No.

LRN NAME MONTH DAY YEAR

1 101422120363 Andaya, Harchelo Robert Francisco 2 2 2005
2 101427100005 Baldevia, John Benedict Aquino 8 3 2005
3 101429100026 Bulatao, John Mark Peralta

4 101422100047 Bunoan, Andrew Roque 5 16 2005

5 102154100017 Caballero, Hans Idos 3 7 2005
6 102151100030 Calimlim, Jace Asdren Claveria 8 24 2005
7 102155100026 Casequin, Carlos Daniel Jr Gutierrez 7 22 2005
8 101422100109 Duque, Mj Quebec 7 20 2005
9 411554150067 Fernandez, Miro Raphael Namias

10 101432100032 Ferrer, Jhon Michael Lopez 12 31 2004

11 101432100031 Ferrer, John Lloyd Ong

12 101422100151 Garcia, Roderick Cerineo

13 101425100030 Jovero, James Aficial 3 29 2005

14 101439090015 Layno, Mark Jayson Embuido 3 28 2005
15 101428120133 Lopez, Quintz Beaver Bautista 9 22 2004
16 101422090191 Mamaradlo, Sharwin Soriano
17 101422130278 Matsuzaki, Kentaro De Vera
18 101417100028 Maure, John Salvador Agustin 10 11 2004
19 101429100112 Maynigo, Kevin Peralta 7 26 2005
20 101910100063 Ochoco, John Paul Solomon 9 16 2005
21 101422100216 Orienza, Mark Carlo Refuerzo
22 101426100066 Pasaoa, Hari Andrew Idos 3 30 2005
23 101426100069 Prado, John Zeus Quinto 3 2 2005
24 411553150090 Quinto, John Carl 6 24 2005
25 101439100024 Ramos, Jayson Bogs Jimenez 1 17 2005
26 101429100144 Roque, Ken Tyrone Hart Macaraeg 2 4 2005
27 136413120262 Soriano, Railey Dacanay

28 101432100082 Ticman, Kenny Orlan Santilian 9 6 2005

29 400309150478 Untalan, Cedrick Andrei Ison 4 11 2005
30 101422130179 Velasco, Gabriel Raul Daliposa

31
32
33
34
35
36
37
38
39
 40
41
42
43
44
45
46
47
48
49
50

GIRLS
No. LRN NAME MONTH DAY YEAR
1 411520150126 Anchiboy, Nicole Kate Bauzon 8 4 2004
2 411553150092 Aquino, Ghislaine Joy Gonzales 10 8 2004
3 101415100022 Beroñ a, Aesha Fine Hudencial 6 3 2005
4 101426100013 Caburian, Erica Lambino 7 1 2005
5 101428100010 Carpio, Joniella Carpo
6 101429100041 Carpizo, Ardie May Lopez 5 15 2005
7 411518150290 Claveria, Alexa Margarette Limjuico 1 20 2005
8 101425100010 Cubos, Jodi Leya Bucaloy 11 18 2004
9 101424100017 De Vera Antoinette Austria 12 13 2003
10 101434100042 Domalanta. Kyla Mae Caron 11 28 2004
11 101422100117 Estanislao, Stefhany Berania 10 27 2005
12 101422100125 Evangelista, Karen Claire Urayan 4 29 2005
13 151512100019 Gonzales, Kaye Cee Menor 3 24 2005
B-DAY AGE
2/2/2005 17

8/3/2005 17

11/30/1999 22

5/16/2005 17

3/7/2005 17

8/24/2005 17

7/22/2005 17

7/20/2005 17

11/30/1999 22

12/31/2004 17

11/30/1999 22

11/30/1999 22

3/29/2005 17

3/28/2005 17

9/22/2004 18

11/30/1999 22

11/30/1999 22

10/11/2004 18

7/26/2005 17

9/16/2005 17

11/30/1999 22

3/30/2005 17

3/2/2005 17

6/24/2005 17

1/17/2005 17

2/4/2005 17

11/30/1999 22

9/6/2005 17

4/11/2005 17

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22
11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

11/30/1999 22

B-DAY AGE
8/4/2004 18

10/8/2004 18

6/3/2005 17

7/1/2005 17

11/30/1999 22

5/15/2005 17

1/20/2005 17

11/18/2004 17

12/13/2003 18

11/28/2004 17

10/27/2005 16

4/29/2005 17

3/24/2005 17
 School Form 1 School Register for Senior High School (SF1-SHS)
School Name CALASIAO COMPREHENSIVE School ID 300183 District CALASIAO I Division PANGASINAN I Region I
NATIONAL HIGH SCHOOL
Semester FIRST School Year 2021-2022 Grade Level 12 Track and Strand ACADEMIC/STEM

