FORM 2: LAC Facilitator Information Sheet

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

Cluster: V

School: DASMARINAS II CENTRAL SCHOOL

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

NOREEN P. SASIS FEMALE NOV. 16, 1984 38

Contact details: Email: Mobile Number: Facebook Name:

09958322333 knowrain2002@gmai 09958322333 Knowrain Paras
l.com

Preferred contact (Indicate all: email, phone, Skype, Viber, WhatsApp, Zoom,
mode: Googlemeet, FB, Messenger, etc.)
FB Messenger FB (Knowrain Paras)