Scribd Logo
Upload

Welcome to Scribd!

  • TA Form

    Uploaded by

    Edwin Lopez
    51 views2 pages
    TA Form

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    TA Form

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    51 views2 pages

    TA Form

    Uploaded by

    Edwin Lopez
    TA Form

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    Republic of the Philippines

    DEPARTMENT OF EDUCATION
    Regional Office No. 02 (Cagayan Valley)
    SCHOOLS DIVISION OFFICE OF CAGAYAN
    Regional Government Center, Carig Sur, Tuguegarao City, 3500

    LIS CHANGE REQUEST AND ISSUANCE OF LRN FORM

    Control Number: ___________________ Date:_______________________


    CLIENT INFORMATION CHANGE REQUEST
    Enrolment with gap
    Name:____________________________________
    Reason/s for the gap (pls specify) ___________
    Position/Designation:________________________
    _________________________________________
    School ID and Name:________________________
    _________________________________________
    Contact Number:___________________________
    _________________________________________
    E-mail address: ____________________________
    Enrolment of ineligible
    ISSUANCE OF NEW LRN
    Erroneously tag EOSY/no status
    Name of the learner: ________________________
    Correct status: _________________________
    Section: __________________________________
    Reason for the correction:_________________
    Reasons for not having LRN:
    _________________________________________
    1. From accredited/recognized school
    _________________________________________
    School year last attended: _________________
    Others (pls specify): ________________________
    School last attended: _____________________
    2. Undergone catch-up program and assessed _________________________________________
    school readiness _________________________________________
    Result of the assessment: __________________ _________________________________________
    _______________________________________ _________________________________________
    3. From not accredited local school
    Certification/Accreditation/Equivalency Exam: (For Planning Officer’s use only)
    a. PEPT Certificate no. _______________
    Approved Disapproved
    b. PVT Certificate no. ________________
    4. From foreign/Philippine school abroad REMARKS/ ACTION TAKEN
    _________________________________________
    Last school year attended: _________________
    _________________________________________
    Last school attended: _____________________
    _________________________________________
    Country: _______________________________ _________________________________________
    5. From ALS _________________________________________
    Certification/Accreditation/Equivalency Exam: Date Acted: _______________________________________

    a. PEPT Certificate no. _________________


    Received/Acted by:
    b. PVT Certificate no. _________________
    6. Others (pls specify) ___________________ EDLYNNE QAE A. CALAYAN
    ___________________________________ Planning Officer III

    (078) 377-1065 Deped Tayo – Division of Cagayan Document Code: FM-SGO-PLA-001


    https://deped-sdocagayan.com.ph Rev.: 00
    sdo.cagayan@deped.gov.ph As of: 07-02-2018
    Republic of the Philippines

    DEPARTMENT OF EDUCATION
    Regional Office No. 02 (Cagayan Valley)
    SCHOOLS DIVISION OFFICE OF CAGAYAN
    Regional Government Center, Carig Sur, Tuguegarao City, 3500

    (078) 377-1065 Deped Tayo – Division of Cagayan Document Code: FM-SGO-PLA-001


    https://deped-sdocagayan.com.ph Rev.: 00
    sdo.cagayan@deped.gov.ph As of: 07-02-2018

    You might also like