Section ODL STEM 12A Course (For TVL Only) 0

COMPLETE ADDRESS PARENTS GUARDIAN REMARKS
(if learner is not Living with Parent) Contact

Sex (M/F)
NAME Religious Mother's Maiden Name Number of (Please refer to the
LRN BIRTHDATE AGE Father's Name Name
(Last Name, First Name, Name
(mm/dd/yyyy) Affiliation House No./ Street/ Municipality/ (Last Name, First Name, Parent/ legend)
Extension, Middle Name) Barangay Province (Last Name, First Name, Name (Last Name, First Name, Name Relationship
Sitio/ Purok
City Extension, Middle Name) Name Extension, Middle
Extension, Middle Name) Guardian
Name)
NALSIAN MRS. ANNABELLE A.
101422120363 Andaya, Harchelo Robert Francisco M February 02, 2005 17 CHRISTIANITY CALASIAO PANGASINAN
1 93 POGO ANDAYA

101427100005 Baldevia, John Benedict Aquino M August 03, 2005 17 CHRISTIANITY MANCUP CALASIAO PANGASINAN MR. GERARDO ANDAYA
2 136
101429100026 Bulatao, John Mark Peralta M November 30, 1999 22 CHRISTIANITY TALIBAEW CALASIAO PANGASINAN MR. ROQUE B. ANDAYA
3 433
101422100047 Bunoan, Andrew Roque M May 16, 2005 17 CHRISTIANITY SAN MIGUEL CALASIAO PANGASINAN MR. SALVADOR ASPIRAS
4
MRS. SALVACION C.
102154100017 Caballero, Hans Idos M March 07, 2005 17 CHRISTIANITY MACABITO CALASIAO PANGASINAN
5 148 BALLESTEROS
PUGO MR. ODELON B.
102151100030 Calimlim, Jace Asdren Claveria M August 24, 2005 17 CHRISTIANITY CALASIAO PANGASINAN
6 25 NALSIAN CABATBAT

102155100026 Casequin, Carlos Daniel Jr Gutierrez M July 22, 2005 17 CHRISTIANITY GABON CALASIAO PANGASINAN MR. BOY E. CALAGUIO
7 178
101422100109 Duque, Mj Quebec M July 20, 2005 17 CHRISTIANITY TALIBAEW CALASIAO PANGASINAN MR. ERNESTO CARAULIA
8
MR. MARLON F.
411554150067 Fernandez, Miro Raphael Namias M November 30, 1999 22 CHRISTIANITY MANCUP CALASIAO PANGASINAN
9 176 CATUGAS

