Professional Documents
Culture Documents
1
1
Cabled/Non-Cabled TV=Television
Basic/Smartphone = Cellular Phone
Desktop/Laptop = Desktop/Laptop
Non-
cable TV
Only 1 2 3
Grade Level Household Household Household
Member Members Members
Kinder 1
Sample
From MLESF, the respondent selected Kinder, Grade
Kinder
Grade 3
Grade 7
Total 3
From 1-7 (columns) Select Column 3
D3. What devices are available at home that the learner can us
Cabled/Non-Cabled TV = Television
Basic/Smartphone - Cellular Phone
Desktop and/or Laptop = Desktop/Laptop
TABULATION
ER
Learner 2
Learner 4
MENTS OF MLESF
13
13
ng ang kinakailangan, pumili lamang ng isang (1) nararapat na tugon kung may iba't ibang pagkasasamang naaangk
ng bawat kolum ay kinakailangang pantay sa kabuuang bilang ng tumugon sa bawat baitang.
ng bawat kolum sa bawat baitang ay hindi maaring humigit sa bilang na 5000.
urong Tagapagpayo
wastuhan/pagkakumpleto ng lahat ng MLSEF.
gang maaring magkaroon ng iba't ibang tugon, pilliin ang pinaka-naaangkop na pagkasasamang naitala sa form na i
Enrollment Chair (GLEC) kung mayroon man o sa School Enrollment Focal Person (SEFP).
dministrator
na School Level Summary Matrix at tiyakin ang kawastuhan ng bilang ng pagpapatala mula sa kabuuang bilang ng
liin ang kalupi ng QC na makikita sa Dashboard.
lang ng bawat talaan katulad ng nasa Summary Matrix. Maaring gamitin ang itinalagang mga palahudyatan bilang sa
onal Attainment (select only parent/guardian per learner having the highest educational attainment)
ational Attainment )- Choose only the Highest Educational Attainment of Mother from MLESF and tag to the MLESF Summary
embers (including the enrollee) are studying in School Year 2021-2022? (No.of Learner/s in a Household)
Total (Must
be equalled
4 5 6 7 vis-à-vis
Household Household Household Household Enrollment
Members Members Members Members per
Class/Grad
e Level)
t Column 3
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
Kinder 0 0 0
1 4 0 4
2 0 0 0
3 0 0 0
4 0 0 0
5 0 0 0
6 0 0 0
Non-Graded 0 0 0
Total 4 0 4
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
Kinder 0 0 0 0
1 0 2 2 0
2 0 0 0 0
3 0 0 0 0
4 0 0 0 0
5 0 0 0 0
6 0 0 0 0
Non-Graded 0 0 0 0
Total 0 2 2 0
D2. Who among the household members can provide instructional support to the child’s distan
Parent/
Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of
family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone Cellphone,
Grade Level Only Cellphone & Radio Radio &
Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
Kinder 0 0 0
1 2 2 4
2 0 0 0
3 0 0 0
4 0 0 0
5 0 0 0
6 0 0 0
Non-Graded 0 0 0
Total 2 2 4
D6. What distance learning modality/ies do you prefer for your child?
online learning,
online
online learning & online learning, television, radio
learning
Grade Level television television & radio & modular
only
learning
DLM1 DLM2 DLM3 DLM4
Kinder 0 0 0 0
1 0 0 0 0
2 0 0 0 0
3 0 0 0 0
4 0 0 0 0
5 0 0 0 0
6 0 0 0 0
Non-Graded 0 0 0 0
Total 0 0 0 0
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of
available
gadgets/
lack of available equipment ,
lack of
lack of available gadgets/ equipment , insufficient
available
gadgets/ equipment insufficient load/ data load/ data
gadgets/
Grade Level equipment & insufficient load/ allowance & unstable allowance,
data allowance mobile/ internet unstable
only
connection mobile/ internet
connection &
existing health
condition/s
E.2 If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Helping in
Existing Illness or
Infected of transportation from health related concens household
Grade Level chores
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
Kinder 0 0 0 0
1 2 0 0 0
2 0 0 0 0
3 0 0 0 0
4 0 0 0 0
5 0 0 0 0
6 0 0 0 0
Non-Graded 0 0 0 0
Total 2 0 0 0
0 0 0 0
0 0 0 4
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 4
Parent/ Guardian,
Siblings, Grand Siblings, Grand Parent,
Parent, Other Siblings Only Siblings & Grand Parent Other members of family
members of & Others
family & Others
e specific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0 0 0 0
0 0 0 2
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 2
ccuracy/completeness
of all sections
hool Enrollment Focal Person (SEFP)
Matrix. May use the assigned code as appopriate for easy reference.
