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FORM 2: LAC Facilitator Information Sheet

This form should be accomplished by the designated LAC Facilitator on or before the first LAC
session.

Region: VII

Division: Talisay City

NAME: DARREN Male/Female: Male Date of Birth: Age: 26


DAVE A. BERNAS December 30, 1993

Contact details: Email: Mobile Number: Facebook Name:


darrendave.bernas@ 09453812472 Dazzier Ruzic
deped.gov.ph 09617096724

Preferred contact
mode: email, phone, Google Meet, FB, Messenger

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