[MG Form 1)

Republic of the Philippines

Department of Education
Region VIII [Eastern Visayas]
DIVISION OF LEYTE
Government Center, Palo Leyte

MULTIGRADE SCHOOL PROFILE CARD

[January 2020]
SCHOOL PROFILE
School ID No.:: ___________ School:____________________ Year Established: _________District: ________________ Area: _______
Distance from District Office (Klmtrs]: ____Location [please check]: Plain _____Upland _____Coastal____Riverside______ Island_________
_

SBM Level of Practice [please check]: __ ____ Validated by [please check]: District_ _ Area____ Division____ Region_______

SCHOOL HEAD’s PROFILE

Name of School Head____________________________ Sex: ___ Civil Status:____________ Birthdate: ______________ Age: ___
Position/Title: ____________________ Year/s as MG School Head in this School: _________ Highest Educational Attainment: _________
Type of Management [please check]: Immediate Head: ___ Cluster Head: ________ Office-In-Charge of the School: ________
Active Cellphone Number: ________________ Active e-Mail Add: __________________________________
MULTIGRADE TEACHER’s PROFILE
MG Teacher: MG Teacher:
Sex: Civil Status: Sex: Civil Status:
Birthdate: Age: Birthdate: Age:
Position/Title: Year/s as MG Teacher: Position/Title: Year/s as MG Teacher:
Highest Educational Attainment: Highest Educational Attainment:
Cp Number: e-Mail Add: Cp Number: e-Mail Add:
ENROLMENT ENROLMENT
Grade Level Boys Girls Total Grade Level Boys Girls Total

Grand Total Grand Total

MG Teacher: MG Teacher
Sex: Civil Status: Sex: Civil Status:
Birthdate: Age: Birthdate: Age:
Position/Title: Year/s as MG Teacher: Position/Title: Year/s as MG Teacher:
Highest Educational Attainment: Highest Educational Attainment:
Cp Number: e-Mail Add: Cp Number: e-Mail Add:
ENROLMENT ENROLMENT
Grade Level Boys Girls Total Grade Level Boys Girls Total

Grand Total Grand Total

MG Teacher MG Teacher
Sex: Civil Status: Sex: Civil Status:
Birthdate: Age: Birthdate: Age:
Position/Title: Year/s as MG Teacher: Position/Title: Year/s as MG Teacher:
Highest Educational Attainment: Highest Educational Attainment:
Cp Number: e-Mail Add: Cp Number: e-Mail Add:
ENROLMENT ENROLMENT
Grade Level Boys Girls Total Grade Level Boys Girls Total

Grand Total Grand Total

NOTE: Please just include the enrolment of the Kindergarten Class,if there is.