Return to File Directory
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0 0 0
0 0 4
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 4
0
4
0
0
0
0
0
0
4
unstable mobile/
internet connection,
unstable unstable mobile/
existing health existing health
mobile/ internet connection,
condition/s, difficulty in condition/s,
internet existing health
independent learning, existing difficulty in
connection, condition/s,
conflict with other health independent
existing health difficulty in
activities (i.e., house condition/s learning &
condition/s & independent
chores), high electrical only conflict with other
difficulty in learning & conflict
consumption & activities (i.e.,
independent with other activities
distractions (i.e., social house chores)
learning (i.e., house chores)
media, noise from
community/neighbor)
CH33
0 0
0 4
0 0
0 0
0 0
0 0
0 0
0 0
0 4
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL Dona Felisa Navarro ES
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
Kinder 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
Kinder
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
Kinder 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
Kinder
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
Kinder
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
condition/s, difficulty in
unstable mobile/ existing health
independent learning, existing
internet connection, condition/s,
conflict with other health
existing health difficulty in
activities (i.e., house condition/s
condition/s & difficulty independent
chores), high electrical only
in independent learning learning & conflict
consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF (Class Adviser Report)
(This form can be used to tabulate survey result of Class/Section, Grade and School level)
NAME OF SCHOOL SCHOOL ID DISTRICT/CLUSTER
Grade/School Level *Section Prospective Adviser/GLEC/SEFP
Last updated (date): For LIS Admin Use Only
Date Posted in LIS QC Posted by: (LIS System Admin)
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
Kinder 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner having the highest educational attainment)
After High School
No Formal Education or
No Formal Elementary High School High School
Schooling but able Elementary level Vocational
Grade Level Schooling to read and write Graduate Level Graduate
(Tech/Voc/College/
Post Grad)
HEA1 HEA2 HEA3 HEA4 HEA5 HEA6 HEA7
Kinder
D1. How many of your household members (including the enrollee) are studying in School Year 2021-2022? (No.of Learner/s in a Household)
Only 1
2 Household 3 Household 4 Household 5 Household 6 Household 7 Household
Grade Level Household
Members Members Members Members Members Members
Member
Kinder
D2. Who among the household members can provide instructional support to the child’s distance learning?
Parent/
Parent/ Guardian, Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand Siblings, Grand Siblings & Grand
Guardian Siblings & Grand Siblings Only
Grade Level and Siblings Parent & Other Parent, Other Parent
Only Parent
members of family members of
family & Others
HM1 HM2 HM3 HM4 HM5 HM6 HM7
Kinder
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone Cellphone, Radio &
Cellphone, Radio Cellphone Only Cellphone & Radio
Grade Level Only Cellphone & Radio Desktop/laptop
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
Kinder 0
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning, Television, radio &
learning television, radio & Television Only Television & radio
Grade Level television television & radio modular learning
only modular learning
DLM1 DLM2 DLM3 DLM4 DLM5 DLM6 DLM7
Kinder
D7. What are the challenges that may affect your child’s learning process through distance education?
lack of available
gadgets/ lack of available
lack of available
equipment , gadgets/ equipment
gadgets/
lack of available insufficient load/ , insufficient load/
equipment ,
gadgets/ data allowance, data allowance,
insufficient load/
lack of available equipment , unstable mobile/ unstable mobile/
lack of lack of available data allowance,
gadgets/ equipment , insufficient load/ internet internet connection,
available gadgets/ unstable mobile/
insufficient load/ data data allowance, connection, existing health
gadgets/ equipment & internet
Grade Level equipment allowance & unstable unstable mobile/ existing health condition/s, difficulty
insufficient load/ connection,
mobile/ internet internet condition/s, in independent
only data allowance existing health
connection connection & difficulty in learning, conflict
condition/s &
existing health independent with other activities
difficulty in
condition/s learning & conflict (i.e., house chores)
independent
with other activities & high electrical
learning
(i.e., house consumption
chores)
E2. If the answer is no , please select only 1 major consideration or state specific reason
Limited or no
Fear of available helping in family
Getting transportation Existing Illness or Helping in Presence of Arm Other Reason, if
business or
Grade Level Infected of from home to health related concens household chores Conflict in the area any
working
Corona school and vice
Virus versa
MC1 MC2 MC3 MC4 MC5 MC6 MC7
Kinder
ER DIVISION REGION
ent)
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
sehold)
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
Siblings, Grand
Grand Parent & Grand Parent, Other members of Learner able to do
Parent, Other Grand Parent Other members of Other (tutor/helper)
Other members of Other members of family and Other independent
members of family Only family only only
family family & Others (tutor/helper) learning
& Others
lack of available
gadgets/ equipment insufficient load/
, insufficient load/ data allowance,
data allowance, unstable mobile/
unstable mobile/ internet connection,
insufficient load/
internet connection, insufficient load/ existing health
data allowance,
existing health data allowance, condition/s, difficulty
insufficient load/ unstable mobile/
condition/s, difficulty insufficient load/ unstable mobile/ in independent
data allowance, internet connection,
in independent insufficient load/ data allowance & internet connection, learning, conflict unstable mobile/
unstable mobile/ existing health
learning, conflict data allowance unstable mobile/ existing health with other activities internet connection
internet connection condition/s, difficulty
with other activities only internet condition/s & (i.e., house chores), only
& existing health in independent
(i.e., house chores), connection difficulty in high electrical
condition/s learning & conflict
high electrical independent consumption &
with other activities
consumption & learning distractions (i.e.,
(i.e., house chores)
distractions (i.e., social media, noise
social media, noise from
from community/neighbor
community/neighbo )
r)
CH8 CH9 CH10 CH11 CH12 CH13 CH14 CH15
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
strator
Total (Must be
None equalled vis-à-vis
Enrollment per
Class/Grade Level)
HM16
0
unstable mobile/
internet connection, existing health
unstable mobile/ existing health
existing health existing health condition/s, difficulty in
unstable internet connection, condition/s,
unstable mobile/ condition/s, difficulty in condition/s, independent learning,
mobile/ existing health difficulty in
internet connection, independent learning, existing difficulty in conflict with other
internet condition/s, independent
existing health conflict with other health independent activities (i.e., house
connection & difficulty in learning, conflict
condition/s & difficulty activities (i.e., house condition/s learning & chores), high electrical
existing independent with other activities
in independent chores), high electrical only conflict with other consumption &
health learning & conflict (i.e., house chores)
learning consumption & activities (i.e., distractions (i.e., social
