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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: V

Division: ALBAY

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

MARLYN E. AZURIN Female February 18, 1969 51

Contact details: Email: Mobile Number: Facebook Name:


marlyn.azurin@depe 09672480564
d.gov.ph 09519345318 Marlyn Azurin

Preferred contact (Indicate all: email, phone, Skype, Viber, WhatsApp, Zoom,
mode: Googlemeet, FB, Messenger, etc.)

marlyn.azurin@deped.gov.ph
09672480564/09519345318
Marlyn Azurin

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