Professional Documents
Culture Documents
A4. Grade Level to enroll: A7. Last School Attended: A8. School ID: A11. School to enroll in: A12. School ID:
_______________________ ____________________________________ ___________________ ________________________________________ __________________
A5. Last grade level completed: A9. School Address: A13. School Address:
_______________________ ___________________________________________________________ _______________________________________________________________
A6. Last school year completed: A10. School Type:
_______________________ Public Private
TVL – HE: Cookery (NC II), Bread & Pastry Production (NC II)
B. STUDENT INFORMATION
B1. PSA Birth Certificate No. B2. Learner Reference
(if available upon enrolment) Number (LRN)
B9.
B8. Age Male Female
Sex
C2. Highest Educational Attainment C7. Highest Educational Attainment C12. Highest Educational Attainment
connection (library,
Master’s/Doctorate degree barangay/ municipal hall, Master’s/Doctorate degree Master’s/Doctorate degree
neighbor,
Did not attendrelatives)
school Did not attend school Did not attend school
none
Others: _______________ Others: _______________ Others: _______________
Self-employed (i.e. family business) Self-employed (i.e. family business) Self-employed (i.e. family business)
Unemployed due to community quarantine Unemployed due to community quarantine Unemployed due to community quarantine
C4. Working from home due to community quarantine? C9. Working from home due to community quarantine? C14. Working from home due to community quarantine?
C5. Contact number/s (cellphone/ telephone) C10. Contact number/s (cellphone/ telephone) C15. Contact number/s (cellphone/ telephone)
D2. How many of your household members (including the enrollee) are studying D3. Who among the household members can
in School Year 2020-2021? Please specify each. provide instructional support to the child’s
distance learning? Choose all that applies.
Kinder Grade 4 Grade 8 Grade 12 parents/ guardians others (tutor, house
_______ ______ ______ ______ helper)
Grade 1 Grade 5 Grade 9 Others (ie
college, vocational, elder siblings none
_______ ______ ______
etc) _______ able to do
grandparents
Grade 2 Grade 6 Grade 10 independent learning
_______ ______ ______ extended members
Grade 3 Grade 7 Grade 11 of the family
_______ ______ ______
D4. What devices are D5. Do you D6. How do you connect to
available at home that have a way to the internet? Choose all
the learner can use for connect to that applies.
learning? Check all that the internet?
applies.
Yes
cable TV
non-cable TV No
basic cellphone (If NO, proceed to D7)
smartphone
tablet
D7. What distance learning modality/ies do you D8. What are the challenges that may affect your child’s learning process
prefer for your child? Choose all that applies. through distance education? Choose all that applies.
lack of available gadgets/ conflict with other activities (i.e., house chores)
online modular learning equipment
learning insufficient load/ data allowance No or lack of available space for studying
combination of face to
television unstable mobile/ internet
face with other modalities distractions (i.e., social media, noise from
radio others: connection community/neighbor)
________________ existing health condition/s others: ______________________________
difficulty in independent learning
I hereby certify that the above information given are true and correct to the best of my knowledge and I allow the
Department of Education to use my child’s details to create and/or update his/her learner profile in the Learner Information
System. The information herein shall be treated as confidential in compliance with the Data Privacy Act of 2012.
Grade
Track (for SHS)
Level