Learner Enrollment and Survey Information Summary (SY 2020 - 2021)

Grade and Section: _______________________________________

Father's Information
INCOMING LEARNERS SY
2020-2021 C4. Working from
C3. Employment Status home due to ECQ

Nane of
Learners C.1
Father Self- Unemplo
Not
C.7
Mother
Male Female Total Full Time Part Time Employe yed due YES No
Working
d to ECQ
 Mother's Information Guardian's Information
C10. Working from
C9. Employment Status home due to ECQ C15. Employment Status

C.13
Self- Unemplo Guardian Self- Unemplo
Not Not
Full Time Part Time Employe yed due YES NO Full Time Part Time Employe yed due
Working Working
d to ECQ d to ECQ
tion
C18. a beneficiary of
4Ps D1. HOW DOES YOUR CHILD GO TO SCHOOL? D2. How many of your household m
C16. Working from
home due to ECQ

Public
Family-
Commute School
YES NO YES NO Walking owned Kinder Grade 1 Grade 2 Grade 3
(Land/Wa Service
vehicle
ter)
 D3. Who among the household members can prov
D2. How many of your household members (including the enrollee) are studying in School the child’s distance learnin

Parents/
Elded Grand
Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Others Guardian Siblings parents
s

0 0 0 0 0 0 ###
0 0 0 0

0 0 0 0 0 0 ###
0 0 0 0

0 0 0 0 0 0 ###
0 0 0 0
 D4. What devices are available at home that the learner can use for learning?
he household members can provide instructional support to
the child’s distance learning?
With Television With Cellphone

With
Internet With With Dekstop
Extended Others Tablet/ Laptop
Members (Tutor, Able to do Connectio Smart Radio Computer
None independe n at Home Cable Non- Cable Basic Ipad
of the House nt learning phone
Family helper)

0 0 0 ###
0 0 0 0 0 0 0 0 0 0

0 0 0 ###
0 0 0 0 0 0 0 0 0 0

0 0 0 ###
0 0 0 0 0 0 0 0 0 0
for learning? D5. Do you have a D6. How do you connect to the internet? D7. What distance learning modality/ies do you prefer for yo
way to connect to the
internet

Own Other
Broadband Places
Outside
Own Internet Computer the Home
None Others:___ Mobile (DSL, Shop with None Online Television Radio
YES NO Data Wireless Internet
Fiber,
Satellite) Connectio
n

0 ###
0 0 ###
0 0 0 0 0 ###
0 0 0 0

0 ###
0 0 ###
0 0 0 0 0 ###
0 0 0 0

0 ###
0 0 ###
0 0 0 0 0 ###
0 0 0 0
learning modality/ies do you prefer for your child FOR SPED
D8. What are the challenges that may affect your child’s process through distance education?
Available Assisted
Device at Home

Distracti
Combinati Conflict ons (i.e.,
on of Face Lack of Insufficie Unstable Difficulty with No or lack social
Modular to Face Other Existing
available nt load/ mobile/ in other of media,
with other health
gadgets/ data internet independ activities available noise Others With
Modalities condition space for
equipme allowanc connecti ent (i.e., from
/s studying
nt e on learning house communi
chores) ty/neighb
or)

0 0 ###
0 0 0 0 0 0 0 0 0 0 0

0 0 ###
0 0 0 0 0 0 0 0 0 0 0

0 0 ###
0 0 0 0 0 0 0 0 0 0 0
 FOR SPED Number of Learners
move in from Private, SUC/LUC, and ALS to Public
Available Assisted schools
Device at Home

Elementa Learner
ry Junior Senior With
Without (Kinderg High High Disabiliti Total
arten to School School es (Non-
Grade 6) Graded)

0 0 0 0 0 0

0 0 0 0 0 0

0 0 0 0 0 0
Learner Enrollment and Survey Information Summary (SY 2020 - 2021)
Grade and Section: _______________________________________
Father's Information
INCOMING LEARNERS SY
2020-2021
C3. Employment Status

Name of
Learners C.1
Father Self- Unemplo
Not
Male Female Total Full Time Part Time Employe yed due
Working
d to ECQ
 Mother's Information
C4. Working from C9. Employment Status C10. Working from
home due to ECQ home due to ECQ

C.7
Mother Self- Unemplo
Not
YES No Full Time Part Time Employe yed due YES NO
Working
d to ECQ
 Guardian's Information
C18. a beneficiary of
C16. Working from 4Ps
C15. Employment Status
home due to ECQ

