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Republic of the Philippines

Department of Education
Region X – Northern Mindanao
DIVISION OF ILIGAN CITY

FORM 1: LAC PROFILE

This form should be accomplished by the LAC Facilitator and its members at the first LAC
session.
REGION:

LAC ID (name or number): Number of LAC members:

Name of LAC Facilitator: Designation/Position:

LAC Members

Contact
Preferred contact
details
DESIGNATION/ DIVISION mode (email, phone,
NAME Sex (email,
POSITION /S Skype, Zoom, Google
mobile
Meet, Viber, FB)
number)

ESPERIDION F. ENCABO I MEMORIAL HIGH SCHOOL


Puga-an, Iligan City, Philippines 9200
(063) 224-4718
School ID: 304154

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