Professional Documents
Culture Documents
STUDENT INFORMATION
PSA Birth Certificate No.
Learner Reference No. (LRN)
LAST NAME
FIRST NAME
MIDDLE NAME ANNEX 2
EXTENSION NAME e.g. Jr., III (if applicable)
DATE OF BIRTH / / SEX MALE FEMALE AGE
(Month/Day/Year)
ADDRESS
House Number and Street
Barangay
City/Municipality/Province/Country
Zip Code
PARENT’S/GUARDIAN’S INFORMATION
Father’s Name (Last Name, First Name, Middle Name) Mother’s Maiden Name (Last Name, First Name, Middle Name)
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.
__________________________________________________________________________________________
LEARNING CONTINUITY PLAN (LCP) SURVEY
Do you have internet connectivity at home?
______Yes _______ None
If YES, what is your internet provider?
___________________________
What gadget/s do you use while accessing the internet?
_____ laptop
_____ smart phone
_____ desktop
_____ tablet
What is your average internet usage per day?
______ hours/day
Grade Sectio
Level n
There are 19 major languages identified by DepEd which are: Tagalog, Kapampangan, Pangasinense,
Iloko, Bikol, Cebuano, Hiligaynon, Waray, Tausug, Maguondanaoan, Maranao, Chabacano, Ybanag,
Ivatan, Sambal, Aklanon, Kinaray-a, Yakan, and Surigaonon.