condition/s with other activities & high electrical
distractions (i.e., social house chores) media, noise from
(i.e., house chores) consumption
media, noise from community/neighbor)
community/neighbor)
CH24 CH25 CH26 CH27 CH28 CH29 CH30 CH31 CH32 CH33
Total (Must be
equalled vis-à-
vis Enrollment
per Class/Grade
Level)
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
Kinder 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
Kinder
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
Kinder 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
Kinder
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
Kinder
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
condition/s, difficulty in
unstable mobile/ existing health
independent learning, existing
internet connection, condition/s,
conflict with other health
existing health difficulty in
activities (i.e., house condition/s
condition/s & difficulty independent
chores), high electrical only
in independent learning learning & conflict
consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
Kinder 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
Kinder
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
Kinder 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
Kinder
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
Kinder
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
condition/s, difficulty in
unstable mobile/ existing health
independent learning, existing
internet connection, condition/s,
conflict with other health
existing health difficulty in
activities (i.e., house condition/s
condition/s & difficulty independent
chores), high electrical only
in independent learning learning & conflict
consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF (Class Adviser Report)
(This form can be used to tabulate survey result of Class/Section, Grade and School level)
NAME OF SCHOOL Dona Felisa Navarro ES SCHOOL ID 102127 DISTRICT/CLUSTER
Grade/School Level *Section Prospective Adviser/GLEC/SEFP
Last updated (date): For LIS Admin Use Only
Date Posted in LIS QC Posted by: (LIS System Admin)
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
1 4 4
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner having the highest educational attainment)
D1. How many of your household members (including the enrollee) are studying in School Year 2021-2022? (No.of Learner/s in a Household)
Only 1
2 Household 3 Household 4 Household 5 Household 6 Household
Grade Level Household 7 Household Members
Members Members Members Members Members
Member
1 2 2
D2. Who among the household members can provide instructional support to the child’s distance learning?
Parent/ Guardian,
Parent/ Guardian,
Parent/ Parent/ Guardian, Siblings, Grand
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand Parent, Other Siblings Only Siblings & Grand Parent
Grade Level and Siblings Parent & Other
Only Parent members of
members of family
family & Others
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone Cellphone, Radio &
Cellphone, Radio Cellphone Only Cellphone & Radio
Grade Level Only Cellphone & Radio Desktop/laptop
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
1 2 2 4
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning, Television, radio &
learning television, radio & Television Only Television & radio
Grade Level television television & radio modular learning
only modular learning
DLM1 DLM2 DLM3 DLM4 DLM5 DLM6 DLM7
1
D7. What are the challenges that may affect your child’s learning process through distance education?
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available helping in family
Existing Illness or Helping in Presence of Arm
Infected of transportation from health related concens household chores business or Other Reason, if any
Grade Level Conflict in the area
Corona home to school and working
Virus vice versa
MC1 MC2 MC3 MC4 MC5 MC6 MC7
1 2
Siblings, Grand Parent, Grand Parent & Grand Parent, Other Other members of
Grand Parent Other members of
Other members of family Other members of members of family & family and Other Other (tutor/helper) only
Only family only
& Others family Others (tutor/helper)
lack of available
gadgets/ equipment , insufficient load/ data
insufficient load/ data allowance, unstable
insufficient load/ data
allowance, unstable mobile/ internet
allowance, unstable
mobile/ internet insufficient load/ data connection, existing
mobile/ internet
connection, existing insufficient load/ data allowance, unstable health condition/s,
insufficient load/ connection, existing
health condition/s, insufficient load/ allowance, unstable mobile/ internet difficulty in independent
data allowance & health condition/s,
difficulty in independent data allowance mobile/ internet connection, existing learning, conflict with
unstable mobile/ difficulty in
learning, conflict with only connection & existing health condition/s & other activities (i.e.,
internet connection independent learning
other activities (i.e., health condition/s difficulty in house chores), high
& conflict with other
house chores), high independent learning electrical consumption &
activities (i.e., house
electrical consumption & distractions (i.e., social
chores)
distractions (i.e., social media, noise from
media, noise from community/neighbor)
community/neighbor)
2
Total (Must be
Learner able to do equalled vis-
independent None à-vis
learning Enrollment
per
Class/Grade
HM15 HM16 Level)
4
unstable mobile/
internet connection,
unstable unstable mobile/ existing health
existing health existing health
unstable mobile/ internet connection, condition/s,
condition/s, difficulty in condition/s,
mobile/ internet existing health difficulty in
independent learning, existing difficulty in
unstable mobile/ internet connection, condition/s, independent
conflict with other health independent
internet connection connection & existing health difficulty in learning, conflict
activities (i.e., house condition/s learning &
only existing condition/s & independent with other activities
chores), high electrical only conflict with other
health difficulty in learning & conflict (i.e., house chores)
consumption & activities (i.e.,
condition/s independent with other activities & high electrical
distractions (i.e., social house chores)
learning (i.e., house chores) consumption
media, noise from
community/neighbor)
CH32 CH33
4
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
1 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
1 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
1
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
1
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
1 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
1 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
1
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
1
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
1 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
1 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
1
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
1
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF (Class Adviser Report)
(This form can be used to tabulate survey result of Class/Section, Grade and School level)
NAME OF SCHOOL SCHOOL ID DISTRICT/CLUSTER
Grade/School Level *Section Prospective Adviser/GLEC/SEFP
Last updated (date): For LIS Admin Use Only
Date Posted in LIS QC Posted by: (LIS System Admin)
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
2 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner having the highest educational attainment)
D1. How many of your household members (including the enrollee) are studying in School Year 2021-2022? (No.of Learner/s in a Household)
Only 1
2 Household 3 Household 4 Household 5 Household 6 Household
Grade Level Household 7 Household Members
Members Members Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distance learning?
