Department of Education Department of Education

District of Dalaguete I District of Dalaguete I

Catambisan ELEMENTARY SCHOOL Catambisan ELEMENTARY SCHOOL

DISTRIBUTION AND RETRIEVAL FORM DISTRIBUTION AND RETRIEVAL FORM

Mag-aaral: ____________________________ Mag-aaral: ____________________________
Baitang: __ Pangkat: Baitang: __ Pangkat:

Guro: KEITHANIEL T. LEGASPI_ Guro: KEITHANIEL T. LEGASPI_

Araw at oras ng pagkuha ng module:___________________ Araw at oras ng pagkuha ng module:___________________

___________________________________________________________________________ ___________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

KEITHANIEL T. LEGASPI KEITHANIEL T. LEGASPI

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Araw at oras ng pagsauli ng module:______________________ Araw at oras ng pagsauli ng module:______________________

_____________________________________________________________________________ _____________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

KEITHANIEL T. LEGASPI KEITHANIEL T. LEGASPI

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Department of Education Department of Education

District of Dalaguete I District of Dalaguete I
Catambisan ELEMENTARY SCHOOL Catambisan ELEMENTARY SCHOOL

DISTRIBUTION AND RETRIEVAL FORM DISTRIBUTION AND RETRIEVAL FORM

Mag-aaral: ____________________________ Mag-aaral: ____________________________
Baitang: __ Pangkat: Baitang: __ Pangkat:

Guro: KEITHANIEL T. LEGASPI_ Guro: KEITHANIEL T. LEGASPI_

Araw at oras ng pagkuha ng module:___________________ Araw at oras ng pagkuha ng module:___________________

___________________________________________________________________________ ___________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

KEITHANIEL T. LEGASPI KEITHANIEL T. LEGASPI

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Araw at oras ng pagsauli ng module:______________________ Araw at oras ng pagsauli ng module:______________________

_____________________________________________________________________________ _____________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

KEITHANIEL T. LEGASPI KEITHANIEL T. LEGASPI

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Department of Education Department of Education

District of Dalaguete I District of Dalaguete I
 Catambisan ELEMENTARY SCHOOL Catambisan ELEMENTARY SCHOOL

DISTRIBUTION AND RETRIEVAL FORM DISTRIBUTION AND RETRIEVAL FORM

Mag-aaral: KENT JOPHIT GERONDA Module Control No: Mag-aaral: IVAN REY GESLAGA Module Control No:

Baitang: SIX Q1Wk1-

Pangkat: Baitang: SIX Pangkat: Q1Wk1-
Guro: MRS. LILIAN L. CARIQUITAN 005 Guro: MRS. LILIAN L. CARIQUITAN 006

Araw at oras ng pagkuha ng module:___________________ Araw at oras ng pagkuha ng module:___________________

___________________________________________________________________________ ___________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Araw at oras ng pagsauli ng module:______________________ Araw at oras ng pagsauli ng module:______________________

_____________________________________________________________________________ _____________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro
Department of Education Department of Education
District of Dalaguete I District of Dalaguete I
Catambisan ELEMENTARY SCHOOL Catambisan ELEMENTARY SCHOOL

DISTRIBUTION AND RETRIEVAL FORM DISTRIBUTION AND RETRIEVAL FORM

Mag-aaral: NIÑO LANUGAN Module Control No: Mag-aaral: GIOVANNI MOCOY Module Control No:

Baitang: SIX Q1Wk1-

Pangkat: Baitang: SIX Pangkat: Q1Wk1-
Guro: MRS. LILIAN L. CARIQUITAN 007 Guro: MRS. LILIAN L. CARIQUITAN 008
Araw at oras ng pagkuha ng module:_____________________ Araw at oras ng pagkuha ng module:_____________________

___________________________________________________________________________ ___________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Araw at oras ng pagsauli ng module:______________________ Araw at oras ng pagsauli ng module:______________________

_____________________________________________________________________________ _____________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Department of Education Department of Education

District of Dalaguete I District of Dalaguete I
Catambisan ELEMENTARY SCHOOL Catambisan ELEMENTARY SCHOOL

