emplate for Reporting Learners with Special Characters, Single Character and/or other Exemption on their name (Request

Form 06
Subject: Registration of Learner with Special Characters, Single Character and/or other Exemptions on name
Send to: icts.usd@deped.gov.ph
Note: Please attach a copy of Birth Certificate as supporting document
Currently Enrolled (Present enrollment)

Region Division School School ID Grade

USER ID:
NAME OF REQUESTING PERSONNEL:
DESIGNATION:

Section

Personal Information of Learners as Appeared in Birth Certificate

Correct LRN

First Name Middle Name Last Name

Ext Name

Date of
Birth

Gender

Date of 1st
Attendance
(MM/DD/YYYY)

REMARK

LIS HOUSE KEEPING REQUEST FORM (Request Form 05)

FOR PENDING MULTIPLE ENROLLMENT ISSUE ELEVATED TO CENTRAL OFFICE
Subject: Multiple Enrollment
Send to: icts.usd@deped.gov.ph
Copy furnish: Division Planning Unit
Note: Endorsement of School Head is required (signed and scanned). Please use worksheet/excel format for the matrix.
I. CURRENT ENROLLMENT AND BASIC PROFILE
as appeared in Birth Certificate

Currently Enrolled (Present enrollment)

Region

Division

School

School ID

Grade

Correct Name
Section

LRN
First Name Middle Name Last Name Ext Name
(Currently Used)

Date of
Birth

Date of 1st
Attendance
(MM/DD/YYYY
Gender
)

II. ENROLLMENT HISTORY AS APPEARED IN PERMANENT RECORD (FORM 137)

NAME OF SCHOOL
(Provide additional
row/s if needed)

DIVISION

REGIO School
N
Year

Grade/Year
Level

STATUS AS APPEARED IN FORM IS THIS ENROLLMENT

137
RECORD VALID? YES OR
(Promoted, Retained,
NO. (If NO, provide
Transferred Out, Dropout)
explanation)

III. REQUESTING SCHOOL

Reported
by

Teacher/ICT Coordinator

LIS USER NA

Name of School

School ID

Division

Region

Endorsed by
School Head

OTHER
EXISTING
LRN

Template for Reporting TWIN Learners that Merged Iden

Subject: TWIN Learners that Merged Identity

Send to: icts.usd@deped.gov.ph
Note: Endorsement of School Head is required (signed and scanned). Please use worksheet
Currently Enrolled (Present enrollment)

Region Division School School ID Grade

USER ID:
NAME OF REQUESTING PERSONNEL:
DESIGNATION:

Section

Personal Information of Learners as Appeared in Birth

Correct LRN

First Name Middle Name Last Name

hat Merged Identity (Request Form 04)

ease use worksheet/excel format for the matrix.

Learners as Appeared in Birth Certificate

Ext Name

Date of
Birth

Gender

Date of 1st
Attendance
(MM/DD/YYYY)

REMARK
Learner 1 (Twin 1)
Learner 2 (Twin 2)

Template for Enrollment with Data Issues (Request Form 02)

Subject: Enrollment with Possible Multiple Enrollment or Data Issues
Send to: icts.usd@deped.gov.ph
Note: Endorsement of School Head is required (signed and scanned). Please use worksheet/excel format for the matrix.
Currently Enrolled (Present enrollment)

Code:

Correct Name

1 - No enrollment Found

LRN
First Name Middle Name Last Name
(Currently Used)

Region Division School School ID Grade

Section

Reporte
d by

Name of School

Teacher/ICT Coordinator

as appeared in Birth Certificate

School ID

Ext Name

Division

Date of
Birth

Gender

Region

Date of 1st
2 - Update Failed
Attendance
(MM/DD/YYYY) 3 - Enrolment Failed

Endorsed by
School Head

Template for Reporting Multiple LRN/Enrollment (Request Form 01)

Subject: Multiple LRN/Enrollment
Send to: icts.usd@deped.gov.ph
Note: Endorsement of School Head is required (signed and scanned). Please use worksheet/excel format for the matrix.
as appeared in Birth Certificate

Currently Enrolled (Present enrollment)

Region Division School School ID Grade

Reporte
d by

Teacher/ICT Coordinator

LRN
Section
(Currently Used)

Name of School

Correct Name
First Name Middle Name Last Name

School ID

Ext Name

Division

Date of
Birth

Gender

Region

Date of 1st
Attendance
(MM/DD/YYYY)

Endorsed by
School Head

OTHER
EXISTING LRN