Parent/ Guardian,
Parent/ Guardian,
Parent/ Parent/ Guardian, Siblings, Grand
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand Parent, Other Siblings Only Siblings & Grand Parent
Grade Level and Siblings Parent & Other
Only Parent members of
members of family
family & Others
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone Cellphone, Radio &
Cellphone, Radio Cellphone Only Cellphone & Radio
Grade Level Only Cellphone & Radio Desktop/laptop
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
2 0
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning, Television, radio &
learning television, radio & Television Only Television & radio
Grade Level television television & radio modular learning
only modular learning
DLM1 DLM2 DLM3 DLM4 DLM5 DLM6 DLM7
2
D7. What are the challenges that may affect your child’s learning process through distance education?
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available helping in family
Existing Illness or Helping in Presence of Arm
Infected of transportation from health related concens household chores business or Other Reason, if any
Grade Level Conflict in the area
Corona home to school and working
Virus vice versa
MC1 MC2 MC3 MC4 MC5 MC6 MC7
2
DIVISION REGION
Siblings, Grand Parent, Grand Parent & Grand Parent, Other Other members of
Grand Parent Other members of
Other members of family Other members of members of family & family and Other Other (tutor/helper) only
Only family only
& Others family Others (tutor/helper)
lack of available
gadgets/ equipment , insufficient load/ data
insufficient load/ data allowance, unstable
insufficient load/ data
allowance, unstable mobile/ internet
allowance, unstable
mobile/ internet insufficient load/ data connection, existing
mobile/ internet
connection, existing insufficient load/ data allowance, unstable health condition/s,
insufficient load/ connection, existing
health condition/s, insufficient load/ allowance, unstable mobile/ internet difficulty in independent
data allowance & health condition/s,
difficulty in independent data allowance mobile/ internet connection, existing learning, conflict with
unstable mobile/ difficulty in
learning, conflict with only connection & existing health condition/s & other activities (i.e.,
internet connection independent learning
other activities (i.e., health condition/s difficulty in house chores), high
& conflict with other
house chores), high independent learning electrical consumption &
activities (i.e., house
electrical consumption & distractions (i.e., social
chores)
distractions (i.e., social media, noise from
media, noise from community/neighbor)
community/neighbor)
0
Learner able to do
independent None Total (Must be equalled
learning vis-à-vis Enrollment per
Class/Grade Level)
HM15 HM16
0
unstable mobile/
internet connection,
unstable mobile/ existing health
existing health existing health
unstable internet connection, condition/s,
condition/s, difficulty in condition/s,
mobile/ existing health difficulty in
unstable mobile/ internet independent learning, existing difficulty in
unstable mobile/ internet condition/s, independent
connection, existing health conflict with other health independent
internet connection connection & difficulty in learning, conflict
condition/s & difficulty in activities (i.e., house condition/s learning &
only existing independent with other activities
independent learning chores), high electrical only conflict with other
health learning & conflict (i.e., house chores)
consumption & activities (i.e.,
condition/s with other activities & high electrical
distractions (i.e., social house chores)
(i.e., house chores) consumption
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
2 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
2 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
2
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
2
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
condition/s, difficulty in
existing health
unstable mobile/ internet independent learning, existing
condition/s,
connection, existing health conflict with other health
difficulty in
condition/s & difficulty in activities (i.e., house condition/s
independent
independent learning chores), high electrical only
learning & conflict
consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
2 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
2 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
2
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
2
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
condition/s, difficulty in
existing health
unstable mobile/ internet independent learning, existing
condition/s,
connection, existing health conflict with other health
difficulty in
condition/s & difficulty in activities (i.e., house condition/s
independent
independent learning chores), high electrical only
learning & conflict
consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
2 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
2 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
2
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
2
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
condition/s, difficulty in
existing health
unstable mobile/ internet independent learning, existing
condition/s,
connection, existing health conflict with other health
difficulty in
condition/s & difficulty in activities (i.e., house condition/s
independent
independent learning chores), high electrical only
learning & conflict
consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF (Class Adviser Report)
(This form can be used to tabulate survey result of Class/Section, Grade and School level)
NAME OF SCHOOL SCHOOL ID DISTRICT/CLUSTER
Grade/School Level *Section Prospective Adviser/GLEC/SEFP
Last updated (date): For LIS Admin Use Only
Date Posted in LIS QC Posted by: (LIS System Admin)
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
3 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner having the highest educational attainment)
D1. How many of your household members (including the enrollee) are studying in School Year 2021-2022? (No.of Learner/s in a Household)
Only 1
2 Household 3 Household 4 Household 5 Household 6 Household
Grade Level Household 7 Household Members
Members Members Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distance learning?
