School Form 1 (SF 1) School Register

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

School ID 411566 Region I Division Pangasinan I, Lingayen District Calasiao I

School Name Brilliant Achievers Learning Center School Year 2016 - 2017 Grade Pre- Section NO SECTION

GUARDIAN Contact
AGE MOTHE ADDRESS PARENTS
(if Not Parent) Number

Sex (M/F)
as of R
NAME IP of
BIRTH DATE 1st TONGUE RELIGIO Father's Name Mother's
LRN (Last Name, First Name, Middle (Ethnic House #/ Parent
(mm/dd/yyyy) Frida (Grade N (Last Name, Maiden Name
Name) Group) Street/ Municipality Relationsh or
y 1 to 3 Barangay Province First Name, (Last Name, Name
Sitio/ / City ip Guardia
June Only) Middle Name) First Name,
Purok n
Middle
PEDEGLORIO,F
DOMALANTA,
DOMALANTA, FRANZ Pangasi ALE
411566160001 M 08-17-2012 3 MALABAGO CALASIAO PANGASINAN MARJOHN
MARJOHN PEDEGLORIO nan AMIS,DOMAGA
MENOR
S,
ESCUBIO,
ESCUBIO, CLINT ANDREW DM Pangasi DAGUPAN ESCUBIO,GLE
411566160003 M 01-19-2013 3 LUCAO PANGASINAN ERICSON
RAMIREZ nan CITY NDA,RAMIREZ,
MALIKSI
ESCUBIO,
ESCUBIO, CLYDE ANDREI DM Pangasi DAGUPAN ESCUBIO,GLE
411566160004 M 01-19-2013 3 LUCAO PANGASINAN ERICSON
RAMIREZ nan CITY NDA,RAMIREZ,
MALIKSI
GARCIA,
Pangasi GARCIA,JANET,
411566160005 GARCIA, JANRHEY PAGALA M 02-07-2012 4 MALABAGO CALASIAO PANGASINAN RAYMOND
nan PAGALA,
QUEÑANO
GARCIA,
GARCIA, JOHN RONMAR Pangasi GARCIA,MARIA
411566160006 M 06-01-2012 4 NAGSAING CALASIAO PANGASINAN RONALD
GABRIEL nan EN,GABRIEL,
MACARAEG

MAMARADLO, MAMARADLO,
MAMARADLO, RANZ MICKO Pangasi
411566160009 M 05-13-2013 3 MALABAGO CALASIAO PANGASINAN RANDY MERCEDITA,C
CORPUZ nan
BALLESTEROS ORPUZ,

PANCHO, XHENIELLE ANDRIE Pangasi

411566160008 M 01-03-2013 3 LONGOS CALASIAO PANGASINAN ,
DE VERA nan

7 <=== TOTAL MALE

ABALOS,ANNA
EMPIMANO, KHRISTINE ALEXI Pangasi EMPIMANO,
411566160002 F 12-26-2012 3 MALABAGO CALASIAO PANGASINAN MARIE,OFGUA
ABALOS nan JONAS JANDA
R,

MAMINTA,
MAMINTA, RHYCEL FAYE Pangasi MAMINTA,LOW
411566160007 F 01-27-2012 4 MALABAGO CALASIAO PANGASINAN ARSENIO
OSUNA nan ELA,OSUNA,
BALLESTEROS

SORIANO,
SORIANO,JEAN
SORIANO, SAAB CARMELLA Pangasi NELSON
411566160010 F 12-29-2012 3 DOYONG CALASIAO PANGASINAN NEROSE,SAPL
SAPLAN nan DENSIS DE
AN,
VERA

3 <=== TOTAL FEMALE

10 <=== COMBINED

List and Code of Indicators under REMARKS column

Cod Cod Prepared by; Certified Correct:
Indicator Required Information Indicator Required Information REGISTERED BoSY EoSY
e e
N

REMARKS

(Please refer
to the legend
on last page)
Transfered Out T/O Name of Public (P) Private (PR) School & CCT Receipient CCT CCT Control/reference number &
Effectivity Date Effectivity Date MALE 7
Balik Aral B/A BRILLIANT ACHIEVERS LEARNING CENT
Transfered In T/I Name of Public (P) Private (PR) School & Name of school last attended & Year
(Signature of Adviser over Printed (Signature of School Head over Prin
Effectivity Date Learner With LW FEMALE 3 Name) Name)
Disability D Specify
Dropped DRP Reason and Effectivity Date Accelerated
LE Reason (Enrollment beyond 1st Friday of ACL Specify Level & Effectivity Data TOTAL 10
BoSY Date: EoSY Date: BoSY Date: EoSY Date:

Generated on: Friday, April 7, 2017

S LEARNING CENTER
l Head over Printed
me)

EoSY Date: