA, ALTHEA D.

27

BARACALA, RESA MHEL B.

28

CABRILLAS, JASMINE

29

CASTRO, MIA M.

30

CERESO, JESSA MAE B.

31

COLLADO, PRINCESS NICOLE P.

32

DELOS SANTOS, EIRAM KASMAE P.

33

DESTACAMENTO, BEA ANGEL A.

34

GUILING, MIRA JIAN J.

35

JUINIO, CALIEX V.

36

MARCELO, PRINCESS A.

37

MELODIILAR, A MARIE S.

38

NABIA, GELAIZA B.

39

PABILLANO, ANN LEA KIM R.

40

PAMULAKLAKIN, SHAINA B.

41

ZULUETA, RHIALANE E.

41
Accomplished
by:

30

Class Adviser
(Name and
Signature)
Date Accomplished

JAHLENE V. DEQUITO
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
27
Noted by

10

Grade Level
Advisor (Name
and Signature) GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 43
Grade Level and
GRADE FOUR-RIZAL
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ABALOS, AHYRON JAY B.

BAUTISTA, ALEXIS B.

ELAYBA, CHRISTIAN DOMINIC M.

EVANGELISTA, JAMES BENEDICT Q.

GUZMAN, RALPH AARON C.

JABOL, KENNETH V.

LARESMA, HARLEY B.

LITARGO, ANDREI DOMINIC L.

MANAGAT, MARK JUSTIN C.

10

MANGAOANG, EZZRIELLE JHAZZ B.

11

MURING, KARL VINCENT L.

12

QUILLOY, GEM RUSSELL T.

13

REGALADO, JUREL S.

14

RELOS, JURO MATEO B.

15

REYES, TRISTAN CEDRIC B.

16

SAN PEDRO, JOHN RUSSEL G.

17

TANDANG, GIDEON L.

18

TANDANG, JAZPER C.

19

TANDANG, JOHN MATEO A.

20

TIMOSAN, STEEVEN JOSH S.

21

ADOLFO, GEODEE STEVENS

22

BAUTISTA, IRISH GLEN M.

23

BERDIN, AIRA JANE A.

24

BORJA, GUEN ANGELINE O.

25

CABRAL, RUI ANN R.

26

DE LUNA, MA. MINERVA LEA O.

27

ERASGA, LIRA T.

28

FERNANDEZ, GEANN NICOLE J.

29

LAPITAN, CHESKA LYKA F.

30

LAPITAN, MARIA PRINCESS JOY T.

31

MANARPAAC, CHARMELA A.

32

MERCADO, HONEY LEE E.

33

MIEL, IRENE M.

34

PADUA, IRISH S.

35

PANER, NINYA FLOR F.

36

PATOTOY, CZHARZETTE ANNE M.

37

RAMOS, MARSHA ANDREA D.

38

RECTO, REINELYNN G.

39

SAGPAO, NATALIE SAJIE R.

40

SUPLE, STEPHANIE D.

41

TERROBIAS, REEZE JEAN D.

42

TOLENTINO, VENIZE ANNE Q.

43

ZAMUDIO, RAIZA B.

43
Accomplished
by:

42

Class Adviser
(Name and
Signature)
Date Accomplished

CECILIA Q. SAUL
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
36
Noted by

Grade Level
Advisor (Name
and Signature) GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 44
Grade Level and
GRADE FOUR-MABINI
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ALVARADO, MARK KENJIE L.

AREVALO, JHON REY C.

BANASIHAN, JUDE CHRISTIAN

BINAMIRA, DAVE MATTHEW E.

DIMAPILIS, CARLOS T.

GABALES, JAY-CEE M.

GARCIA, GEROME

GAVINO, JHON RAVEN B.

GONZALES, MARVIN A.

10

INDICO, DUSTINE JAY T.

11

JUEGO, IAN BERNARD L.

12

LAPITAN, LOUIS SEBASTIAN L.

13

LOPEZ, JOSHUA KEN E.

14

MERCADO, PAUL MICHAEL H.

15

PAMULAKLAKIN, RUSELL T.

16

INDICO, DUSTINE JAY T.

17

REAMBON, IAN DOMINIC R.

18

SANTOS, EMANUEL T.

19

SAPIN, PETER JOHN R.

20

SOSA, JOHN LLOYD A.

21

SY JR. JOEL F.

22

TALAMBAYAN, JOHN ROCEL B.

23

TOBIAS, DANIEL JEROME B.

24

ANASTACIO, JENIFER I.

25

AONUEVO, JOHANNA V.

26

BANASIHAN, SERLYN S.

27

BANASIHAN, VALERIE M.

28

CABRAL, ANIKA REI A.

29

DELA CRUZ, ANDREA B.

30

DELOS REYES, CLAREN ANN J.

31

DUMALAON, JANNAH MAY Z.

32

GONZALES, MA. AVYGAIL D.

33

ILAGAN, RHIAN M.

34

LARINO, JAY-ANN M.

35

MANILAG, MARIANE O.

36

MENDOZA, RUBIE ANNE C.

37

MENIA, LIANE FAITH O.

38

MOLDEZ, RAICY ANN M.

39

PAMULAKLAKIN, ZYRINE LOREIGN D.

40

PAPA, MERLYN D.

41

PEREZ, ASHLEY P.

42

SARMIENTO, MARIA ELENA L.

43

VALENTINO, DANIELLA JHANE M.

44

VASQUEZ, AIKA MAE G.

44

33

Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

RINA S. HISONA
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)
1
1

1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
30

11

Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 44
Grade Level and
GRADE FOUR-BONIFACIO
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ALMADOVAR, MAC GRAVIN P.

ANDES, ALVIN JR. A.

ARCINUE, JENVER A.

BAUTISTA, AARON EDWARD D.

BIATO, JOSPEH ANGELO R.

BIENES, EUGENE M.

BLANCO, OLIVER

CRUZ, JOHN FRANCIS A.

HORIGUE, LANCE KERVY R.

10

LAPITAN, NEIL KIAN D.

11

LLOSIS, JHON REY D.

12

MACARAIG, JERRY YAN M.

13

MACKAY, LIMBERT

14

MANE, MARC AERON P.

15

MANILAG, EDMARK S.

16

PABILLANO, VIRIEL R.

17

PAMULAKLAKIN, ALLDEN Q.

18

PARAHINOG, JAY-EL T.

19

PELOBELLO, JOHN MICHAEL P.

20

RAMOS, JOHN PATRICK L.

21

RIMAS, JANRY RAFAEL

22

TABACO, ERVIN L.

23

TANDANG, JUSTIN B.

24

TOLENTINO, PAUL JEMZEL P.

25

VASQUEZ, JEO N.

26

BANASIHAN, JONABELLE T.

27

BAUTISTA, KIMBERLY

28

CIRISA, ASHLEY M.

29

CONTADO, KATE MARIE H.

30

DELA CRUZ, JADE GEM B.

31

DURAN, NADINE A.

32

FAJARDO, JOANNA S.

33

IGNACIO, JENNY ANN M.

34

LAINEZ, JHASMINE CEL L.

35

LERON, ALELIE NICOLE B.

36

MOLDEZ, JHOANNA MARIE C.

37

MONTANO, KYLA C.

38

MORRON, JESSICA P.

39

NOEL, LOVELY JOY O.

40

ROMERA, ANGEL HANNAH R.

41

SABANAL, REBECCA T.

42

SAMSON, AKIZSA T.

43

SAMSON, JAN AICELLE B.

44

TANDANG, BILLIE P.

44

43

Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

MALYN D. REYES
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
39

Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 41
Grade Level and
GRADE FOUR-MALVAR
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

BANASIHAN, CEDRICK G.

BANASIHAN, SHANLEI P.

BELLO, JUSTIN

COLLADO, DENMARK P.

ESCOBIN, BRIXZ ADRIAN T.

ESQUILONA, ADRIAN A.

EUSEBIO JR., ARIS B.

LAGANZON III, RICO B.

LAKSAMANA, JOHN REI B.

10

LAPITAN, JARRED B.

11

LONTOC, WILBERT S.

12

MACAPUA, FRANCISCO B.

13

MENIA, JOHN JERICH P.

14

MEIL, JOHN KELLY M.

15

MUDLONG, JEFFREY L.

16

MUDLONG, VINCENT D.

17

OGALIN, RUEL S.

18

PARAISO, JAMES RONALD M.

19

SANTONIA, JOHN PAUL M.

20

TANDANG, ARCHIE V.

21

TANDANG, JEREMIE S.

22

TANDANG, JOHN MARK D.

23

TROLLANO, RONIO B.

24

VALDEZ, PRINCE ALVANO A.

25

VENTURA, FRED JOSEPH A.

26

YANEZA, PRINCE ANGEL E.

27

BELIBER, ALEXIS P.

28

DELA PEA, ASHLEY JOY S.

29

DELA PEA, KIMBERLYN U.

30

ELEC, KATHLEEN P.

31

ENRIQUEZ, ALIZAH KARISSA

32

ESTRELLADO, KIM NICOLE S.

33

GECOMO, MICHELLE N.

34

JEBONE, ANGEL V.

35

MAMPLATA, ANGELICA GRACE L.

36

OGALIN, KRIZZY G.

37

PARAISO, SHINA C.

38

QUIATZON, ANGELYN P.

39

RAMOS, ANA MARIE D.

40

VALENCIA, CHRISTY C.

41

VIVAL, SHYRA MAE C.

38

41
Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

MARIE PAZ L. BARNIDO


7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
31
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 40
Grade Level and
GRADE FIVE-RIZAL
Section

dewormed
(June 1-July 2
Number
Enrolled

Name of Child

with consent
4P's

AGRISOLA, JHONCEL M.

AMPARO, REDEN MARK V.

BIENES, RAVEN J.

CIDELLO, JOHN MELWIN P.

DELMINGUEZ, ARTHUR D.

DUMAGCO, ANTONIO JOAQUIN S.

ENOKIZONO, RYOJI Q.

ESCOBIN, JOHN MHEDRICK C.

ESPLANA, MARK PHILIP L.

10

EVANGELISTA, SAM D.

11

GABALES, CHOLO JUSTINE M.

12

HORIGUE, JUSTINE IVAN E.

13

LAPITAN, KYLE STEPHEN M.

14

MAKILING, MARK G.

15

PELOBELLO, JOHN PRECIOUS P.

1
1

16

REYES, JOHN KYLE B.

17

SUMBINGCO, MARK SAMUEL C.

18

TIMOSAN, SZHAN WAYNE S.

19

VENTURA, UNO ZANDER A.

20

VILLANUEVA, WENCY VICTOR M.

21

ALVAREZ, JASSEN NICOLE P.

22

BACOD, YHANCEE L.

23

BAGSIC, MIKAELLA B.

24

BALGUER, JAMELLA DIANNE M.

25

BARAYANG, CRISLIEN ARIANE S.

26

BLANCO, IRAH JHANE T.

27

CALPO, MEIRENNE C.

28

CECILIANO, CRISTINE JOY C.

29

DE LUNA, JHECILEE I.

30

GUZMAN, RIOME ANN C.

31

HINTURAL, STEPHANIE FRANCINE F.

32

HINTURAL, XYRILLE V.

33

HORIGUE, TRIXIE MAY R.

34

LEONIDAS, ALLYSA M.

35

MADAYAG, CHRISTINE JHAYE C.

36

MAGBOO, KEREN Q.

37

MANIBOG, JANELLE

38

MANUEL, KRIZELA F.

39

MELANIO, JAZMEEN JULIENNE D.

40

MILAGROSA, RICA B.

41

MOJICA, ANGELENE B.

42

MOLDEZ, MIJA L.

43

MULLER, JODIMIN G.

44

RIOLA, FRANCHESCA P.

45

SAPAIH, KEISMIR C.

46

TAMAYO, KATELYN C.

46

44

Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

LERMA L. LITARGO
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

41

Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 46
Grade Level and
GRADE FIVE-MABINI
Section

Number
Enrolled

Name of Child

with consent

AGAR, KELVIN N.

AGUILA, MARK HERVIC B.

ALVAREZ, JAMES PAUL P.

ANCHETA, JOHN EDMUND A.

BARBA, JAY CHRISTIAN T.

BINAMIRA, STEEVEN L.

BUENO, NIO -

BUNDALIAN, DJ S.

BURATA, NELSON G. JR.

10

FLORES, JUSTINE ENZO P.

11

FRIANEZA, SHER-ALYM M.

12

GEBILAGUIN, FELIPE V. III

13

LAINEZ, JAYNAN PAUL L.

14

LAMPASO, JAY-AR M.

15

MAGPANTAY, MARC HARVEY N.

16

MARTIN, ANGELO ANDREI M.

17

PAMULAKLAKIN, ALJERU T.

18

PAPA, ALEXIS OWEN Q.

19

PASCUAL, EISENE E.

20

PEREZ, RAFAEL LOUISE R.

21

TOLENTINO, GERALD P.

22

VIBAL, JOHN CARLO -

23

VILLAMAYOR, ARWIN JOHN G.

24

AEZ, JEAN T-JAY E.

25

ARELLANO, JOVIE ANN A.

26

BANASIHAN, CHARLENE A.

27

BARCALA, IVY P.

28

BELEN, ELYCA G.

29

INDICO, ERIKA MAE -

30

LAPITAN, JELAI D.

31

LARESMA, KIAM AIKEN B.

32

MAZO, KRISTIAN BELL B.

33

MELODILLAR, VANESA T.

34

MONTAO, JANA NICOLE G.

35

PANGAN, ANGEL NICOLE M.

36

PARADO, LORAINNE P.

37

PARAISO, AYUMI D.

38

PASCUA, RAQUELL C.

39

RAUTO, MARY JOLEA T.

40

RELOS, JANEL MAYA B.

41

RESQUITES, ASSHLEY ALAIN V.

42

RIAZON, MA. MARICAR C.

43

TAMISIN, ASHLY JEIZER L.

44

UGDIMAN, NINA PAULA B.

45

VALENZUELA, KHYL M.

46

YSALINA, CYRENE D.

46

33

Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

GERALDINE C. GUEVARRA
7/8/2016

Remarks for not being dewormed


dewormed
(June 1-July 29)

4P's

Ineligible
deferred
(dewormed
Refused
due to
before June deworming prevalence
1)
survey

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

26

13

Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

eing dewormed
Precautionary Measure
(seriously ill, with
abdominal pain,
diarrhea, who has
previous
hypersensitivity with
deworming drug
( annex B MDAP
Guide #1 page 14)

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 46
Grade Level and
GRADE FIVE-BONIFACIO
Section

Number
Enrolled

Name of Child

with consent

ADA, JUSTIN N.

BARBA, ASHLEY M.

BARRAMEDA, JOHN PAUL V.

BIO, JUSTINE L.

CARIO, ROEM V.

DE BORJA, JUNE A.

DELA CRUZ, JOHN JASON

DELMINGUEZ, AUDREY

ELIAS, JHON LLOYD

10

ESPLANA, DALE O.

11

FABIAN, KEITH ZEBASTIAN Q.

12

GIBAS, ANTHONY

13

JARABESE, DWAYNE JARED P.

14

LONGCOP, KEVIN PAOLO V.

15

MOLDES, YUJI KENNETH V.

16

NUEZ, CHARLES ALLEN B.

17

PAMULAKLAKIN, BEEJAY B.

18

PANTUA, JAY KIM U.

19

REYES, KYLLE CHRISTIAN R.

20

SAMSON, MARWINZEN M.

21

SAMSON, JERWIN B.

22

TANDANG, JOHN CLARENCE E.

23

TANDANG, PATRICK ANTONIO E.

24

VERANO, JONAS M.

25

ALCASID, COLINE ANGEL M.

26

ALDAVE, MARIAN T.

27

AQUINO, ALPHA MAE C.

28

BANASIHAN, ANGEL VEA S.

29

BATUCTOC, JEFFANY J.

30

BURATA, SOFIA BIANCA G.

31

CASTRO, RUTH M.

32

CUARTO, ISIAH B.

33

DALGUNTAS, MA KRISTINE C.

34

DAMIAN, HANNA LEEN A.

35

ESPADILLA, JADE LOISE R.

36

EUSEBIO, SHAMEL B.

37

LAPITAN, ERISH NICOLE

38

MERCADO, MICHELYN JOY H.

39

OIRA, MICAH JOY R.

40

PELEGRINA, MHEY D.

41

PEREZ, SOLIVVEN C.

42

PRESA, JASMINE S.

43

QUILLOY, JENNY LEE C.

44

RAMOS, MA SYMONETH CASANDRA G.

45

TABACO, EMERLYN L.

46

TABUETE, KATLYNE JADE P.

46

44

Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

ALARICE C. BANASIHAN
7/8/2016

Remarks for not being dewormed


dewormed
(June 1-July 29)

4P's

Ineligible
deferred
(dewormed
Refused
due to
before June deworming prevalence
1)
survey

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

36

Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

eing dewormed
Precautionary Measure
(seriously ill, with
abdominal pain,
diarrhea, who has
previous
hypersensitivity with
deworming drug
( annex B MDAP
Guide #1 page 14)

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 46
Grade Level and
GRADE FIVE-MALVAR
Section

Number
Enrolled

Name of Child

with consent

AGRISOLA, KRIS LORENCE B.

ALVARADO, MARION KURT L.

ALVAREZ, FERDINAND O.

BAGAAN, JOHN ROBERT T.

BANASIHAN, SHERWIN S.

BANASIHAN, WENDELL V.

BERDIN, TRISTAN AERON L.

CRUZAT, JOHN MARK G.

CUARTO, JAKE RYAN B.

10

DE VILLA, JOEMHELLE MARTHEW P.

11

DELMINGUEZ, KEVIN CLARK -

12

DIMAPILIS, ENRIQUE JR. -

13

EBEC, EDRICH G.

14

IPOSADA, ANGELITO R.

15

LAGUNDINO, TRISTHAN ASHVIN T.

16

LAINEZ, JAYDON DAVE L.

17

MACAPUA, DANILO H. JR.

18

NABIA, DOMINIQUE O.

19

PAMULAKLAKIN, ADRIAN S.

20

PAMULAKLAKIN, GIAN CARLO B.

21

PAMULAKLAKIN, ZORINE IVAN D.

22

SALIVIA, JERICK S.

23

TOMAS, ALVIN M.

24

VILLAVERDE, KIM GERALD R.

25

ANDES, ANGELICA A.

26

CHUA, JEMCEL -

27

CIRISA, RODYLYN M.

28

CORPORAL, SHELA MAY B.

29

CRUZ, DHIYNISE AN B.

30

DELMINGUEZ, RICHELLE M.

31

DE BORJA, JENNY A.

32

DE CASA, SAMANTHA NOREEN E.

33

DOMINGO, DENISE C.

34

DUMALAON, JEAMI MAE Z.

35

LAGANZON, KYLA B.

36

LAYNO, MARIAN CASSANDRA R.

37

LOGINA, FRIXIA B.

38

MACAPUA, HERLYN JANE B.

39

MANCIO, VERA FAITH D.

40

ORDANZA, BLESSY RUTH B.

41

PACIENTE, NIALYN A.

42

REYES, JAYLA L.

43

SANTONIA, KC LYN M.

44

SIGUE, RAILYN MIA A.

45

SIRUMA, FIONA MAE M.

46

TORRES, VALERIE MAE M.

46

37

Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

ELADIO I. HERNANDEZ JR.


7/8/2016

Remarks for not being dewormed


dewormed
(June 1-July 29)

4P's

Ineligible
deferred
(dewormed
Refused
due to
before June deworming prevalence
1)
survey

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

32

Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

eing dewormed
Precautionary Measure
(seriously ill, with
abdominal pain,
diarrhea, who has
previous
hypersensitivity with
deworming drug
( annex B MDAP
Guide #1 page 14)

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 40
Grade Level and
GRADE SIX-RIZAL
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ALVAREZ, ANGELITO O.

AMPARO, BRENDERICK I. JR

ANASTACIO, VINCENT I.

BELLO, JEFF CHENT

BINAMIRA, JOHN LESTER E.

CEDILLO, NORWIN JOHN P.

DELA CRUZ, JEROLL C.

ESPADILLA, ADRIAN S.

GUZMAN, RALPH ALLEN C.

10

LAPIE, RUSSEL E.

11

LITARGO, ADRIAN JAMES L.

12

MARASIGAN, TIMOTHY JAMES R.

13

MELODILLAR, JOHN ZORDIC C.

14

MULLER, JO HANSRUEDI G. II

15

REYES, JOHN HARRY L.