Parent/ Guardian,
Parent/ Guardian,
Parent/ Parent/ Guardian, Siblings, Grand
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand Parent, Other Siblings Only Siblings & Grand Parent
Grade Level and Siblings Parent & Other
Only Parent members of
members of family
family & Others
HM1 HM2 HM3 HM4 HM5 HM6 HM7
3
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone Cellphone, Radio &
Cellphone, Radio Cellphone Only Cellphone & Radio
Grade Level Only Cellphone & Radio Desktop/laptop
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
3 0
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning, Television, radio &
learning television, radio & Television Only Television & radio
Grade Level television television & radio modular learning
only modular learning
DLM1 DLM2 DLM3 DLM4 DLM5 DLM6 DLM7
3
D7. What are the challenges that may affect your child’s learning process through distance education?
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available helping in family
Existing Illness or Helping in Presence of Arm
Infected of transportation from health related concens household chores business or Other Reason, if any
Grade Level Conflict in the area
Corona home to school and working
Virus vice versa
MC1 MC2 MC3 MC4 MC5 MC6 MC7
3
DIVISION REGION
Siblings, Grand Parent, Grand Parent & Grand Parent, Other Other members of
Grand Parent Other members of
Other members of family Other members of members of family & family and Other Other (tutor/helper) only
Only family only
& Others family Others (tutor/helper)
lack of available
gadgets/ equipment , insufficient load/ data
insufficient load/ data allowance, unstable
insufficient load/ data
allowance, unstable mobile/ internet
allowance, unstable
mobile/ internet insufficient load/ data connection, existing
mobile/ internet
connection, existing insufficient load/ data allowance, unstable health condition/s,
insufficient load/ connection, existing
health condition/s, insufficient load/ allowance, unstable mobile/ internet difficulty in independent
data allowance & health condition/s,
difficulty in independent data allowance mobile/ internet connection, existing learning, conflict with
unstable mobile/ difficulty in
learning, conflict with only connection & existing health condition/s & other activities (i.e.,
internet connection independent learning
other activities (i.e., health condition/s difficulty in house chores), high
& conflict with other
house chores), high independent learning electrical consumption &
activities (i.e., house
electrical consumption & distractions (i.e., social
chores)
distractions (i.e., social media, noise from
media, noise from community/neighbor)
community/neighbor)
0
Total (Must be
Learner able to do equalled vis-
independent None à-vis
learning Enrollment
per
Class/Grade
HM15 HM16 Level)
0
unstable mobile/
internet connection,
unstable unstable mobile/ existing health
existing health existing health
unstable mobile/ internet connection, condition/s,
condition/s, difficulty in condition/s,
mobile/ internet existing health difficulty in
independent learning, existing difficulty in
unstable mobile/ internet connection, condition/s, independent
conflict with other health independent
internet connection connection & existing health difficulty in learning, conflict
activities (i.e., house condition/s learning &
only existing condition/s & independent with other activities
chores), high electrical only conflict with other
health difficulty in learning & conflict (i.e., house chores)
consumption & activities (i.e.,
condition/s independent with other activities & high electrical
distractions (i.e., social house chores)
learning (i.e., house chores) consumption
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
3 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
3 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
3
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
3
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
insufficient load/ data
allowance, unstable
insufficient load/ data
mobile/ internet
allowance, unstable
connection, existing unstable
mobile/ internet
health condition/s, mobile/
connection, existing
difficulty in independent unstable mobile/ internet
health condition/s,
learning, conflict with internet connection connection &
difficulty in
other activities (i.e., only existing
independent learning
house chores), high health
& conflict with other
electrical consumption & condition/s
activities (i.e., house
distractions (i.e., social
chores)
media, noise from
community/neighbor)
CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
3 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
3 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
3
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
3
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
insufficient load/ data
allowance, unstable
insufficient load/ data
mobile/ internet
allowance, unstable
connection, existing unstable
mobile/ internet
health condition/s, mobile/
connection, existing
difficulty in independent unstable mobile/ internet
health condition/s,
learning, conflict with internet connection connection &
difficulty in
other activities (i.e., only existing
independent learning
house chores), high health
& conflict with other
electrical consumption & condition/s
activities (i.e., house
distractions (i.e., social
chores)
media, noise from
community/neighbor)
CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
3 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
3 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
3
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
3
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
insufficient load/ data
allowance, unstable
insufficient load/ data
mobile/ internet
allowance, unstable
connection, existing unstable
mobile/ internet
health condition/s, mobile/
connection, existing
difficulty in independent unstable mobile/ internet
health condition/s,
learning, conflict with internet connection connection &
difficulty in
other activities (i.e., only existing
independent learning
house chores), high health
& conflict with other
electrical consumption & condition/s
activities (i.e., house
distractions (i.e., social
chores)
media, noise from
community/neighbor)
CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF (Class Adviser Report)
(This form can be used to tabulate survey result of Class/Section, Grade and School level)
NAME OF SCHOOL SCHOOL ID DISTRICT/CLUSTER
Grade/School Level *Section Prospective Adviser/GLEC/SEFP
Last updated (date): For LIS Admin Use Only
Date Posted in LIS QC Posted by: (LIS System Admin)
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
4 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner having the highest educational attainment)
D1. How many of your household members (including the enrollee) are studying in School Year 2021-2022? (No.of Learner/s in a Household)
Only 1
2 Household 3 Household 4 Household 5 Household 6 Household
Grade Level Household 7 Household Members
Members Members Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distance learning?
