FORM 1: LAC PROFILE

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

REGION: XI

LAC ID (name or number): 5 Number of LAC members: 6

Name of LAC Facilitator: MELANIO R. FLORINO Designation/Position: Master Teacher 1

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