1
1

16

REYES, VON FRANCIS D.

17

RIOLA, ISAAC KIER P.

18

ACEBEDO, CRYSTAGENE G.

19

ALTICHE, ANDREA O.

20

BORJA, ARIANNE GRACE O.

21

BUAG, NIKKIE DANIELLE O.

22

CALUGAY, TRISHA T.

23

CASIO, KATE IRISH E.

24

CLAVE, KYLA Q.

25

CURA, CASSANDRA SHANE A.

26

DE BORJA, KATRINA GLEZY I.

27

DIZON, ALTHEA JODI C.

28

EMOLAGA, SAMANTHA ISABEL M.

29

GATCHALIAN, RAIZA E.

30

HERVACIO, MARJORIE O.

31

JIMENEZ, URIKO MEI B.

32

MANGERON, HANAHMAE B.

33

MILAGROSA, KIMBERLY CARMEN S

34

MOLDEZ, ALTHEA JOY C.

35

PAMULAKLAKIN, NICOLE L.

36

PAR, BEATRICE ANNE P.

37

PRESA, RICAZEL ANNE S.

38

REYES, ELAINE FRANCESCA D.

39

TANDANG, JODIE ANNE L.

40

TERROBIAS, REICHELLE JOI D.

40
Accomplished
by:

40

Class Adviser
(Name and
Signature)
Date Accomplished

CRISTINE C. AGUINALDO
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1
1
1
1
1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
37
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 40
Grade Level and
GRADE SIX-MABINI
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

AGUINALDO, JUSTINE M.

ALCANTARA, KIER L.

AQUINO, CARL ANDREI B.

ASUNCION, JOSHUA P.

BARBA, JERICHO ANDREI D.

BASIBAS, DEO DAN D.

DEL ROSARIO, JOHN KENJIE S.

DIMAPILIS, JOSHUA P.

ESTROPE, DEXTER P.

10

HERRERA, JOHN LLOYD

11

LARESMA, CLARENCE KATE B.

12

LLAMAS, CHESTER B.

13

MANIBOG, JERIC T.

14

MENDOZA, ARREN LEI L.

15

SANGA, EMMANUEL R.

16

TANDANG, JOMAR S.

17

VALENZUELA, JOSHUA E.

18

VILLEGAS, KENNETH G.

19

ZAYAS, CYRUS JAMES A.

20

ZAYAS, ROQUE T.

21

ALANO, JM M.

22

BANASIHAN, PRINCESS M.

23

BERDIN, TRISHA MAE L.

24

CENAON, JAZREEL B.

25

CRUZ, DHEYSHANN HOPE C.

26

DELA CRUZ, ALEXANDRA B.

27

FERRER, FRANCINE D.

28

HERRERA, MARY ANN S.

29

JAVIER, SOFIA LORRAINE S.

30

LAYNO, RUTCHEL MAE C.

31

MARANAN, ROSE ANN B.

32

PARAISO, FRANCINE C.

33

PLANAS, ALLYA MAE D.

34

RELOS, JALEN RHUDEE B.

35

SOSA, ANGELINE A.

36

TABUETE, KATRINA JEANE P.

37

TANDANG, CHRISTINE JOY G.

38

TARZONA, SARAH NICOLE M.

39

TOLENTINO, PAULINE MAE B.

40

VASQUEZ, DIANE FHAY A.

40
Accomplished
by:

1
1

1
36

Class Adviser
(Name and
Signature)
Date Accomplished

ROCHEL L. DEANGKINAY
7/8/2016

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
33
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2015


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BANOS
Name of School BAYOG ELEMENTARY SCHOOL
School Address TAGPUAN ST. BAYOG, LOS BANOS, LAGUNA
Total Enrolment 41
Grade Level and
VI-BONIFACIO
Section

Number
Enrolled

Name of Child

with consent

dewormed (June 1-July 29)

4P's
1

ALVAREZ, ALDWIN L.

ALVAREZ, TYRONE C.

BANASIHAN, JUSTIN T.

BALAGUER, MARK JOSEPH M.

BAUTISTA, DINDO D.

BAUTISTA, RONALD JOHN S.

CABELIN, JANN MARIUS C.

CONTADO, JOHN BENEDICT H.

DE VILLA, JHON MARFIL C.

10

LAPITAN, JONNEL VICTOR L.

11

LUZ, JOHN MICHAEL L.

12

MOLDEZ, CARMELO C.

13

MORRON, JIMBOY P.

14

PADUA, ANGEL JOHN H.

15

PAGHUBASAN, ROY LOUIE B.

16

PARADO, LORENZ P.

17

PASCUAL, KENNETH RALPH M.

18

RAMOS, JOHN MARK L.

19

RAMOS, RAYNIER G.

20

TAGAYONG, NEON LLUTZ G.

21

TANDANG, KEVIN BRYAN P.

22

VASQUEZ, JOHN PAULO L.

23

BANASIHAN, LEXA K.

24

BANASIHAN, NICOLE M.

25

BENAVENTE, CARLA S.

26

BEROY, MA. ADELAIDA -

27

BIAG, NICOLE A.

28

BIO, JERALDINE L.

29

CABRAL, ALEA JOY A.

30

ESQUILONA, ANDREA NICOLE A.

31

HERVACIO, MARY JANE O.

32

INDICO, IMELDA CHEN -

33

LAPITAN, DARYL ANNE F.

34

LAYOSA, NICOLE JAZMINE B.

35

MARTINEZ, ALMIRA FE C.

36

MEDALLON, KIMBERLY D.

37

MORATO, GLORY MAE L.

38

PARAISO, AIYA C.

39

SAN JOSE, JENNA LYN C.

40

TANDANG, MAE CIE D.

41

VASQUEZ, LEA GLAIZA R.

38

10

41
Accomplished
by:

Class Adviser
(Name and
Signature)
Date Accomplished

HAZEL B. MALIGALIG
7/8/2016

1
1

Remarks for not being dewormed


Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
med (June 1-July 29) (dewormed Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug ( annex
B MDAP Guide #1 page
non-4P's
14)
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
28

Noted by

Grade Level
Advisor (Name
and Signature) GISELA I. PINGAD
Principal

National School Deworming Day July 29, 2016


ANNEX C: Form 1 MODIFIED deworming checklist
Province
LAGUNA
Division
LAGUNA
District
LOS BAOS
Name of School BAYOG ELEM. SCHOOL
School Address TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
Total Enrolment 38
Grade Level and
GRADE SIX-MALVAR
Section

dewormed
(June 1-July 29)
Number
Enrolled

Name of Child

with consent
4P's

ABELLA, MARLON

AGUILAR, ANDREI MAURICE C.

BANASIHAN, JOHN CHRISTIAN B.

CACHOLA, PJ M.

CEREZA, JASTHEN O.

CEREZO, JESSIE JR B.

DELOS REYES, ANTHONY J.

DIAZ, JOSHUA L.

ERASGA, DANREV L.

10

ESCOBIN, JAYVIE T.

11

GABRIEL, JOHN CHRISTIAN M.

12

GRICALDA, JERWELL B.

13

MARANAN, JOHN REYMART B.

14

MOLDEZ, REAVER SOLOMONE A.

15

MONTAO, JOSHUA C.

16

OLIVA, JEROME C.

17

PAMULAKLAKIN, CHRISTIAN M.

18

QUILLOY, JOHN KOBE C.

19

RANCES, JOHN C.

20

SANGALANG, ALEJANDRO C.

21

VALEZA, EURIE V.

22

BALAHADIA, ASHLLEY C.

23

CARPIO, ASHLEY MAE A.

24

DALIVA, GIORIS AZEL C.

25

EBEC, CLARENCE B.

26

ESCOBIN, RUFFA MAE T.

27

HINTURAL, GERALDINE C.

28

LUMAYBAY, ALTHEA AIRA S.

29

MONTAO, GESAIRAH JANE M.

30

MORRON, JOANA MAY P.

31

ONOYA, DIANA MAE S.

32

PAJARIT, JOEYLYN S.

33

PAMULAKLAKIN, JOAN B.

34

PAMULAKLAKIN, LEAN L.

35

QUIMBA, CHRISTINE ANN T.

36

VALENTINO, DESIREE JHOY M.

37

VALENZUELA, JADE A.

38

VIRAY, SAMANTHA MJ C.

38
Accomplished
by:

37

1
1

13

Class Adviser
(Name and
Signature)
Date Accomplished

REYMART T. ADA

Remarks for not being dewormed

rmed
June 1-July 29)

non-4P's

1
1

1
1
1
1
1
1
1
1

Precautionary Measure
(seriously ill, with
abdominal pain,
Ineligible
deferred
diarrhea, who has
(dewormed
Refused
due to
previous
before June deworming prevalence
hypersensitivity with
1)
survey
deworming drug
( annex B MDAP
Guide #1 page 14)

1
1
1
1
1
1
1
1
1
1
1
1
1
1

24
Noted by

Grade Level
Advisor (Name
and Signature)

GISELA I. PINGAD
Principal

Province
Division
District
Name of School
School Address
Total Enrolment

National School Deworming Day July 29, 2015


ANNEX C: Form 2 MODIFIED School Level Reporting Form
LAGUNA
LAGUNA
LOS BAOS
BAYOG ELEM. SCHOOL
TAGPUAN ST., BRGY. BAYOG, LOS BAOS, LAGUNA
1069
children Dewormed

Grade Level

Kinder
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
TOTAL

No. of Enrolled Children

with consent

106
112
170
166
172
184
159
1069

105
112
150
137
156
158
151
969

Accomplished by:
School Principal
(Name and
Signature)
Date Accomplished

GISELA I. PINGAD
Principal

4 P's

3
6
12
12
20
23
29
105

Remarks for not being dewormed


children Dewormed

non 4 P's

102
106
138
125
136
135
122
864
Noted by
District
Supervisor (Name
and Signature)

Ineligible
(dewormed
before June
1)

Refused
deworming

0
0
4
1
2
1
0
8

1
0
15
27
14
24
6
87

Precautionary Measure
(seriously ill, with
deferred
abdominal pain, diarrhea,
due to
who has previous
prevalence
hypersensitivity with
survey
deworming drug ( annex B
MDAP Guide #1 page 14)
0
0
0
0
0
0
0
0

0
0
1
1
0
1
2
5

School ID

School Year

Name of School

No.

NAME
(Last Name, First Name, Middle Name)
M

BARBA, AIAN D.