Parent/ Guardian,
Parent/ Guardian,
Parent/ Parent/ Guardian, Siblings, Grand
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand Parent, Other Siblings Only Siblings & Grand Parent
Grade Level and Siblings Parent & Other
Only Parent members of
members of family
family & Others
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone Cellphone, Radio &
Cellphone, Radio Cellphone Only Cellphone & Radio
Grade Level Only Cellphone & Radio Desktop/laptop
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
4 0
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning, Television, radio &
learning television, radio & Television Only Television & radio
Grade Level television television & radio modular learning
only modular learning
DLM1 DLM2 DLM3 DLM4 DLM5 DLM6 DLM7
4
D7. What are the challenges that may affect your child’s learning process through distance education?
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available helping in family
Existing Illness or Helping in Presence of Arm
Infected of transportation from health related concens household chores business or Other Reason, if any
Grade Level Conflict in the area
Corona home to school and working
Virus vice versa
MC1 MC2 MC3 MC4 MC5 MC6 MC7
4
DIVISION REGION
Siblings, Grand Parent, Grand Parent & Grand Parent, Other Other members of
Grand Parent Other members of
Other members of family Other members of members of family & family and Other Other (tutor/helper) only
Only family only
& Others family Others (tutor/helper)
lack of available
gadgets/ equipment , insufficient load/ data
insufficient load/ data allowance, unstable
insufficient load/ data
allowance, unstable mobile/ internet
allowance, unstable
mobile/ internet insufficient load/ data connection, existing
mobile/ internet
connection, existing insufficient load/ data allowance, unstable health condition/s,
insufficient load/ connection, existing
health condition/s, insufficient load/ allowance, unstable mobile/ internet difficulty in independent
data allowance & health condition/s,
difficulty in independent data allowance mobile/ internet connection, existing learning, conflict with
unstable mobile/ difficulty in
learning, conflict with only connection & existing health condition/s & other activities (i.e.,
internet connection independent learning
other activities (i.e., health condition/s difficulty in house chores), high
& conflict with other
house chores), high independent learning electrical consumption &
activities (i.e., house
electrical consumption & distractions (i.e., social
chores)
distractions (i.e., social media, noise from
media, noise from community/neighbor)
community/neighbor)
0
Total (Must be
Learner able to do equalled vis-
independent None à-vis
learning Enrollment
per
Class/Grade
HM15 HM16 Level)
0
unstable mobile/
internet connection,
unstable unstable mobile/ existing health
existing health existing health
unstable mobile/ internet connection, condition/s,
condition/s, difficulty in condition/s,
mobile/ internet existing health difficulty in
independent learning, existing difficulty in
unstable mobile/ internet connection, condition/s, independent
conflict with other health independent
internet connection connection & existing health difficulty in learning, conflict
activities (i.e., house condition/s learning &
only existing condition/s & independent with other activities
chores), high electrical only conflict with other
health difficulty in learning & conflict (i.e., house chores)
consumption & activities (i.e.,
condition/s independent with other activities & high electrical
distractions (i.e., social house chores)
learning (i.e., house chores) consumption
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
4 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
4 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
4
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
4
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
4 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
4 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
4
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
4
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
4 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
4 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
4
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
4
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF (Class Adviser Report)
(This form can be used to tabulate survey result of Class/Section, Grade and School level)
NAME OF SCHOOL SCHOOL ID DISTRICT/CLUSTER
Grade/School Level *Section Prospective Adviser/GLEC/SEFP
Last updated (date): For LIS Admin Use Only
Date Posted in LIS QC Posted by: (LIS System Admin)
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
5 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner having the highest educational attainment)
D1. How many of your household members (including the enrollee) are studying in School Year 2021-2022? (No.of Learner/s in a Household)
Only 1
2 Household 3 Household 4 Household 5 Household 6 Household
Grade Level Household 7 Household Members
Members Members Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distance learning?
Parent/ Guardian,
Parent/ Guardian,
Parent/ Parent/ Guardian, Siblings, Grand
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand Parent, Other Siblings Only Siblings & Grand Parent
Grade Level and Siblings Parent & Other
Only Parent members of
members of family
family & Others
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone Cellphone, Radio &
Cellphone, Radio Cellphone Only Cellphone & Radio
Grade Level Only Cellphone & Radio Desktop/laptop
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
5 0
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning, Television, radio &
learning television, radio & Television Only Television & radio
Grade Level television television & radio modular learning
only modular learning
DLM1 DLM2 DLM3 DLM4 DLM5 DLM6 DLM7
5
D7. What are the challenges that may affect your child’s learning process through distance education?