C.13
Guardian Self- Unemplo
Not
Full Time Part Time Employe yed due YES NO YES NO
Working
d to ECQ
D1. HOW DOES YOUR CHILD GO TO SCHOOL? D2. How many of your household members (includ

Public
Family-
Commute School
Walking owned Kinder Grade 1 Grade 2 Grade 3 Grade 4 Grade 5
(Land/Wa Service
vehicle
ter)

0
ur household members (including the enrollee) are studying in School D3. Who among the household member
the child’s dista

Parents/
Elded
Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Others Guardian Siblings
s

0 0 0 0 0 0 0 ###
0 0 0

0 0 0 0 0 0 0 ###
0 0 0

0 0 0 0 0 0 0 ###
0 0 0
 D4. What devices are available at home that the lea
among the household members can provide instructional support to
the child’s distance learning?
With Television With Cellphone

With
Extended Others Internet
Grand Members (Tutor, Able to do Connectio Smart
None independe n at Home Cable Non- Cable Basic
parents of the House nt learning phone
Family helper)

0 0 0 0 ###
0 0 0 0 0 0

0 0 0 0 ###
0 0 0 0 0 0

0 0 0 0 ###
0 0 0 0 0 0
e available at home that the learner can use for learning? D5. Do you have a D6. How do you connect to the
way to connect to the
internet

Own
Broadband
With With Dekstop Own Internet
Tablet/ Radio Computer Laptop None Others:___ Mobile (DSL,
Ipad YES NO Data Wireless
Fiber,
Satellite)

0 0 0 0 0 ###
0 0 ###
0 0 0

0 0 0 0 0 ###
0 0 ###
0 0 0

0 0 0 0 0 ###
0 0 ###
0 0 0
6. How do you connect to the internet? D7. What distance learning modality/ies do you prefer for your child
D8. What are the challe

Other
Places Combinati
Outside
Computer the Home on of Face Lack of
Shop with None Online Television Radio Modular to Face Other available
Internet with other gadgets/
Modalities
Connectio equipme
n nt

0 0 ###
0 0 0 0 0 0 ###
0 0

0 0 ###
0 0 0 0 0 0 ###
0 0

0 0 ###
0 0 0 0 0 0 ###
0 0
 FOR SPED
D8. What are the challenges that may affect your child’s process through distance education?
Available Assisted
Device at Home

Distracti
Conflict ons (i.e.,
Insufficie Unstable Difficulty with No or lack social
Existing
nt load/ mobile/ in other of media,
health
data internet independ activities available noise Others With Without
condition space for
allowanc connecti ent (i.e., from
/s studying
e on learning house communi
chores) ty/neighb
or)

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0
 Number of Learners
move in from Private, SUC/LUC, and ALS to Public
schools

Elementa Learner
ry Junior Senior With
(Kinderg High High Disabiliti Total
arten to School School es (Non-
Grade 6) Graded)

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
Learner Enrollment and Survey Information Summary (SY 2020 - 2021)
Grade and Section: _______________________________________
Father's Information
INCOMING LEARNERS SY
2020-2021
C3. Employment Status

Name of
Learners C.1
Father Self- Unemplo
Not
Male Female Total Full Time Part Time Employe yed due
Working
d to ECQ
 Mother's Information
C4. Working from C9. Employment Status C10. Working from
home due to ECQ home due to ECQ

C.7
Mother Self- Unemplo
Not
YES No Full Time Part Time Employe yed due YES NO
Working
d to ECQ
 Guardian's Information
C18. a beneficiary of
C16. Working from 4Ps
C15. Employment Status
home due to ECQ

C.13
Guardian Self- Unemplo
Not
Full Time Part Time Employe yed due YES NO YES NO
Working
d to ECQ
D1. HOW DOES YOUR CHILD GO TO SCHOOL? D2. How many of your household members (includ

Public
Family-
Commute School
Walking owned Kinder Grade 1 Grade 2 Grade 3 Grade 4 Grade 5
(Land/Wa Service
vehicle
ter)
ur household members (including the enrollee) are studying in School D3. Who among the household member
the child’s dista

Parents/
Elded
Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Others Guardian Siblings
s
 D4. What devices are available at home that the lea
among the household members can provide instructional support to
the child’s distance learning?
With Television With Cellphone

With
Extended Others Internet
Grand Members (Tutor, Able to do Connectio Smart
None independe n at Home Cable Non- Cable Basic
parents of the House nt learning phone
Family helper)
e available at home that the learner can use for learning? D5. Do you have a D6. How do you connect to the
way to connect to the
internet