CARACUEL, CALVIN V.

CHAVEZ, MARK

ELLEC, KYLE ESZEKIEL

DE LOS REYES, JOSH SANIELLE A.

ESCOBIN, JOHN R.

ESQUILONA, ALJON A.

FERNANDO, JOHN MATHEW


L.

GALVEZ, ALDEN CRIS

10

GARCIA, BRENDAN RICARDO ANDRIE M.

11

GRICALDA, BRENT JOZZWELL B.

12

LANUANG, LLOYD D.

13

MIEL, JAMIR M.

14

MOLDEZ,
JOHN
CHRISTOPHE
R

15

NOEL, JAY ALFRED M.

16
17

OIRA, JOHN
JOHN G.
PANISALES,
PRINCE KYLE
L.

18

PETRAS, CHRISTIAN A.

19

RESQUITES, KIAN ALAIN V.


SAN PEDRO, JOHN PATRICK
M.

20
21

SERRANO, ADRIAN JASKIE A.

22

TOLENTINO, JOEL JR. B.

23

UMALI, MARK JOSEPH M.

23

<=== MALE | TOTAL Per Day ===>

ALVARADO, MICHAELA L.

ALVARADO,
MICHAELA
LOPEZ

DIMAPILIS, RHEILYN B.

DIMAPILIS,
RHEILYN
BANASIHAN

ELLAS, JHANETH TUD

ELLAS,
JHANETH TUD

FLORES JEN MARIE O.

FLORES JEN
MARIE
ORDANZA

LALAP, PRINCESS SHAIRA E.

LALAP,
PRINCESS
SHAIRA
ESCOBIN

MACAPUA, DENISE H.

MACAPUA,
DENISE
HOMO

MACAPUA, MAYAN E.

MACAPUA,
DENISE
HOMO

TH

MALIHAN, LHARA MAE I.

MALIHAN,
LHARA MAE
INGATAN

MERCADO, CHYNNA MAE H.

MERCADO,
CHYNNA MAE
HOYOHOY

10

MULIMBAYAN, ANGEL H.

11

PAMULAKLAKIN, CHRISTINE
MAE C.

PAMULAKLAKI
N, CHRISTINE
MAE
CABISADA

12

PAMULAKLAKIN, LIANNE D.

PAMULAKLAKI
N, LIANNE
DUMALAON

13

RANCES JOVIELYN P.

RANCES
JOVIELYN
PLANAS

14

VIERNEZA FERLYN M.

VIERNEZA
FERLYN
MORENO

15

VILORIA, RHIAN E.

VILORIA,
RHIAN
ESCOBIN

15

<=== FEMALE | TOTAL Per Day ===>

38

Combined TOTAL Per Day

GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:

Registered Learners a

Enrolment as of 1st Fr

Total Daily

Number of School Da

Average dail

Registered Learners a

4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summary table into School Form 4. Once signed by the principal, this f
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days and/or those at risk of dropping
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.

School Form
2015 - 2016

School Year

TH

Registered Learners as of end of the month


x 100
Enrolment as of 1st Friday of the school year
Total Daily Attendance
Number of School Days in reporting month
Average daily attendance
x 100
Registered Learners as of end of the month

Form 4. Once signed by the principal, this form should be returned to the adviser.
utive days and/or those at risk of dropping out.

School Form 2 (SF2) Daily Attendance Report of Learners


(This replaces Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

July

Report for the Month of

Grade 1

Grade Level

TH

1. CODES FOR CHECKING ATTENDANCE

(blank) - Present; (x)- Absent; Tardy (hal

2. REASONS/CAUSES FOR DROPPING OUT

a. Domestic-Related Factors

x 100
a.1.
a.2.
a.3.
a.4.

Had to take care of siblings


Early marriage/pregnancy
Parents' attitude toward schooling
Family problems

x 100
b. Individual-Related Factors
b.1.
b.2.
b.3.
b.4.
b.5.
b.6.
b.7.

Illness
Overage
Death
Drug Abuse
Poor academic performance
Lack of interest/Distractions
Hunger/Malnutrition

c. School-Related Factors

c.1. Teacher Factor


c.2. Physical condition of classroom
c.3. Peer influence

d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters

e. Financial-Related
e.1. Child labor, work
f. Others (Specify)

July
Grade 1

TH

Section

TH

(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer, Lower for Cutting Classes)

Bonifacio
Total for the Month
ABSENT

TARDY

REMARKS (If DROPPED OUT, state reason, please refer to legend


number 2. If TRANSFERRED IN/OUT, write the name of School.)

Month:

No. of Days of Classes:

* Enrolment as of (1st Friday of June)

Late Enrollment during the month

Summary
M

TOTAL

23

15

38

(beyond cut-off)

Registered Learners as of
end of month

Percentage of Enrolment as of
end of month

Average Daily Attendance

Percentage of Attendance for the month


Number of students absent for 5 consecutive days

Dropped out

Transferred out

Transferred in

I certify that this is a true and correct report.

JEAN Q. TOLENTINO
(Signature of Adviser over Printed Name)

Attested by:

GISELA I. PINGAD
(Signature of School Head over Printed Name)

School ID 108304
Name of School
No.

NAME
(Last Name, First Name,
Middle Name)

ARGONCILLO, MAURITONIE ANGELO A.

CASTILLO, JOHN CHRISDEL R.

DAYAG, DARYL M.

DEANGKINAY, PTEROCHRIST R.

DE VILLA, ADRIEL MC GILLIAN V.

JIMENEZ, KNIGHT B.

LAGUERTA, JERWYN T.

MANTALA, JAYVEE B.

MAQUILING, VICENTE III T.

10

MOJICA, JUAN CARLOS B.

11

MURIN G, KAYDEN JADE L.

12

PADILLA, KIETH ANDRIED B.

13

PARAMIO, ELIJAH CHRISTOF C.

14

REGONDOLA, ROAN M.

15

SAGADO, RENZ WILSON S.

16

SAMADAN, CHEZTER XAVIERY E.

17

SUMBINGCO, GABRIEL C.
18

TANDANG, FRANZ ASIS M.

19

TANDANG, LON RAILEY F.

20

TOLENTINO, RALLEN O.

20

<=== MALE | TOTAL Per Day ===>

ALMONTE, PRECIOUS LEA JEAN M.

ARANGO, ALTHEA DARLENE B.

BANASIHAN, TRIXZIE G.

BELTRAN, PRINCESS LYANA T.

DEANGKINAY, MARY JANE CARLA C.

DELMINGUEZ, DANIELA MAE A.

DIJAN, RHAYZELLE MAY D.

DUMAGCO, STHEACY EHRA S.

EMOLAGA, BERNADETH M.

10

ESPADILLA, CASSANDRA S.

11

ESPINOSA, JENNIFER B.

12

GARCIA, JANISABEN SAI M.

13

LAPINID, KAYMAE JAN LIAN M.

14

MOLDEZ, PRINCESS APRIL M.

15

PELOBELLO, PRECIOUS MAE P.

16

PONDIVIDA, RICA MAE R.

17

QUILLOY, ARIANNE H.

18

RETUERTO, SAMANTHA MAE L.

BAY

19

RIVERA, CHRISTINE GAILE D.

20

SEDIEGO, MARHJIE C.

21

TANDANG, ALEKRISH RAIN L.

22

TANDANG, ROMAY G.

23

TOLENTINO, ANNE LORAIN Q.

24

VALENZUELA, AUDREY E.
<=== FEMALE | TOTAL Per Day
===>
Combined TOTAL Per Day

24
44
GUIDELINES:

1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:

a. Percentage of Enrolment =

b. Average Daily Attendance =

c. Percentage of Attendance for the month =

4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summary table into School Form 4. Once signed by the principal, this f
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days and/or those at risk of dropping
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.

*Beginning of School Year cut-off report is every 1st Friday of the School Year

Sch
School Year

2016 - 2017

BAYOG ELEMENTARY SCHOOL

TH

TH

Registered Learners as of end of the month

Enrolment as of 1st Friday of the school year


Total Daily Attendance
Number of School Days in reporting month
Average daily attendance
Registered Learners as of end of the month

Form 4. Once signed by the principal, this form should be returned to the adviser.
utive days and/or those at risk of dropping out.

School Form 2 (SF2) Daily Attendance Report of Learners


(This replaces Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

Report for the Month of


Grade Level

TH

1. CODES FOR CHECKING ATTENDANCE

2. REASONS/CAUSES FOR DROPPING OUT

a. Domestic-Related Factors

x 100
a.1.
a.2.
a.3.
a.4.

Had to take care of siblings


Early marriage/pregnancy
Parents' attitude toward schooling
Family problems

x 100
b. Individual-Related Factors
b.1.
b.2.
b.3.
b.4.
b.5.
b.6.
b.7.

Illness
Overage
Death
Drug Abuse
Poor academic performance
Lack of interest/Distractions
Hunger/Malnutrition

c. School-Related Factors

c.1. Teacher Factor


c.2. Physical condition of classroom
c.3. Peer influence

d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters

e. Financial-Related
e.1. Child labor, work
f. Others (Specify)

earners

Grade 2

TH

Se

TH

CKING ATTENDANCE

ES FOR DROPPING OUT

ed Factors

of siblings
pregnancy
toward schooling

ed Factors

erformance
Distractions
tion

Factors

n of classroom

ironmental

en home and school


ncl. Tribal wars & clanfeuds)
sters

(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer, Lower for Cutting Classes)

Section

RIZAL
Total for the Month

ABSENT

TARDY

REMARKS (If DROPPED OUT, state


reason, please refer to legend number
2. If TRANSFERRED IN/OUT, write the
name of School.)

Month:

No. of Days of Classes:

Summary
M

20

24

20

24

Dropped out

Transferred out

Transferred in

* Enrolment as of (1st Friday of June)

Late Enrollment during the month

(beyond cut-off)

Registered Learners as of
end of month

Percentage of Enrolment as of
end of month

Average Daily Attendance

Percentage of Attendance for the month


Number of students absent for 5 consecutive days

I certify that this is a true and correct report.

AIDA C. LITARGO
(Signature of Adviser over Printed Name)

Attested by:

GISELA I. PINGAD
(Signature of School Head over Printed Name)

OPPED OUT, state


r to legend number
D IN/OUT, write the
School.)