101432100032 Ferrer, Jhon Michael Lopez M December 31, 2004 17 CHRISTIANITY LONGOS CALASIAO PANGASINAN MR. ARNOLD P. CRUZ
10
DINALAOAN
101432100031 Ferrer, John Lloyd Ong M November 30, 1999 22 CHRISTIANITY CALASIAO PANGASINAN MRS. ARLENE DANGOY
11 179 SAGUR
NALSIAN
101422100151 Garcia, Roderick Cerineo M November 30, 1999 22 CHRISTIANITY CALASIAO PANGASINAN MR. PEDRO DE VERA
12 BACAYAO
101425100030 Jovero, James Aficial M March 29, 2005 17 CHRISTIANITY BRGY CRUZ SAN CARLOS PANGASINAN MR. ROLLY B. DELA CRUZ
13
MRS. LORETA
101439090015 Layno, Mark Jayson Embuido M March 28, 2005 17 CHRISTIANITY LONGOS CALASIAO PANGASINAN
FERNANDEZ
14
MR. ANICETO S. GABRIEL
101428120133 Lopez, Quintz Beaver Bautista M September 22, 2004 18 CHRISTIANITY TALIBAEW CALASIAO PANGASINAN
JR.
15
101422090191 Mamaradlo, Sharwin Soriano M November 30, 1999 22 CHRISTIANITY AMBUETEL CALASIAO PANGASINAN MR. DOMINADOR GARCIA
16
101422130278 Matsuzaki, Kentaro De Vera M November 30, 1999 22 CHRISTIANITY BUENLAG CALASIAO PANGASINAN MR. FRANKIE B. GUARIN
17
SITIO BALANI
101417100028 Maure, John Salvador Agustin M October 11, 2004 18 CHRISTIANITY
18 AMBONAO CALASIAO PANGASINAN MR. DARWIN HEPIGA
101429100112 Maynigo, Kevin Peralta M July 26, 2005 17 CHRISTIANITY LONGOS CALASIAO PANGASINAN MR. ROBERTO JOVES
19
MRS. THELMA P.
101910100063 Ochoco, John Paul Solomon M September 16, 2005 17 CHRISTIANITY SONGKOY CALASIAO PANGASINAN
20 70 MACAOAY
LEET NALSIAN-
101422100216 Orienza, Mark Carlo Refuerzo M November 30, 1999 22 CHRISTIANITY CALASIAO PANGASINAN MR. GEORGE R. MARZAN
21 103 BACAYAO
101426100066 Pasaoa, Hari Andrew Idos M March 30, 2005 17 CHRISTIANITY MALABAGO CALASIAO PANGASINAN MR. VICENTE T. MENOR
22 98
101426100069 Prado, John Zeus Quinto M March 02, 2005 17 CHRISTIANITY LONGOS CALASIAO PANGASINAN MR. JOBERT D. MINA
23 287
SAN MIGUEL MR. CHARLIE M.
411553150090 Quinto, John Carl M June 24, 2005 17 CHRISTIANITY CALASIAO PANGASINAN
24 PARONGKING MONTEMAYOR
MRS. JACQUELYN
101439100024 Ramos, Jayson Bogs Jimenez M January 17, 2005 17 CHRISTIANITY DINALAOAN CALASIAO PANGASINAN
MURLA
25
101429100144 Roque, Ken Tyrone Hart Macaraeg M February 04, 2005 17 CHRISTIANITY POB. EAST CALASIAO PANGASINAN MR. SEVERINO B. NANIP
26
MR. GERRY Q.
136413120262 Soriano, Railey Dacanay M November 30, 1999 22 CHRISTIANITY SONGKOY CALASIAO PANGASINAN
PALAGANAS
27

SFRT 2017
 COMPLETE ADDRESS PARENTS GUARDIAN REMARKS
(if learner is not Living with Parent) Contact

Sex (M/F)
NAME Religious Mother's Maiden Name Number of (Please refer to the
LRN BIRTHDATE AGE Father's Name Name
(Last Name, First Name, Name
(mm/dd/yyyy) Affiliation House No./ Street/ Municipality/ (Last Name, First Name, Parent/ legend)
Extension, Middle Name) Sitio/ Purok Barangay Province (Last Name, First Name, Name (Last Name, First Name, Name Relationship
City Extension, Middle Name) Name Extension, Middle
Extension, Middle Name) Guardian
Name)

101432100082 Ticman, Kenny Orlan Santilian M September 06, 2005 17 CHRISTIANITY BUENLAG CALASIAO PANGASINAN MR. SAMUEL M. QUIDILIG
28
MRS. EUCRECIA C.
400309150478 Untalan, Cedrick Andrei Ison M April 11, 2005 17 CHRISTIANITY TALIBAEW CALASIAO PANGASINAN
29 247 QUIROS

101422130179 Velasco, Gabriel Raul Daliposa M November 30, 1999 22 CHRISTIANITY TALIBAEW CALASIAO PANGASINAN MR. FEDERICO QUITLONG
30
0 0 M November 30, 1999 22 CHRISTIANITY NAGSAING CALASIAO PANGASINAN MR. JOSELITO V. SAPLAN
31
PANDAYAN ST, MR. ANTON V.
0 0 M November 30, 1999 22 CHRISTIANITY CALASIAO PANGASINAN
32 GABON SARMIENTO

0 0 M November 30, 1999 22 CHRISTIANITY TALIBAEW CALASIAO PANGASINAN MRS. CECILLE SOBREDO
33
0 0 M November 30, 1999 22 CHRISTIANITY AMBONAO CALASIAO PANGASINAN MR. FELIX D. SORIANO
34 176
BALANI,
0 0 M November 30, 1999 22 CHRISTIANITY CALASIAO PANGASINAN MR. FELIMON RICO
35 173 AMBONAO
MRS. MARILOU
0 0 M November 30, 1999 22 CHRISTIANITY DOYONG CALASIAO PANGASINAN
VILLANUEVA
36
30 <=== TOTAL MALE
MRS. FRESSIE
411520150126 Anchiboy, Nicole Kate Bauzon F 18 CHRISTIANITY
PNR SAN MIGUEL CALASIAO PANGASINAN
August 04, 2004
1 SATURNINO

