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FORM A.

LEARNERS’ PROFILE

Learners Code: ____ -____- G- LRN: 119296180021

Date of Assessment (Month/Day/Year): 07/29/2019

Date of Birth (Month/Day/Year): 11/11/2012

Order of Birth (1st, 2nd, etc.): 2nd

Mother Tongue:
 Tagalog  Kapampangan  Pangasinense
 Iloko  Bikol  Chabacano
 Cebuano  Hiligaynon  Waray
 Tausug  Maguindanaoan  Maranao

FORM B. SCHOOL PROFILE

Division: Cebu Province District: Dalaguete 1 School ID: 119296

School Name: Catolohan Elementary School Name of School Head: Roel C. Cartilla

School Address: Catolohan, Dalaguete, Cebu

Contact Number of School: 09278437736

Type of School:
 Central
 Non- Central
 Multi-Grade
 Mono Grade

Number of Teachers and Learners:

Level Number of Learners Number of Teachers

Grade I 26 1

Total 26 1
FORM A. LEARNERS’ PROFILE

Learners Code: ____ -____- G- LRN: 119296180024

Date of Assessment (Month/Day/Year): 07/30/2019

Date of Birth (Month/Day/Year): 08/09/2012

Order of Birth (1st, 2nd, etc.): 10th

Mother Tongue:
 Tagalog  Kapampangan  Pangasinense
 Iloko  Bikol  Chabacano
 Cebuano  Hiligaynon  Waray
 Tausug  Maguindanaoan  Maranao

FORM B. SCHOOL PROFILE

Division: Cebu Province District: Dalaguete 1 School ID: 119296

School Name: Catolohan Elementary School Name of School Head: Roel C. Cartilla

School Address: Catolohan, Dalaguete, Cebu

Contact Number of School: 09278437736

Type of School:
 Central
 Non- Central
 Multi-Grade
 Mono Grade

Number of Teachers and Learners:

Level Number of Learners Number of Teachers

Grade I 26 1

Total 26 1

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