Summary
TOTAL

44

44

0
0

School ID

108304

School Year

Name of School

(Last Name, First Name,


Middle 1Name)
ABARQUEZ, MARK ANTH

BAYOG

2 ADOLFO, JHON CYRILL


BANASIHAN, JOHN
3 P.
A. PAULO M.
CACHOLA,
4 HOMER
5 CENAJO, MICO PRINCE
FABIAN,JOHN PAUL C.
6 V.
7 GARDOCE, JOHN
P. CYRELL
GANZALAO,
8 EZEKIEL
ILAGAN,L.JHAREL M.
9 ALLEN
10 LANTE, ENZO C.
11 LAPIE, ALEXIS DERICK
12 J.
LAPITAN, WARREN I.
13 LAYNO, JURRY R.
14 MONILLA, MARK JAYDEN
15 PEREJA MHART JHAY A.
16 REPLAN, JOHN ALLEN D
17 REYES, DAVE CONNON
18 RODICO, MARK JHON C.
19 TANDANG, JAZZ C.
20 TANDANG ZYRUS E.
21 TERROBIAS, RALPH JUSTNIE D.
22 VASQUEZ, JHONZEL
23 VICTORIA, JAMES CARLO
24
25

MALE | TOTAL Per Day


1 ALVAREZ, RACHEL C.
2 ARMECIN, LEA MAY M.

TH

BANASIHAN,

3 CHASELYN
A.

4 BANASIHAN, JENICA T.
BARCALA, DARLENE
5
JOY
A.
BARAYANG,
6
CHRISTNEIL S.
7 BAYANI, HAYLEY C.
8 BERDIN, IRISH JANE A.
CAPITAN,
9 GLYDALLE
M.
CORTEZ, KYLE
10
NATHALIE A.
DELA

11 CRUZ,

RAIZA JOI C.
DELOS
12 REYES,
SOPIA E.

DE LUNA, JHOSA MAE


13
I.EVANGELISTA, MA.
14
CAMILLE
Q.
FABIAN, CHAMIQUE
15
JHADE Q.
GONZALES,,
MA.
16 STEPHANIE
D.

17 JUEGO, JOANA MAY R.


18 LAYNO, KRISTNE CASSANDRA
MOLDEZ, YSSHA FAE
19
M.
SILO,
20
JHENIAH V.
VASARINO,
21 VANESSA
M.
VASQUEZ,
22 FERSYBEL
A.
23

VASQUES,
JEANZEL L.

FEMALE | TOTAL Per Day

Combined TOTAL PER DAY


GUIDELINES:

1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
Registered Learners as of end of the month
a. Percentage
Enrolment as of 1st Friday of the school year
Average
Total Daily Attendance
Daily
b.
Attendance
Number of School Days in reporting month
=
Average daily attendance
c. Percentage of Attendanc
Registered Learners as of end of the month

4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summary table in
principal, this form should be returned to the adviser.

5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent fo
out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
* Beginning of School Year cut-off report is every 1st Friday of the School Year

School Form 2 : Page ___ of ________

School Form 2 (SF2) Daily Attendance

(This replaces Form 1, Form 2 & STS Form 4 - Absenteeis

2016-2017

(1st row for date)


T

TH

TH

1. CODES FOR CHECKING ATTENDANCE

nce.

as of end of the month


day of the school year
Attendance
ys in reporting month
y attendance
as of end of the month

(blank) - Present; (x)- Absent; T

x 100

x 100

recording of summary table into School Form 4. Once signed by the

o learner/s who were absent for 5 consecutive days and/or those at risk of dropping

2. REASONS/CAUSES FOR DROPPING OU


a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental

d.1. Distance between home and school


d.2. Armed conflict (incl. Tribal wars & clanfeu
d.3. Calamities/Disasters
e. Financial-Related
e.1. Child labor, work
f. Others (Specify)

aily Attendance Report of Learners


2 & STS Form 4 - Absenteeism and Dropout Profile)

Report for the Month of


Grade Level

TH

TWO

Section

TH

OR CHECKING ATTENDANCE

(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer, Lower for Cutting Classes)

S/CAUSES FOR DROPPING OUT


-Related Factors
ake care of siblings
arriage/pregnancy
attitude toward schooling

-Related Factors

ademic performance
nterest/Distractions

elated Factors
condition of classroom

hic/Environmental

between home and school


onflict (incl. Tribal wars & clanfeuds)

Section

MABINI
Total for the Month

ABSENT

TARDY

REMARKS (If DROPPED OUT, state reason, please refer to legend


number 2.
If TRANSFERRED IN/OUT, write the name of School.)

Month:

No. of Days of Classes:

Summary

No. of Days of Classes:

* Enrolment as of (1st Friday of June)


Late Enrollment during the month
(beyond cut-off)
Registered Learners as of end of the month
Percentage of Enrolment as of end of the month
Average Daily Attendance
Percentage of Attendance for the month
Number of students absent for 5 consecutive days:
Drop out
Transferred out
Transferred in

I certify that this is a true and correct report.


ALMA B. MACASADIA
(Signature of Teacher over Printed Name)
Attested by:
GISELA I. PINGAD
(Signature of School Head over Printed Name)

TOTAL

108304

School ID
Name of School

No.

NAME
(Last Name, First Name, Middle Name)
M
AGRISOLA, KIAN LEI B.

ALVAREZ, CHESTER LUIS A.

BAUTISTA, BJ M.

CIRIACO, JHON MHYCO L.

CRUZ, JERWIN A.

DALGUNTAS,KING C.

IMPERIAL, PRINCE C.

IPOSADA, ACE R.

LAPITAN, JHON ANDREI B.

MALIHAN, CARL LUIS M.

10

MANUEL, PRINCE ARLO F.

11

MENIA, ADRIAN V.

12

MONTANO, JADE M.

13

OGALIN, JHON PRANCIS,V.

14

PALCONIT, JERICO P.

15

RIVERA, ARMAN P.

16

SUENO, BEJAY D.

17

SULTAN, AEDRIAN P.

18

TANDANG, JOHN PAOLO J.

19

TANDANG, KENT BRYAN P.

20

VIBAL, AARON C.

20

<=== MALE | TOTAL Per Day ===>

ALDAVE, CHANTELLE JANE T.

BARRAMEDA, ATHENA RAINE V.

CASTILLO DOROTHY KEI T.

ESCOBIN, CRISTEL T.

FERNANDEZ, KATE HAIDEE Y.

LLOSIS, RINA JANE D.

LONTOC, PRINCESS S.

LUBATON, RHIAN NICOLE L.

10

MACAPUA, ZIDJANE B.

11

MARTINEZ, PRINCESS VIONALYN A.

12

MONTANO, JISSEL C.

13

MUDLONG, JAZMINE L.

14

NIVAL, ALYZZA L.

15

PUPA, LYRA MAE L.

16

RIVERA, AYA FRANCHESKA B.

17

SANTONIA, CHE CHE M.

18

TANDANG, GENCEL L.

19

TOBIAS, CEANA B.
VASQUEZ,
MA. AGNES R.

20
20

<=== FEMALE | TOTAL Per Day ===>

40

Combined TOTAL Per Day

GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:

a. Percentage of Enrolment =

b. Average Daily Attendance =

c. Percentage of Attendance for the month =

4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summary table into School Form 4. Once signed by the principal, this f
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days and/or those at risk of dropping
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.

*Beginning of School Year cut-off report is every 1st Friday of the School Year

Sch
2016 - 2017

School Year

Bayog ES

13
TH

TH

Registered Learners as of end of the month

Enrolment as of 1st Friday of the school year


Total Daily Attendance
Number of School Days in reporting month
Average daily attendance
Registered Learners as of end of the month

Form 4. Once signed by the principal, this form should be returned to the adviser.
utive days and/or those at risk of dropping out.

/
/
/
/

School Form 2 (SF2) Daily Attendance Report of Learners


(This replaces Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

Report for the Month of


Grade Level
(1st row for date)

13

14
M

15
T

16
W

17
TH

20
F

1. CODES FOR CHECKING ATTENDANCE

2. REASONS/CAUSES FOR DROPPING OUT

a. Domestic-Related Factors

x 100
a.1.
a.2.
a.3.
a.4.

Had to take care of siblings


Early marriage/pregnancy
Parents' attitude toward schooling
Family problems

x 100
b. Individual-Related Factors
b.1.
b.2.
b.3.
b.4.
b.5.
b.6.
b.7.

Illness
Overage
Death
Drug Abuse
Poor academic performance
Lack of interest/Distractions
Hunger/Malnutrition

c. School-Related Factors

c.1. Teacher Factor


c.2. Physical condition of classroom
c.3. Peer influence

d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters

e. Financial-Related
e.1. Child labor, work

f. Others (Specify)

earners
JULY
Grade Two

21

22
T

23
W

24
TH

27
F

28
M

29
T

30
W

TH

CKING ATTENDANCE

ES FOR DROPPING OUT

ed Factors

of siblings
pregnancy
toward schooling

ed Factors

erformance
Distractions
tion

Factors

n of classroom

ironmental

en home and school


ncl. Tribal wars & clanfeuds)
sters

(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer, Lower for Cutting Classes)

BONIFACIO

Section

Total for the Month


F

ABSENT

TARDY

REMARKS (If DROPPED OUT, state reason, please refer to legend


number 2. If TRANSFERRED IN/OUT, write the name of School.)

JULY

No. of Days of Classes:

* Enrolment as of (1st Friday of June)

Late Enrollment during the month

Summary
M

20

20

(beyond cut-off)

Registered Learners as of
end of month

Percentage of Enrolment as of
end of month

Average Daily Attendance

Percentage of Attendance for the month


Number of students absent for 5 consecutive days

Dropped out

Transferred out

Transferred in

I certify that this is a true and correct report.

ALONA L. LONTOK
(Signature of Adviser over Printed Name)

Attested by:

GISELA ILAGAN PINGAD

e reason, please refer to legend


OUT, write the name of School.)

