FORM 2: LAC Facilitator Information Sheet

This form should be accomplished by the designated LAC Facilitator on or before the first LAC
session.

District: Vincenzo Sagun

School : Kabatan National High School

NAME: Male/Female: Date of Birth: Age: 48

GEMMA S.SINGSON Female
Nov. 8 ,1972

Contact details; Email: Mobile Number: Facebook Name:

Apolinar.cuizon@dep 09098984128 gemma.singson003@
ed.gov.ph deped.gov.ph

Preferred contact (Indicate all: email, phone, Skype, Viber, WhatsApp, Zoom, Google
mode: phone,email meet, FB, Messenger, etc.)
facebook,google
meet,messenger.