ICTS - User Support Division

Learner Information System National Helpdesk

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

Subject: Multiple LRN/Enrollment

Send to: support.ebeis-lis@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) Date of 1st
Correct Name Attendance OTHER
LRN (MM/DD/YYYY EXISTING LRN
Date of )
Region Division School School IDGrade Section (Currently First NameMiddle NameLast Name Ext Name Gender
Birth
Used)
JOSE D.
UDASCO KRISTEL DECEMBER
309009 X OBEDIENCE 403430150213 TORRELIZA PILOR FEMALE 6/5/2007 110340070034
ORIENTAL MANGANGA ANNE 27,2001
MIMAROPA MINDORO N I NHS

Reported by Teacher/ICT Coordinator Name of School School ID Division Region Endorsed by SARLEN. CASTILLO, Ph.D.
MIRIAM G. DATINGGALING JOSE D. UDASCO MANGANGAN I NHS 309009 ORIENTAL MINDORO MIMAROPA School Head Principal II

Fill up and email to

support.ebeis-lis@deped.gov.ph