Summary
TOTAL

40

School Form 2 (SF2) Da

(This replaced Form 1, Form 2

School ID

108304

Name of School

School Year

2016 - 2017

BAYOG ELEMENTARY

LEARNER'S NAME

(1st row for date,

(Last Name,
First Name, Middle Name)

TH

1 ALANO, RENZ MICHAEL B.


2 BARNIDO, KIAN CLEIN L.

3 BUNDALIAN, CARL JAVIN S.


4 BUNDALIAN, JEAN CLAUDE S.

5 CABRAL, JOHN LERICK A.


6 CHUA, JUSTINE

7 DE DIOS, JOHN LENARD T.


8 FLORES, TROY ANDREI C.

9 GIBAS, JOHN TEDDY P.


10 GUILING, AR-JAY J.
11 LIWANAGAN, MIGZ ANTON L.
12 MENIA, JAMES R.

13 NATIVIDAD, JR. LOUIE M.


14 NAVASERO, ARON H.

15 PASCUAL, JOHN LAWRENCE B.


16 ROBRIGADO, OWEN A.

17 TENORIO, JOHN LAWRENCE B.


18 TOLENTINO, GERWIN P.

19 VILLAREZ, WINTER PAUL A.


20 VILLORIA, JAMES ROBERT B.
MALE | TOTAL Per Day

1 ACOSTA, TRIXIA L.
2 ANDES, SHERAIN A.
3 ALVAREZ, KEYSHIA N.
4 CARILLAGA, FATIMA M.
5 CARIO, ROXANNE V.
6 CASILAO, AYCEL A.
7 CILLS, CHRISTAL C.
8 DIZON, SHUNELA THERESE T.
9 GALIMBA, JOANA JOYCE
10 GARCIA, JACKIE RICE O.

11 MANARIN, LOUGIE M.
12 MARCELO, AIRA MAY

13 MORRON, APRIL JOYCE P.


14 PAMULAKLAKIN, RHIAN D.
15 PATOTOY, CZHARLENE ANNE M.
16 RIMAS, MARY JANE RAFAEL
17 SURETA, ANGEL CEREI A.
18 SY, KRISHIA P.
19 VALENCIA, SHEILA MAE C.
20 VILLA, CHRISTINA R.

F
I
T
R

FEMALE | TOTAL Per Day

Combined TOTAL PER DAY


GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the preceding columns beside Learner's Name.
3. To compute the following:
Registered Learner as of End of the Month
a.
Percentage of Enrolment =
Enrolment as of 1st Friday of June
Total Daily Attendance
b.
Average Daily Attendance =
Number of School Days in reporting month
Average daily attendance
c. Percentage of Attendance for the month =
Registered Learner as of End of the month

4. Every End of the month, the class adviser will submit this form to the office of the principal for recording of
summary table into the School Form 4. Once signed by the principal, this form should be returned to the adviser.
5. The adviser will extend neccessary intervention including but not limited to home visitation to learner/s that committed 5
consecutive days of absences or those with potentials of dropping out
6. Attendance performance of learner is expected to reflect in Form 137 and Form 138 every grading period
* Beginning of School Year cut-off report is every 1st Friday of School Calendar Days

School Form 2: Page 2 of ________

rm 2 (SF2) Daily Attendance Report of Learners


replaced Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

2016 - 2017

Report for the Month of

JULY

Grade Level

II

Section

(1st row for date, 2nd row for Day: M,T,W,TH,F)


8

11

12

13

14

15

18

19

20

21

22

25

TH

TH

26
T

27
W

28
TH

29
F

MALVAR
Total for the
Month
ABSENT TARDY

1. CODES FOR CHECKING ATTENDANCE

the Month
f June

ting month
ce
the month

x 100

x 100

Month:

JULY

blank- Present; (x)- Absent; Tardy (half shaded=


Upper for Late Commer, Lower for Cutting Classes)

* Enrolment as of (1st Friday of June)

2. REASONS/CAUSES OF DROP-OUTS
a. Domestic-Related Factors

Late Enrollment during the month


(beyond cut-off)

a.1. Had to take care of siblings


a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling

Registered Learner as of end of the


Percentage of Enrolment as of end of

a.4. Family problems


b. Individual-Related Factors

Average Daily Attendance

ording of
d to the adviser.

ner/s that committed 5

b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school

Percentage of Attendance for the m

Number of students with 5 consecutiv


absences:
Drop out
Transferred out
Transferred in

I certify that this is a true and correct report.

IMELDA QUIL
(Signature of Teache

d.2. Armed conflict (incl. Tribal wars & clanfeuds)


d.3. Calamities/Disasters
e. Financial-Related
e.1. Child labor, work
f. Others

Attested by:

GISELA ILA
(Signature of School H

MALVAR
REMARK/S (If DROPPED OUT, state reason,
please refer to legend number 2.
If TRANSFERRED IN/OUT, write the name of
School.)

No. of Days of
Classes:

as of (1st Friday of June)

ent during the month


(beyond cut-off)

ed Learner as of end of the month


of Enrolment as of end of the month

Average Daily Attendance

Summary for the


Month
M

TOTAL

20

20

40

tage of Attendance for the month


students with 5 consecutive days of
absences:
Drop out
Transferred out
Transferred in

is is a true and correct report.


IMELDA QUILLOY SALAZAR
(Signature of Teacher over Printed Name)

GISELA ILAGAN PINGAD


(Signature of School Head over Printed Name)

School ID

108304

School Name
NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

LRN

Bayog ES
BIRTH DATE
(mm/dd/yyyy)

108304120327

ABALOS, AHYRON JAY B.

09-23-2007

108304120303

BAUTISTA, ALEXIS B.

06-04-2007

108304130009

ELAYBA, CHRISTIAN DOMINIC M.

09-16-2006

108304130002

EVANGELISTA, JAMES BENEDICT Q.

09-20-2007

108304130003

GUZMAN, RALPH AARON C.

08-31-2006

108304120308

JABOL, KENNETH V.

11-22-2006

108304130004

LARESMA, HARLEY B.

08-02-2007

108304130005

LITARGO, ANDREI DOMINIC L.

12-27-2006

108304120338

MANAGAT, MARK JUSTIN C.

02-19-2007

108304120312

MANGAOANG, EZZRIELLE JHAZZ B.

12-15-2006

108311130074

MURING, KARL VINCENT L.

05-12-2007

108304120317

QUILLOY, GEM RUSSELL T.

03-13-2007

108304130007

REGALADO, JUREL S.

02-22-2007

108244120068

RELOS, JURO MATEO B.

07-09-2007

108304120320

REYES, TRISTAN CEDRIC B.

11-06-2007

108304110031

SAN PEDRO, JOHN RUSSEL G.

108304120323

TANDANG, GIDEON L.

07-14-2007

108304120324

TANDANG, JAZPER C.

08-14-2007

108304130006

TANDANG, JOHN MATEO A.

12-18-2006

108304130010

TIMOSAN, STEEVEN JOSH S.

11-02-2007

108304120348

ADOLFO, GEODEE STEVENS

12-02-2006

108304120279

BAUTISTA, IRISH GLEN M.

10-17-2007

108311120436

BERDIN, AIRA JANE A.

02-25-2007

108304130012

BORJA, GUEN ANGELINE O.

11-06-2006

108304130013

CABRAL, RUI ANN R.

06-04-2007

108304120283

DE LUNA, MA. MINERVA LEA O.

05-22-2007

108304120363

ERASGA, LIRA T.

04-30-2007

164502130015

FERNANDEZ, GEANN NICOLE J.

07-28-2007

107605120129

LAPITAN, CHESKA LYKA F.

09-05-2006

108304120366

LAPITAN, MARIA PRINCESS JOY T.

08-26-2007

108304120285

MANARPAAC, CHARMELA A.

02-11-2007

108304120287

MERCADO, HONEY LEE E.

06-12-2007

108304130125

MIEL, IRENE M.

04-11-2006

108311120457

PADUA, IRISH S.

12-23-2006

108304130017

PANER, NINYA FLOR F.

05-26-2007

108304130035

PATOTOY, CZHARZETTE ANNE M.

03-29-2007

108304120290

RAMOS, MARSHA ANDREA D.

06-05-2007

108304120291

RECTO, REINELYNN G.

11-16-2006

108480120266

SAGPAO, NATALIE SAJIE R.

02-26-2007

108304130018

SUPLE, STEPHANIE D.

10-21-2004

108304120295

TERROBIAS, REEZE JEAN D.

04-13-2007

108304120294

TOLENTINO, VENIZE ANNE Q.

02-14-2007

108304120297

ZAMUDIO, RAIZA B.

01-05-2007

23 <=== TOTAL FEMALE


43 <=== COMBINED

List and Code of Indicators under REM


Indicator
Transfered
Out

Code
T/O

Required Information

Indicator

Name of Public (P) Private (PR) School & Effectivity Date

CCT Receipient

Name of Public (P) Private (PR) School & Effectivity Date

Balik Aral

Reason and Effectivity Date


Reason (Enrollment beyond 1st Friday of

Learner With Disability


Accelerated

T/I
Transfered In
Dropped

DRP
LE

School Form 1

(This replaces Form 1, M

Region IV-A

Division

Bayog ES
AGE as of 1st Friday June

School Year
MOTHER TONGUE (Grade 1 to
IP
3 Only)
(Ethnic Group)

RELIGION

House #/
Street/ Sitio/
Purok

Barangay

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BATONG MALAKE

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAGONG BAYAN II-A (POB.)

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

MAMATID

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

SAN SALVADOR

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

11

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Code of Indicators under REMARKS column

Indicator

CCT Receipient

Code

Required Information

CCT

CCT Control/reference number & Effectivity Date

Balik Aral

B/A

Name of school last attended & Year

Learner With Disability


Accelerated

LWD

Specify

ACL

Specify Level & Effectivity Data

hool Form 1 (SF 1) School Register


(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)

Laguna
2016 - 2017
ADDRESS
Barangay

KE

N II-A (POB.)