DISTRIBUTION AND RETRIEVAL FORM DISTRIBUTION AND RETRIEVAL FORM

Module Control No: Module Control No:

Q1Wk1- Q1Wk1-
009 010
Mag-aaral: ARIEL PIA Mag-aaral: DARWIN REVALDE
Baitang: SIX Pangkat:________ Baitang: SIX Pangkat:________

Guro: MRS. LILIAN L. CARIQUITAN Guro: MRS. LILIAN L. CARIQUITAN

Araw at oras ng pagkuha ng module:_____________________ Araw at oras ng pagkuha ng module:_____________________

___________________________________________________________________________ ___________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Araw at oras ng pagsauli ng module:______________________ Araw at oras ng pagsauli ng module:______________________

_____________________________________________________________________________ _____________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Department of Education Department of Education

District of Dalaguete I District of Dalaguete I
Catambisan ELEMENTARY SCHOOL Catambisan ELEMENTARY SCHOOL

DISTRIBUTION AND RETRIEVAL FORM DISTRIBUTION AND RETRIEVAL FORM

Mag-aaral: LOUISSE JANE C. GEOMAN Mag-aaral: JULIET Y. MIRANDA Module Control No:

Module Control No:

Baitang: SIX Pangkat:________ Baitang: SIX Pangkat:________ Q1Wk1-
Guro: MRS. LILIAN L. CARIQUITAN
Q1Wk1- Guro: MRS. LILIAN L. CARIQUITAN 012
011
Araw at oras ng pagkuha ng module:_____________________ Araw at oras ng pagkuha ng module:_____________________

___________________________________________________________________________ ___________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Araw at oras ng pagsauli ng module:______________________ Araw at oras ng pagsauli ng module:______________________

_____________________________________________________________________________ _____________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro
Department of Education Department of Education
District of Dalaguete I District of Dalaguete I
Catambisan ELEMENTARY SCHOOL Catambisan ELEMENTARY SCHOOL

DISTRIBUTION AND RETRIEVAL FORM DISTRIBUTION AND RETRIEVAL FORM

Mag-aaral: MA. KRIZIA PIA Module Control No:

Mag-aaral: CRISHEL ROSE RESPONSO
Module Control No:
Baitang: SIX Pangkat:________ Q1Wk1- Baitang: SIX Pangkat:________
013 Q1Wk1-
014
Guro: MRS. LILIAN L. CARIQUITAN Guro: MRS. LILIAN L. CARIQUITAN
Araw at oras ng pagkuha ng module:_____________________
Araw at oras ng pagkuha ng module:_____________________

___________________________________________________________________________ ___________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Araw at oras ng pagsauli ng module:______________________ Araw at oras ng pagsauli ng module:______________________

_____________________________________________________________________________ _____________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang o Guardian

LILIAN L. CARIQUITAN LILIAN L. CARIQUITAN

Pangalan at Lagda ng Guro Pangalan at Lagda ng Guro

Department of Education Department of Education

District of Dalaguete I District of Dalaguete I
Catambisan ELEMENTARY SCHOOL Catambisan ELEMENTARY SCHOOL

DISTRIBUTION AND RETRIEVAL FORM DISTRIBUTION AND RETRIEVAL FORM

Mag-aaral: RACHEL ANNE RESPONSO Mag-aaral: ________________

Module Control No: Baitang: Pangkat:
Baitang: SIX Pangkat:________
Guro: ________________________
Guro: MRS. LILIAN L. CARIQUITAN
Q1Wk1-
014 Araw at oras ng pagkuha ng module:____________________
Araw at oras ng pagkuha ng module:_____________________

___________________________________________________________________________ ___________________________________________________________________________

Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulang

_________________________________________________________________________
LILIAN L. CARIQUITAN Pangalan at Lagda ng Guro
Pangalan at Lagda ng Guro

Araw at oras ng pagsauli ng module:______________________ Araw at oras ng pagsauli ng module:______________________

_____________________________________________________________________________
_____________________________________________________________________________
Pangalan at Lagda ng Magulang o Guardian Pangalan at Lagda ng Magulan

LILIAN L. CARIQUITAN _________________________________________________________________________

Pangalan at Lagda ng Guro
Pangalan at Lagda ng Guro