Own
Broadband
With With Dekstop Own Internet
Tablet/ Radio Computer Laptop None Others:___ Mobile (DSL,
Ipad YES NO Data Wireless
Fiber,
Satellite)
6. How do you connect to the internet? D7. What distance learning modality/ies do you prefer for your child
D8. What are the challe

Other
Places Combinati
Outside
Computer the Home on of Face Lack of
Shop with None Online Television Radio Modular to Face Other available
Internet with other gadgets/
Modalities
Connectio equipme
n nt

###
0 0 0 0 0 0 ###
0 0

###
0 0 0 0 0 0 ###
0 0

###
0 0 0 0 0 0 ###
0 0
 FOR SPED
D8. What are the challenges that may affect your child’s process through distance education?
Available Assisted
Device at Home

Distracti
Conflict ons (i.e.,
Insufficie Unstable Difficulty with No or lack social
Existing
nt load/ mobile/ in other of media,
health
data internet independ activities available noise Others With Without
condition space for
allowanc connecti ent (i.e., from
/s studying
e on learning house communi
chores) ty/neighb
or)

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0
 Number of Learners
move in from Private, SUC/LUC, and ALS to Public
schools

Elementa Learner
ry Junior Senior With
(Kinderg High High Disabiliti Total
arten to School School es (Non-
Grade 6) Graded)

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
Learner Enrollment and Survey Information Summary (SY 2020 - 2021)
Grade and Section: _______________________________________
Father's Information
INCOMING LEARNERS SY
2020-2021
C3. Employment Status

Name of
Learners C.1
Father Self- Unemplo
Not
Male Female Total Full Time Part Time Employe yed due
Working
d to ECQ
 Mother's Information
C4. Working from C9. Employment Status C10. Working from
home due to ECQ home due to ECQ

C.7
Mother Self- Unemplo
Not
YES No Full Time Part Time Employe yed due YES NO
Working
d to ECQ
 Guardian's Information
C18. a beneficiary of
C16. Working from 4Ps
C15. Employment Status
home due to ECQ

C.13
Guardian Self- Unemplo
Not
Full Time Part Time Employe yed due YES NO YES NO
Working
d to ECQ

0 0 0 0 00 0 00

0 0 0 0 00 0 00

0 0 0 0 00 0 00
D1. HOW DOES YOUR CHILD GO TO SCHOOL? D2. How many of your household members (includ

Public
Family-
Commute School
Walking owned Kinder Grade 1 Grade 2 Grade 3 Grade 4 Grade 5
(Land/Wa Service
vehicle
ter)

0 0 0 00 0 0 0 0 0 0

0 0 0 00 0 0 0 0 0 0

0 0 0 00 0 0 0 0 0 0
ur household members (including the enrollee) are studying in School D3. Who among the household member
the child’s dista

Parents/
Elded
Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Others Guardian Siblings
s

0 0 0 0 0 0 0 ###
0 0 0

0 0 0 0 0 0 0 ###
0 0 0

0 0 0 0 0 0 0 ###
0 0 0
 D4. What devices are available at home that the lea
among the household members can provide instructional support to
the child’s distance learning?
With Television With Cellphone

With
Extended Others Internet
Grand Members (Tutor, Able to do Connectio Smart
None independe n at Home Cable Non- Cable Basic
parents of the House nt learning phone
Family helper)

0 0 0 0 ###
0 0 0 0 0 0

0 0 0 0 ###
0 0 0 0 0 0

0 0 0 0 ###
0 0 0 0 0 0
e available at home that the learner can use for learning? D5. Do you have a D6. How do you connect to the
way to connect to the
internet

Own
Broadband
With With Dekstop Own Internet
Tablet/ Radio Computer Laptop None Others:___ Mobile (DSL,
Ipad YES NO Data Wireless
Fiber,
Satellite)

0 0 0 0 0 ###
0 0 ###
0 0 0

0 0 0 0 0 ###
0 0 ###
0 0 0

0 0 0 0 0 ###
0 0 ###
0 0 0
6. How do you connect to the internet? D7. What distance learning modality/ies do you prefer for your child
D8. What are the challe

Other
Places Combinati
Outside
Computer the Home on of Face Lack of
Shop with None Online Television Radio Modular to Face Other available
Internet with other gadgets/
Modalities
Connectio equipme
n nt

