Scribd Logo
Upload

Welcome to Scribd!

  • Enrolment With Gap 1

    Uploaded by

    Clifford Tungpalan Borromeo
    9 views1 page

    Original Title

    Enrolment with Gap 1.docx

    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

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    9 views1 page

    Enrolment With Gap 1

    Uploaded by

    Clifford Tungpalan Borromeo

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Republic of the Philippines

    DEPARTMENT OF EDUCATION
    Region 02-Cagayan Valley
    SCHOOLS DIVISION OF ISABELA

    LIS CHANGE REQUEST AND ISSUANCE OF LRN FORM

    Control Number: ___________________ Date:_______________________


    CLIENT INFORMATION CHANGE REQUEST
    Name:_ALEX D. BEDAÑA Enrolment with gap
    Position/Designation: Teacher III/LIS Coordinator Reason/s for the gap (pls specify
    School ID and Name: 300565-PALAYAN REGION HS 103009050001 AGUSTIN, MARVIN JAY, SANTOS - The
    Contact Number:09977850285
    learner stopped during grade 11 second semester
    E-mail address: alexlone.ab@gmail.com
    school year 2016-2017 and completed the same
    subjects second semester school year 2017-2018.
    ISSUANCE OF NEW LRN
    Name of the learner: ________________________ The learner is a grade 12 regular student school

    Section: __________________________________ year 2018-2019.

    Reasons for not having LRN: Enrolment of ineligible

    From accredited/recognized Erroneously tag EOSY/no status


    Correct status: _________________________
    school
    Reason for the correction: ________________
    School year last attended:
    _________________________________________
    _________________
    School last attended:
    _________________________________________

    _____________________ Others (pls specify): _______________________


    _________________________________________
    Undergone catch-up program and
    _________________________________________
    assessed school readiness (For Planning Officer’s use only)
    _________________________________________
    Result of the assessment: ____________________________________________
    Approved Disapproved
    ______________________________ ________________________________________
    REMARKS/ ACTION TAKEN
    __________________________ _________________________________________
    From not accredited local school _________________________________________
    _________________________________________
    Certification/Accreditation/Equivalen _________________________________________
    cy Exam: _________________________________________
    Date Acted: _______________________________________
    PEPT Certificate no.
    Received/Acted by:
    _______________
    TIRSO T. REYES
    PVT Certificate no.
    Planning Officer III
    ________________
    FM-SGO-PLA-001 Rev. 00
    From foreign/Philippine school
    abroad

    You might also like