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available helping in family
Existing Illness or Helping in Presence of Arm
Infected of transportation from health related concens household chores business or Other Reason, if any
Grade Level Conflict in the area
Corona home to school and working
Virus vice versa
MC1 MC2 MC3 MC4 MC5 MC6 MC7
5
DIVISION REGION
Siblings, Grand Parent, Grand Parent & Grand Parent, Other Other members of
Grand Parent Other members of
Other members of family Other members of members of family & family and Other Other (tutor/helper) only
Only family only
& Others family Others (tutor/helper)
lack of available
gadgets/ equipment , insufficient load/ data
insufficient load/ data allowance, unstable
insufficient load/ data
allowance, unstable mobile/ internet
allowance, unstable
mobile/ internet insufficient load/ data connection, existing
mobile/ internet
connection, existing insufficient load/ data allowance, unstable health condition/s,
insufficient load/ connection, existing
health condition/s, insufficient load/ allowance, unstable mobile/ internet difficulty in independent
data allowance & health condition/s,
difficulty in independent data allowance mobile/ internet connection, existing learning, conflict with
unstable mobile/ difficulty in
learning, conflict with only connection & existing health condition/s & other activities (i.e.,
internet connection independent learning
other activities (i.e., health condition/s difficulty in house chores), high
& conflict with other
house chores), high independent learning electrical consumption &
activities (i.e., house
electrical consumption & distractions (i.e., social
chores)
distractions (i.e., social media, noise from
media, noise from community/neighbor)
community/neighbor)
0
Learner able to do Total (Must be
independent None equalled vis-à-vis
learning Enrollment per
Class/Grade Level)
HM15 HM16
0
unstable mobile/
internet connection,
unstable mobile/ existing health
existing health existing health
unstable internet connection, condition/s,
unstable mobile/ condition/s, difficulty in condition/s,
mobile/ existing health difficulty in
internet connection, independent learning, existing difficulty in
unstable mobile/ internet condition/s, independent
existing health conflict with other health independent
internet connection connection & difficulty in learning, conflict
condition/s & difficulty activities (i.e., house condition/s learning &
only existing independent with other activities
in independent chores), high electrical only conflict with other
health learning & conflict (i.e., house chores)
learning consumption & activities (i.e.,
condition/s with other activities & high electrical
distractions (i.e., social house chores)
(i.e., house chores) consumption
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
5 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
5 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
5
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
5
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
unstable mobile/ condition/s, difficulty in
existing health
internet connection, independent learning, existing
condition/s,
existing health conflict with other health
difficulty in
condition/s & difficulty activities (i.e., house condition/s
independent
in independent chores), high electrical only
learning & conflict
learning consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
5 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
5 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
5
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
5
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
unstable mobile/ condition/s, difficulty in
existing health
internet connection, independent learning, existing
condition/s,
existing health conflict with other health
difficulty in
condition/s & difficulty activities (i.e., house condition/s
independent
in independent chores), high electrical only
learning & conflict
learning consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
5 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
5 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
5
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
5
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
unstable mobile/ condition/s, difficulty in
existing health
internet connection, independent learning, existing
condition/s,
existing health conflict with other health
difficulty in
condition/s & difficulty activities (i.e., house condition/s
independent
in independent chores), high electrical only
learning & conflict
learning consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF (Class Adviser Report)
(This form can be used to tabulate survey result of Class/Section, Grade and School level)
NAME OF SCHOOL SCHOOL ID DISTRICT/CLUSTER
Grade/School Level *Section Prospective Adviser/GLEC/SEFP
Last updated (date): For LIS Admin Use Only
Date Posted in LIS QC Posted by: (LIS System Admin)
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
5 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner having the highest educational attainment)
D1. How many of your household members (including the enrollee) are studying in School Year 2021-2022? (No.of Learner/s in a Household)
Only 1
2 Household 3 Household 4 Household 5 Household 6 Household
Grade Level Household 7 Household Members
Members Members Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distance learning?
Parent/ Guardian,
Parent/ Guardian,
Parent/ Parent/ Guardian, Siblings, Grand
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand Parent, Other Siblings Only Siblings & Grand Parent
Grade Level and Siblings Parent & Other
Only Parent members of
members of family
family & Others
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone Cellphone, Radio &
Cellphone, Radio Cellphone Only Cellphone & Radio
Grade Level Only Cellphone & Radio Desktop/laptop
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
6 0
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning, Television, radio &
learning television, radio & Television Only Television & radio
Grade Level television television & radio modular learning
only modular learning
DLM1 DLM2 DLM3 DLM4 DLM5 DLM6 DLM7
6
D7. What are the challenges that may affect your child’s learning process through distance education?
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available helping in family
Existing Illness or Helping in Presence of Arm
Infected of transportation from health related concens household chores business or Other Reason, if any
Grade Level Conflict in the area
Corona home to school and working
Virus vice versa
MC1 MC2 MC3 MC4 MC5 MC6 MC7
6
DIVISION REGION
Siblings, Grand Parent, Grand Parent & Grand Parent, Other Other members of
Grand Parent Other members of
Other members of family Other members of members of family & family and Other Other (tutor/helper) only
Only family only
& Others family Others (tutor/helper)
lack of available
gadgets/ equipment , insufficient load/ data
insufficient load/ data allowance, unstable
insufficient load/ data
allowance, unstable mobile/ internet
allowance, unstable
mobile/ internet insufficient load/ data connection, existing
mobile/ internet
connection, existing insufficient load/ data allowance, unstable health condition/s,
insufficient load/ connection, existing
health condition/s, insufficient load/ allowance, unstable mobile/ internet difficulty in independent
data allowance & health condition/s,
difficulty in independent data allowance mobile/ internet connection, existing learning, conflict with
unstable mobile/ difficulty in
learning, conflict with only connection & existing health condition/s & other activities (i.e.,
