FORM 1: LAC PROFILE

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

REGION: V

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

SALAZAR

Name of LAC Facilitator: Designation/Position:

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

EDEN S. FEMALE SP-1 CAMARINES 09198260461 FB, GOOGLE

YANSON SUR eden.yanson001@ MEET
dep.gov.ph