Grade

Municipality/ City

Province

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

SAN PABLO CITY

LAGUNA

LOS BAOS

LAGUNA

BAY

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

CABUYAO

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LIPA CITY

BATANGAS

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

REGISTERED

BoSY

MALE

20

FEMALE
23
TOTAL

43

EoSY

District
Grade 4

Father's Name (Last Name, First Name, Middle Name)

Mother's Maiden Name (Last


Name, First Name, Middle

ABALOS, JULIUS MUNOZ

BANASIHAN, MARILYN
GAERLAN

BAUTISTA, ALEX ARTONI

BILBAO, CATHERINE PASIGAY

ELAYBA, CHRISTIAN MANERIN

MOLDEZ, AILEEN HERNADEZ

EVANGELISTA, BENITO CASTILLO

QUIMING, MYLENE DUMALE

JABOL, FLORANTE ROMAWAK

CUPON, ANNMELODY
PATINIO
VALENZUELA, NELLY
NASARINO

LARESMA, ROLLY VILLEGAS

BAUTISTA, HAZEL VIVERO

LITARGO, NONILON CASTILLO

LANSIN, LERMA GIBE

MANAGAT, JEFF TANDANG

CARILLAGA, MARIE ANN


NOTARTE

MANGAONG, SANDE PASCUAL

BAUTISTA, EVELYN PASCUAL

MURING, JULIUS JADE DULTES

LARA, KATCHELA GARGAR

QUILLOY, GEMILIANO PLAZA

TROCIO, ROSPER AJERO

REGALADO, JUN MERCADO

SAWALI, BERNADETTE
HATULAN

RELOS, JOSE JOEL CARREON

BANASIHAN, GRACE PONCE

REYES, ALEZ MAMALAYAN

BANASIHAN, ESMERALDA
ANGELES

TANDANG, JEFFREY CUSI

LANTE, JESUSA ALVAREZ

TANDANG, ELMER SUYOT

CANTANO, MARILY ADORCO

TANDANG, GREGORIO EMPLEYO

ACIAS, ARLENE JURADO

TIMOSAN, EMMANUEL PAMULAKLAKIN

SALAS, HAYDEE CECILIANO

ADOLFO, CELESTINO PAMULAKLAKIN

STSEVEN, MARILEN DELOS


REYES

BAUTISTA, MICHAEL PASCUAL

MASACAYAN, LILIBETH ONA

BERDIN, JAYSON BORBE

ABANES, MESEIL SANTONIA

BORJA, GREGORIO CAPREA


CABRAL, BONIFACIO TANGCA
DE LUNA, GERARDO LUNA
ERASGA, ROMEL DUMALAON
FERNANDEZ, GALAHAD VILLAR
LAPITAN, LEONARDO LAPIE

ORDONA, LORENA
DEANGKINAY
ROBRIGADO, ANALYN
ORDANZA
OLIQUIANO, IMELDA JACOBE
TANDANG, MA. LEONORA
SARMIENTO
JACER, ANACA ROLINA
DUHAY LUNGSOD
FLORIDA, SNOOKY
PANGILINAN

MANARPAAC, LINO PAMULAKLAKIN

AREVALO, BIVERLY TRILLADO

MERCADO, CARLOS MANALO

ECLARINAL, SUSAN
CRUCILLO

MIEL, RODOLFO

MORENO, CRISTINA

PADUA, ALVIN FERDINAND HINTURAL

SATOS, JOSEPHINE NERI

PANER, AARON ANTIPORDA

FRIAS, ANNIE ADOLFO

PATOTOY, EDMON URIAN


RAMOS, MARCELINO MENGUITO

RIZAL
GUARDIAN
(if Not Parent)

PARENTS

GUZMAN, RAMER BELDIA

Los Baos

Section

MONEDO, CONNIE
CONSERVADO
DELA TORRE, LILIBETH
BLASTIQUE

RECTO, REENE SOMBRERO

GARCIA, JOANALYN SABAS

SALCEDO, JERIS ANTHONY

REJALDE, MYLA SEGOMA

SUPLE, LINDON BUGOY

DANION, JOCELYN GUINANG

Name

EoSY

TERROBIAS, RENATO VILLANUEVA

DUMALAON, REINITZ
MAGSINO

TOLENTINO, JOEL QUIATZON

QUINTANA, JEAN CANICOSA

ZAMUDIO, RAUL BARACENO

BEREDIANA, ALONA BOMBAY

Prepared by;

Certified Correct:

CECILIA QUIATZON SAUL

GIS

(Signature of Adviser over Printed Name)

BoSY Date:

EoSY Date:

(Signature of S

BoSY Date:

Los Baos
RIZAL

DIAN
Parent)
Relationship

REMARKS
Contact Number of Parent or
Guardian
(Please refer to the legend on
last page)

Certified Correct:

BoSY Date:

GISELA ILAGAN PINGAD


(Signature of School Head over Printed Name)

EoSY Date:

School ID

108304

School Name
NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

LRN

Bayog ES
BIRTH DATE
(mm/dd/yyyy)

108304110040

AGRISOLA, JHONCEL M.

04-17-2006

108304120101

AMPARO, REDEN MARK V.

11-04-2005

108304120104

BIENES, RAVEN J.

12-05-2005

108304110052

CIDELLO, JOHN MELWIN P.

07-13-2006

108304120106

DELMINGUEZ, ARTHUR D.

05-05-2002

108304120107

DUMAGCO, ANTONIO JOAQUIN S.

12-08-2005

108304120108

ENOKIZONO, RYOJI Q.

11-06-2005

108304120109

ESCOBIN, JOHN MHEDRICK C.

03-11-2005

108304110033

ESPLANA, MARK PHILIP L.

12-29-2005

164502110016

EVANGELISTA, SAM D.

02-19-2006

108304110043

GABALES, CHOLO JUSTINE M.

06-05-2005

108304110023

HORIGUE, JUSTINE IVAN E.

10-18-2005

108304120111

LAPITAN, KYLE STEPHEN M.

08-07-2006

108304110028

MAKILING, MARK G.

12-11-2005

108304110048

PELOBELLO, JOHN PRECIOUS P.

08-02-2006

108304110007

REYES, JOHN KYLE B.

08-20-2006

108304130076

SUMBINGCO, MARK SAMUEL C.

08-07-2005

108304130081

TIMOSAN, SZHAN WAYNE S.

12-11-2005

108304110006

VENTURA, UNO ZANDER A.

01-14-2006

108304120175

VILLANUEVA, WENCY VICTOR M.

06-27-2006

108304110049

ALVAREZ, JASSEN NICOLE P.

01-13-2006

108304120113

BACOD, YHANCEE L.

11-04-2005

108312110005

BAGSIC, MIKAELLA B.

10-18-2005

108304110045

BALGUER, JAMELLA DIANNE M.

09-26-2006

108304110061

BARAYANG, CRISLIEN ARIANE S.

09-20-2005

108304110062

BLANCO, IRAH JHANE T.

12-10-2005

108304120117

CALPO, MEIRENNE C.

05-19-2006

108304120118

CECILIANO, CRISTINE JOY C.

11-21-2005

108304120119

DE LUNA, JHECILEE I.

11-21-2005

108304120120

GUZMAN, RIOME ANN C.

08-05-2005

108304140002

HINTURAL, STEPHANIE FRANCINE F.

09-29-2005

108304110065

HINTURAL, XYRILLE V.

11-02-2005

108304110057

HORIGUE, TRIXIE MAY R.

06-22-2006

108304120122

LEONIDAS, ALLYSA M.

02-22-2006

MADAYAG, CHRISTINE JHAYE C.

01-02-2006

108304120125

MAGBOO, KEREN Q.

03-17-2005

108304110010

MANIBOG, JANELLE

05-19-2006

108304120126

MANUEL, KRIZELA F.

01-22-2006

108304120127

MELANIO, JAZMEEN JULIENNE D.

11-30-2005

108304110014

MILAGROSA, RICA B.

06-21-2006

109814120017

MOJICA, ANGELENE B.

12-01-2005

108304110034

MOLDEZ, MIJA L.

11-03-2005

MULLER, JODIMIN G.

11-12-2005

108304110054

RIOLA, FRANCHESCA P.

09-01-2006

108304120129

SAPAIH, KEISMIR C.

09-23-2005

108304120132

TAMAYO, KATELYN C.

03-23-2006

26 <=== TOTAL FEMALE


46 <=== COMBINED

List and Code of Indicators under REM


Indicator
Transfered
Out

Code
T/O

Required Information

Indicator

Name of Public (P) Private (PR) School & Effectivity Date

CCT Receipient

Name of Public (P) Private (PR) School & Effectivity Date

Balik Aral

Reason and Effectivity Date


Reason (Enrollment beyond 1st Friday of

Learner With Disability


Accelerated

T/I
Transfered In
Dropped

DRP
LE

Generated on: Saturday, February 6, 2016

School Form 1

(This replaces Form 1, M

Region IV-A

Division

Bayog ES
AGE as of 1st Friday June

School Year
MOTHER TONGUE (Grade 1 to
IP
3 Only)
(Ethnic Group)

RELIGION

House #/
Street/ Sitio/
Purok

Barangay

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

14

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

11

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Others

SANTO DOMINGO

11

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

SAN ANTONIO

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

PUTHO TUNTUNGIN

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BATONG MALAKE

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

11

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

10

Tagalog

Christianity

BAYOG

Tagalog

Christianity

BAYOG

Code of Indicators under REMARKS column

Indicator

CCT Receipient

Code

Required Information

CCT

CCT Control/reference number & Effectivity Date

Balik Aral

B/A

Name of school last attended & Year

Learner With Disability


Accelerated

LWD

Specify

ACL

Specify Level & Effectivity Data

hool Form 1 (SF 1) School Register

GO

NGIN

KE

(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)

Laguna
2016 - 2017

Grade
ADDRESS

Barangay

Municipality/ City

Province

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

BAY

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

LOS BAOS

LAGUNA

REGISTERED

BoSY

MALE

20

FEMALE
26
TOTAL

46

EoSY

District
Grade 5

Father's Name (Last Name, First Name, Middle Name)