internet connection independent learning
other activities (i.e., health condition/s difficulty in house chores), high
& conflict with other
house chores), high independent learning electrical consumption &
activities (i.e., house
electrical consumption & distractions (i.e., social
chores)
distractions (i.e., social media, noise from
media, noise from community/neighbor)
community/neighbor)
0
Learner able to do Total (Must be
independent None equalled vis-à-vis
learning Enrollment per
Class/Grade Level)
HM15 HM16
0
unstable mobile/
internet connection,
unstable mobile/ existing health
existing health existing health
unstable internet connection, condition/s,
unstable mobile/ condition/s, difficulty in condition/s,
mobile/ existing health difficulty in
internet connection, independent learning, existing difficulty in
unstable mobile/ internet condition/s, independent
existing health conflict with other health independent
internet connection connection & difficulty in learning, conflict
condition/s & difficulty activities (i.e., house condition/s learning &
only existing independent with other activities
in independent chores), high electrical only conflict with other
health learning & conflict (i.e., house chores)
learning consumption & activities (i.e.,
condition/s with other activities & high electrical
distractions (i.e., social house chores)
(i.e., house chores) consumption
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
5 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
5 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
5
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
5
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
unstable mobile/ condition/s, difficulty in
existing health
internet connection, independent learning, existing
condition/s,
existing health conflict with other health
difficulty in
condition/s & difficulty activities (i.e., house condition/s
independent
in independent chores), high electrical only
learning & conflict
learning consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
5 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
5 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
5
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
5
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
unstable mobile/ condition/s, difficulty in
existing health
internet connection, independent learning, existing
condition/s,
existing health conflict with other health
difficulty in
condition/s & difficulty activities (i.e., house condition/s
independent
in independent chores), high electrical only
learning & conflict
learning consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
5 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
5 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
5
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
5
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
0
unstable mobile/
internet connection,
unstable mobile/
existing health
internet connection,
unstable mobile/ condition/s, difficulty in
existing health
internet connection, independent learning, existing
condition/s,
existing health conflict with other health
difficulty in
condition/s & difficulty activities (i.e., house condition/s
independent
in independent chores), high electrical only
learning & conflict
learning consumption &
with other activities
distractions (i.e., social
(i.e., house chores)
media, noise from
community/neighbor)
CH32 CH33
0
SUMMARY MATRIX OF SELECTED DATA ELEMENTS OF MLESF
(This form can be used to tabulate survey result of Class/Section, Grade and School lev
NAME OF SCHOOL
Grade/School Level *Section
Last updated (date): For LIS Adm
Date Posted in LIS QC
B9. Gender
Total (Must be
equalled vis-à-vis
Grade Level Male Female
Enrollment per
Class/Grade Level)
Non-Graded 0
C2. Parent/Guardian Highest Educational Attainment (select only parent/guardian per learner ha
No Formal Schooling
No Formal Elementary
but able to read and Elementary level
Grade Level Schooling write
Graduate
D1. How many of your household members (including the enrollee) are studying in School Year
Only 1
2 Household 3 Household 4 Household
Grade Level Household
Members Members Members
Member
Non-Graded
D2. Who among the household members can provide instructional support to the child’s distan
Parent/ Guardian,
Parent/ Parent/ Guardian,
Parent/ Guardian Siblings, Grand
Guardian Siblings & Grand
Grade Level and Siblings Parent & Other
Only Parent
members of family
D3. What devices are available at home that the learner can use for learning?
Television,
Television Television and Television, Cellphone
Cellphone, Radio
Grade Level Only Cellphone & Radio
& Desktop/laptop
Total (Must be
equalled vis-à-vis
Grade Level Yes No
Enrollment per
Class/Grade Level)
Non-Graded 0
Mobile data,
Mobile data,
Mobile data Mobile data & broadband,
broadband & computer
Grade Level only broadband computer shop &
shop
other places
D6. What distance learning modality/ies do you prefer for your child?
online online learning,
online learning & online learning,
learning television, radio &
Grade Level television television & radio
only modular learning
DLM1 DLM2 DLM3 DLM4
Non-Graded
D7. What are the challenges that may affect your child’s learning process through distance edu
lack of available
gadgets/
lack of available
lack of equipment ,
lack of available gadgets/ equipment ,
available insufficient load/
gadgets/ equipment insufficient load/ data
gadgets/ data allowance,
Grade Level equipment & insufficient load/ allowance & unstable unstable mobile/
data allowance mobile/ internet
only internet connection
connection
& existing health
condition/s
E2. If the answer is no , please select only 1 major consideration or state specific reason
Fear of Limited or no
Getting available Existing Illness or Helping in
Infected of transportation from health related concens household chores
Grade Level
Corona home to school and
Virus vice versa
MC1 MC2 MC3 MC4
Non-Graded
broadband,
Computer shop and
Broadband only computer shop & Computer shop only
other places
other places
lack of available
lack of available lack of available gadgets/ equipment ,
gadgets/ gadgets/ lack of available gadgets/ insufficient load/ data
equipment , equipment , equipment , insufficient allowance, unstable
insufficient load/ insufficient load/ load/ data allowance, mobile/ internet
data allowance, data allowance, unstable mobile/ internet connection, existing
unstable mobile/ unstable mobile/ connection, existing health condition/s,
internet internet connection, health condition/s, difficulty in independent
connection, existing health difficulty in independent learning, conflict with
existing health condition/s, difficulty learning, conflict with other activities (i.e.,
condition/s & in independent other activities (i.e., house chores), high
difficulty in learning & conflict house chores) & high electrical consumption &
independent with other activities electrical consumption distractions (i.e., social
learning (i.e., house chores) media, noise from
community/neighbor)
ur child/children to participate?
ecific reason
helping in family
Presence of Arm Total (Must be equalled
business or Other Reason, if any
Conflict in the area vis-à-vis Enrollment per
working
Class/Grade Level)
MC5 MC6 MC7
0
racy/completeness
ll sections
l Enrollment Focal Person (SEFP)
ck for accuracy/completeness
ll Grade Levels
ol Head for review and approval and then to LIS System Administrator
DIVISION REGION
Grand Parent & Grand Parent, Other
Grand Parent Other members of
Other members of members of family &
Only family only
family Others
IC9 IC10
0
Total (Must be
equalled vis-à-vis
Enrollment per
Class/Grade Level)
0
CH33
0