411553150092 Aquino, Ghislaine Joy Gonzales F October 08, 2004 18 CHRISTIANITY BUED CALASIAO PANGASINAN MR. JOBERT B. DION
2 150
MRS. ANGELINA M.
101415100022 Beroña, Aesha Fine Hudencial F 17 CHRISTIANITY
464 MACABITO CALASIAO PANGASINAN
June 03, 2005
3 FRANCISCO

101426100013 Caburian, Erica Lambino F 17 CHRISTIANITY

183 AMBONAO CALASIAO PANGASINAN MR. RICARDO U. GABIS
July 01, 2005
4
101428100010 Carpio, Joniella Carpo F 22 CHRISTIANITY
340 MALABAGO CALASIAO PANGASINAN MR. MARLON GONZALES
November 30, 1999
5
MR. ALEXANDER M.
101429100041 Carpizo, Ardie May Lopez F May 15, 2005 17 CHRISTIANITY MACABITO CALASIAO PANGASINAN
JUNIO
6
411518150290 Claveria, Alexa Margarette Limjuico F 17 CHRISTIANITY
124 AMBUETEL CALASIAO PANGASINAN MRS. SUZIMA S. MABUTI
January 20, 2005
7
DINALAOAN MR. BERLY
101425100010 Cubos, Jodi Leya Bucaloy F November 18, 2004 17 CHRISTIANITY CALASIAO PANGASINAN
8 72 RIVERSIDE MONTEMAYOR
SITIO-TOKOK, MRS. MADELENE
101424100017 De Vera Antoinette Austria F December 13, 2003 18 CHRISTIANITY DAGUPAN CITY PANGASINAN
9 283 BACAYAO SUR PASAOA
MR. JOSELITO G.
101434100042 Domalanta. Kyla Mae Caron F November 28, 2004 17 CHRISTIANITY BUENLAG CALASIAO PANGASINAN
10 954 PERALTA
BALANI, MRS. MARICRIS D.
101422100117 Estanislao, Stefhany Berania F October 27, 2005 16 CHRISTIANITY CALASIAO PANGASINAN
11 AMBONAO GABICA
POGO MRS. SHERYLL M.
101422100125 Evangelista, Karen Claire Urayan F April 29, 2005 17 CHRISTIANITY CALASIAO PANGASINAN
12 27 NALSIAN TARROZA

151512100019 Gonzales, Kaye Cee Menor F March 24, 2005 17 CHRISTIANITY BUED CALASIAO PANGASINAN MR. MARIO A. VILORIA
13 34
31 <=== TOTAL FEMALE

61 <=== COMBINED
Legend: List and Code of Indicators under REMARKS column
Beginning of the Prepared By:
Indicator Code Required Information Indicator Code Required Information REGISTERED End of the Semester
Semester
Transferred T/O CCT Recipient CCT CCT Control/reference number
Out & Effectivity Date Name of
MALE
Balik Aral B/A school last attended & Year
Transferred In Specify Exceptionality of the MERIAN D. GALANG
T/I
Name of School, Date of 1st Learner With LWE
Learner Signature of Adviser over Printed Name
Attendance and Date of Last Exceptionality Specify Level & Effectivity Date FEMALE
Attendance if Transferred Out Accelerated ACL
Beginning of the Semester Date: October 29,2018 End of the Semester Date: April 5,2019
TOTAL

SFRT 2017
SFRT 2017
 School Form 2 Daily Attendance Report of Learners for Senior High School (SF2-SHS)
School Name School ID District Division

Semester School Year Grade Level Track and Strand

Section Course/s (only for TVL) Month of

DATE
NAME Total for the Month
No. (Last Name, First Name, Name Extension, Middle
Name) M T W TH F S M T W TH F S M T W TH F S M T W TH F S M T W TH F S ABSENT TARDY

10

11

12

13

14

15

16

17

<=== MALE | TOTAL Per Day ===>

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25
HS)
Region

REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If TRANSFERRED
IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).
 DATE
NAME Total for the Month
No. (Last Name, First Name, Name Extension, Middle
Name) M T W TH F S M T W TH F S M T W TH F S M T W TH F S M T W TH F S ABSENT TARDY

26

27

<=== FEMALE | TOTAL Per Day ===>

Combined TOTAL Per Day

No. of Days of Classes:

GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance (blank) - Present; (x) - Absent; Tardy (half shaded = Upper for
2. To compute the following: Late Comer, Lower for Cutting Classes)
* Enrolment (as of 1st Friday of the semester)