Mother's Maiden Name (Last


Name, First Name, Middle

AGRISOLA, EDCELL MALIHAN

MATUNDAN, GINALYN
DIMATIRA

AMPARO, DINDO RAMIREZ

VALLEJOS, CONNIE SANTOS

BIENES, RONALDO BAYLON

BIENES, SALLY MEJIA

CIDELLO, NORWIN CASTILLO

PERALTA, MELINDA QUILALA

DELMINGUEZ, SALVADOR ANGELES

DELOS REYES, JOSEFA


GUEVARRA

DUMAGCO, KENNETH FLORES

SUIZA, JERALYN GO

ENOKIZONO, RYOCHI TONEMOTO

QUILLOY, EVA GRACE LABIOS

ESCOBIN, NICOMEDES HINTURAL

CENTENO, MARJORIE
JORDAN

ESPLANA, ABSALON BARRAMEDA

LABAJO, JOSEPHINE JORDAN

GABALES, RICHARD MAAT


HORIGUE, HERVEY BARCALA
TANDANG, CRYSLER SUAREZ

DEANGKINAY, MAILYN
CARILLAGA
GABALES, PERALTA
VALENZUELA
ESCOBIN, MA CRISTINA
PASUQUIN
MANAGAT, JEMERLYN
LAPITAN

MAKILING, LADISLAO TANDANG

GALVEZ, EDNA NICHOLAS

PELOBELLO, PRECIOUS CHRISTIANO

PALOMINO, MAYRA BADILLA

REYES, ALLAN FERMANES

BAQUILAR, GRACE VALDEZ

SUMBINGCO, ARVIN TANDANG

CONARCO, CRISTINE JOY


PINEDA

TIMOSAN, EMMANUEL PAMULAKLAKIN

SALAS, HAYDEE CECILIANO

VENTURA, ROMER BASILIO

AZURES, SANDRA MARCOS

VILLANUEVA, BELLO COLONA


ALVARO, ROMAN PASCUAL
BACOD, RUEL CAPONPON
BAGSIC, WILLIAM BAUTISTA
DIFUNTORUM, ADRIAN TANDANG

MENGURIA, ROWENA
QUILLOY
PAMULAKLAKIN, CECILIA
DEANGKINAY
LAPITAN, RINA ELINDO
BALAWED, MA CHRISTINA
CASACLANG
MARQUEZ, JACKIELOU
BALAGUER

BARAYANG, NEIL AGUILA

SARASAP, CRISTINA TUBOG

BLANCO, JOSELITO TANDANG

TANDANG, IRENEE MANAGAT

CALPO, ROMEL CAPUNITAN

CASTILLO, EDUARDA
ARELLANO

CECILIANO, GILMAR BENALLA

CAHUCOM, MERALYN JANET

DE LUNA, FELIZARDO LUNA

ILAGAN, MARLYN LEONA

GUZMAN, RAMER BELDIA

CUPON, ANNMELODY
PATINIO

HINTURAL, DANTE MENDOZA

FABOR, SALVE CALISO

HINTURAL, RODEL CARPIO

VELASCO, AMELIA GALLARTE

HORIGUE, JOHN MARTIN BARCALA

RENALES, MARY ANN


BRIONES

LEONIDAS, EDMUNDO ANTONES

MENGURIA, WILMA QUILLOY

MADAYAG, JAYSON DE VERA

CUNANAN, MA. CRISTINA


CAS

MAGBOO, REYNALDO MANAGAT

QUILLOY, MARITES TANDANG

MANUEL, FLORANTE YUTOC

RIZAL
GUARDIAN
(if Not Parent)

PARENTS

EVANGELISTA, NORMAN PERALTA

Los Baos

Section

MANIBOG, MAUREEN
BANASIHAN
FELIX, JOSEPHINE DE LA
CRUZ

MELANIO, LUIS ORTIZ

DE ADA, DOMINGA PANER

MILAGROSA, RICKY BERNABE

BEJONA, NARCISA
DIANGKINAY

Name

MOJICA, RONALD VINADAS

BANASIHAN, JOCELYN PONCE

MOLDEZ, MICHAEL SOLINAP

LANUANG, MELINDA
LANTICAN

MULLER, JO HANSRUEDI WEBER

GARCIA, JASMIN BANASIHAN


PEREZ, MAXIMA DELOS
REYES
CARILLAGA, CONSORCIA
SAPIN

RIOLA, ROBERTO ALCAYAGA


SAPAIH, SAMIR TAWANEE
TAMAYO, SHERWIN EROLES

EoSY

CABANILLA, LORNA BRINGAS

Prepared by;

Certified Correct:

LERMA LANSIN LITARGO

GIS

(Signature of Adviser over Printed Name)

BoSY Date:

EoSY Date:

(Signature of S

BoSY Date:

Los Baos
RIZAL

DIAN
Parent)
Relationship

REMARKS
Contact Number of Parent or
Guardian
(Please refer to the legend on
last page)

Certified Correct:

BoSY Date:

GISELA ILAGAN PINGAD


(Signature of School Head over Printed Name)

EoSY Date:

School ID

108304

Name of School

No.

NAME
(Last Name, First Name, Middle Name)
T

ALVAREZ, ANGELITO O.

AMPARO, BRENDERICK I. JR

ANASTACIO, VINCENT I.

BELLO, JEFF CHENT

BINAMIRA, JOHN LESTER E.

CEDILLO, NORWIN JOHN P.

DELA CRUZ, JEROLL C.

ESPADILLA, ADRIAN S.

GUZMAN, RALPH ALLEN C.

10

LAPIE, RUSSEL E.

11

LITARGO, ADRIAN JAMES L.

12

MARASIGAN, TIMOTHY JAMES R.

13

MELODILLAR, JOHN ZORDIC C.

14

MULLER, JO HANSRUEDI G. II

15

REYES, JOHN HARRY L.

16

REYES, VON FRANCIS D.

17

RIOLA, ISAAC KIER P.


1

ACEBEDO, CRYSTAGENE G.

ALTICHE, ANDREA O.

BORJA, ARIANNE GRACE O.

BUAG, NIKKIE DANIELLE O.

CALUGAY, TRISHA T.

CASIO, KATE IRISH E.

CLAVE, KYLA Q.

CURA, CASSANDRA SHANE A.

DE BORJA, KATRINA GLEZY I.

10

DIZON, ALTHEA JODI C.

11

EMOLAGA, SAMANTHA ISABEL M.

12

GATCHALIAN, RAIZA E.

13

HERVACIO, MARJORIE O.

14

JIMENEZ, URIKO MEI B.

15

MANGERON, HANAHMAE B.

16

MILAGROSA, KIMBERLY CARMEN S.

17

MOLDEZ, ALTHEA JOY C.

18

PAMULAKLAKIN, NICOLE L.

19

PAR, BEATRICE ANNE P.

20

PRESA, RICAZEL ANNE S.

21

REYES, ELAINE FRANCESCA D.

22

TANDANG, JODIE ANNE L.

23

TERROBIAS, REICHELLE JOI D.

23

<=== FEMALE | TOTAL Per Day ===>

40

Combined TOTAL Per Day

GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:

a. Percentage of Enrolment =

b. Average Daily Attendance =

c. Percentage of Attendance for the month =

4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summary table into School Form 4. Once signed by the principal, this f
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days and/or those at risk of dropping
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.

*Beginning of School Year cut-off report is every 1st Friday of the School Year

Sch
2016 - 2017

School Year

BAYOG ELEMENTARY SCHOOL

TH

TH

Registered Learners as of end of the month

Enrolment as of 1st Friday of the school year


Total Daily Attendance
Number of School Days in reporting month
Average daily attendance
Registered Learners as of end of the month

Form 4. Once signed by the principal, this form should be returned to the adviser.
utive days and/or those at risk of dropping out.

School Form 2 (SF2) Daily Attendance Report of Learners


(This replaces Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

Report for the Month of


Grade Level

TH

1. CODES FOR CHECKING ATTENDANCE

2. REASONS/CAUSES FOR DROPPING OUT

a. Domestic-Related Factors

x 100
a.1.
a.2.
a.3.
a.4.

Had to take care of siblings


Early marriage/pregnancy
Parents' attitude toward schooling
Family problems

x 100
b. Individual-Related Factors
b.1.
b.2.
b.3.
b.4.
b.5.
b.6.
b.7.

Illness
Overage
Death
Drug Abuse
Poor academic performance
Lack of interest/Distractions
Hunger/Malnutrition

c. School-Related Factors

c.1. Teacher Factor


c.2. Physical condition of classroom
c.3. Peer influence

d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters

e. Financial-Related
e.1. Child labor, work
f. Others (Specify)

earners

Grade 6

TH

TH

CKING ATTENDANCE

ES FOR DROPPING OUT

ed Factors

of siblings
pregnancy
toward schooling

ed Factors

erformance
Distractions
tion

Factors

n of classroom

ironmental

en home and school


ncl. Tribal wars & clanfeuds)
sters

(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer, Lower for Cutting Classes)

RIZAL

Section

Total for the Month


F

ABSENT

TARDY

REMARKS (If DROPPED OUT, state reason, please refer to legend


number 2. If TRANSFERRED IN/OUT, write the name of School.)

Month:

No. of Days of Classes:

Summary
M

17

23

17

23

Dropped out

Transferred out

Transferred in

* Enrolment as of (1st Friday of June)

Late Enrollment during the month

(beyond cut-off)

Registered Learners as of
end of month

Percentage of Enrolment as of
end of month

Average Daily Attendance

Percentage of Attendance for the month


Number of students absent for 5 consecutive days

I certify that this is a true and correct report.

CRISTINE C. AGUINALDO
(Signature of Adviser over Printed Name)

Attested by:

GISELA I. PINGAD
(Signature of School Head over Printed Name)

e reason, please refer to legend


OUT, write the name of School.)

Summary
TOTAL

40

40

0
0

ABELLA, MARLON
AGUILAR, ANDREI MAURICE C.
BANASIHAN, JOHN CHRISTIAN B.
CACHOLA, PJ M.
CEREZA, JASTHEN O.
CEREZO, JESSIE JR B.
DELOS REYES, ANTHONY J.
DIAZ, JOSHUA L.
ERASGA, DANREV L.
ESCOBIN, JAYVIE T.
GABRIEL, JOHN CHRISTIAN M.
GRICALDA, JERWELL B.
MARANAN, JOHN REYMART B.
MOLDEZ, REAVER SOLOMONE A.
MONTAO, JOSHUA C.
OLIVA, JEROME C.
PAMULAKLAKIN, CHRISTIAN M.
QUILLOY, JOHN KOBE C.
RANCES, JOHN C.
SANGALANG, ALEJANDRO C.
VALEZA, EURIE V.
BALAHADIA, ASHLLEY C.
CARPIO, ASHLEY MAE A.
DALIVA, GIORIS AZEL C.
EBEC, CLARENCE B.
ESCOBIN, RUFFA MAE T.
HINTURAL, GERALDINE C.
LUMAYBAY, ALTHEA AIRA S.
MONTAO, GESAIRAH JANE M.
MORRON, JOANA MAY P.
ONOYA, DIANA MAE S.
PAJARIT, JOEYLYN S.
PAMULAKLAKIN, JOAN B.
PAMULAKLAKIN, LEAN L.
QUIMBA, CHRISTINE ANN T.
VALENTINO, DESIREE JHOY M.
VALENZUELA, JADE A.
VIRAY, SAMANTHA MJ C.

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