0 0 ###
0 0 0 0 0 0 ###
0 0

0 0 ###
0 0 0 0 0 0 ###
0 0

0 0 ###
0 0 0 0 0 0 ###
0 0
 FOR SPED
D8. What are the challenges that may affect your child’s process through distance education?
Available Assisted
Device at Home

Distracti
Conflict ons (i.e.,
Insufficie Unstable Difficulty with No or lack social
Existing
nt load/ mobile/ in other of media,
health
data internet independ activities available noise Others With Without
condition space for
allowanc connecti ent (i.e., from
/s studying
e on learning house communi
chores) ty/neighb
or)

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0
 Number of Learners
move in from Private, SUC/LUC, and ALS to Public
schools

Elementa Learner
ry Junior Senior With
(Kinderg High High Disabiliti Total
arten to School School es (Non-
Grade 6) Graded)

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
Learner Enrollment and Survey Information Summary (SY 2020 - 2021)
Grade and Section: _______________________________________
Father's Information
INCOMING LEARNERS SY
2020-2021 C4. Working from
C3. Employment Status home due to ECQ

Name of
Learners C.1
Father Self- Unemplo
Not
C.7
Mother
Male Female Total Full Time Part Time Employe yed due YES No
Working
d to ECQ
 Mother's Information Guardian's Information
C10. Working from
C9. Employment Status home due to ECQ C15. Employment Status

C.13
Self- Unemplo Guardian Self- Unemplo
Not Not
Full Time Part Time Employe yed due YES NO Full Time Part Time Employe yed due
Working Working
d to ECQ d to ECQ
tion
C18. a beneficiary of D1. HOW DOES YOUR CHILD GO TO SCHOOL? D2. How many of your household m
C16. Working from 4Ps
home due to ECQ

Public
Family-
Commute School
YES NO YES NO Walking owned Kinder Grade 1 Grade 2 Grade 3
(Land/Wa Service
vehicle
ter)
D2. How many of your household members (including the enrollee) are studying in School D3. Who among the household members can prov
the child’s distance learnin

Parents/
Elded Grand
Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Others Guardian Siblings parents
s
 D4. What devices are available at home that the learner can use for learning?
he household members can provide instructional support to
the child’s distance learning?
With Television With Cellphone

With With
Extended Others Internet Tablet/ With Dekstop Laptop
Able to do Connectio Radio Computer
Members (Tutor, None independe n at Home Cable Non- Cable Basic Smart Ipad
of the House phone
Family helper) nt learning

0 0 ###
0 0 0 0 0 0 0 0 0 0

0 0 ###
0 0 0 0 0 0 0 0 0 0

0 0 ###
0 0 0 0 0 0 0 0 0 0
for learning? D5. Do you have a D6. How do you connect to the internet? D7. What distance learning modality/ies do you prefer for yo
way to connect to the
internet

Other
Own Places
Broadband Outside
Own Internet
None Others:___ Mobile (DSL, Computer the Home None Online Television Radio
Data Wireless Shop with
YES NO Internet
Fiber, Connectio
Satellite) n

0 ###
0 0 ###
0 0 0 0 0 ###
0 0 0 0

0 ###
0 0 ###
0 0 0 0 0 ###
0 0 0 0

0 ###
0 0 ###
0 0 0 0 0 ###
0 0 0 0
learning modality/ies do you prefer for your child FOR SPED
D8. What are the challenges that may affect your child’s process through distance education?
Available Assisted
Device at Home

Distracti
Combinati Conflict ons (i.e.,
on of Face Lack of Insufficie Unstable Difficulty with No or lack social
Modular to Face Other Existing
available nt load/ mobile/ in other of media,
with other health
gadgets/ data internet independ activities available noise Others With
Modalities condition space for
equipme allowanc connecti ent (i.e., from
/s studying
nt e on learning house communi
chores) ty/neighb
or)

0 0 ###
0 0 0 0 0 0 0 0 0 0 0

0 0 ###
0 0 0 0 0 0 0 0 0 0 0

0 0 ###
0 0 0 0 0 0 0 0 0 0 0
 FOR SPED Number of Learners
move in from Private, SUC/LUC, and ALS to Public
Available Assisted schools
Device at Home

Elementa Learner
ry Junior Senior With
Without (Kinderg High High Disabiliti Total
arten to School School es (Non-
Grade 6) Graded)

0 0 0 0 0 0

0 0 0 0 0 0

0 0 0 0 0 0