Republic of the Philippines

Department of Education
REGION III
SCHOOLS DIVISION OFFICE OF NUEVA ECIJA

Schools Division Office –San Isidro Annex

STO. CRISTO INTEGRATED SCHOOL
Sto. Cristo, San Isidro, Nueva Ecija

LEARNER’S INFORMATION
Instructions: Use CAPITAL letters in accomplishing this form. Write legibly all information required and return to your
class adviser. Use black or blue ballpen.

Last name

Middle Name

First Name

Home Address

Birthday Place of Birth

Age Sex Religion

Cellphone Number Year of Graduation

Father’s Name Cellphone Number

Mother’s Name Cellphone Number

Guardian’s Name Cellphone Number

Educational Background
Level Name of School Year Graduated

Kindergarten

Elementary

Get in touch! For more information and for any queries,

please contact

RICKY A. FERNANDEZ
In-Charge, High School Department
We are also accepting
0943 639 24 33

EXEQUIEL O. HIPOLITO, Ph. D.

School Principal III
0927 357 09 05

Learners