2. REASONS/CAUSES FOR NO LONGER IN SCHOOL Late Enrolment during the month (beyond cut-off)

a. Percentage of Enrolment = x 100 (NLS)

Registered Learners as of end of the month Registered Learners as of end of the month

Enrolment as of 1st Friday of the school year

a. Domestic-Related Factors Percentage of Enrolment as of end of the month
a.1. Had to take care of siblings Average Daily Attendance
Total Daily Attendance a.2. Early marriage/pregnancy
b. Average Daily Attendance =
Number of School Days in reporting month a.3. Parents' attitude toward schooling Percentage of Attendance for the month
a.4. Family problems
Number of students absent for 5 consecutive days
Average daily attendance
c. Percentage of Attendance for the month = x 100
Registered Learners as of end of the month
b. Individual-Related Factors
3. Every end of the month, the Class Adviser will submit this form to the Office of the Principal for recording of summary table into School Form 4. Once b.1. Illness
No Longer in School (NLS)
signed by the School Head, this form should be returned to the Class Adviser. b.2. Overage
4. The Class Adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days b.4. Drug Abuse
b.5. Poor Academic Performance
Transferred Out
and/or those at risk of dropping out. b.6. Lack of Interest/Distractions
5. Attendance performance of learners will be reflected in the SF9-SHS of every grading period. b.7. Hunger/Malnutrition Transferred In

Shifting Out

c. School-Related Factors Shifting In

c.1. Teacher Factor
c.2. Physical Condition of Classroom
c.3. Peer Influence
I certify that this report is true and correct:
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. tribal wars & clan feuds)
d.3. Calamities/Disasters Signature of Class Ad

e. Financial-Related
e.1. Child labor, work Attested By:

f. Others (Specify) Signature of School H

a. Death
b. Transferred to School Abroad
c. Transferred to International School
d. Transferred to ALS
 REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If TRANSFERRED
IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).

No. of Days of Classes:

Summary

M F TOTAL
the semester)

h (beyond cut-off)

of the month

end of the month

e month

consecutive days

ol (NLS)

port is true and correct:

Signature of Class Adviser over Printed Name

Signature of School Head over Printed Name

 School Form 3 Books Issued and Returned for Senior High School (SF3-SHS)
School Name School ID District Division

Semester School Year Grade Level Track and Strand

Section Course/s (only for TVL)

Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

NAME
No. (Last Name, First Name, Name Extension,
Middle Name) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
TOTAL MALE ===>
1
2
3
4
5
6
7
8
9
10
11
12
13
SHS)
Region

/ ModuleTitle Book / ModuleTitle

REMARKS/ACTION TAKEN
(Please refer to the codes below)
(mm/dd/yy) Date (mm/dd/yy)
Returned Issued Returned
 Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

NAME
No. (Last Name, First Name, Name Extension,
Middle Name) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
TOTAL FEMALE ===>
COMBINED ===>

GUIDELINES:
1. Title of Books Issued to each learner must be recorded by the Class Adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued shall be reflected in the form.
4. The Total Number of Copies of Books Returned shall be reflected in the form.
5. All textbooks being used must be included. Additional copies of this form may be used if needed.
In case of lost/unreturned books, please provide information with the following code:
Prepared By:
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code
FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian (for code
TDO), PTL=Paid by the Learner (for code NEG). References: DO No.23, s.2001, DO No.25, s.2003, DO No.14, s.2012.
Signature of Class A
/ ModuleTitle Book / ModuleTitle

REMARKS/ACTION TAKEN
(Please refer to the codes below)
(mm/dd/yy) Date (mm/dd/yy)
Returned Issued Returned

ature of Class Adviser over Printed Name

 School Form 4 Monthly Learners' Movement and Attendance for Senior High School (SF4-SH

School Name District Division Region

School ID Semester School Year

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN SHIFTED O

REGISTERED
LEARNERS (A) (A+B) (A) (A+B) (A) (A+B) (A)
(As of End Cumulative Cumulative Cumulative Cumulative Cumulative Cumulative Cumulative
TRACK STRAND Daily % for the
Number as
(B) Total for
Number as of Number as
(B) Total for
Number as Number as
(B) Total for
Number as of Number as
(B) Total fo
of the Month) Average Month the Month the Month the Month the Month
of Previous End of the of Previous of End of the of Previous End of the of Previous
Month Month Month Month Month Month Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M

TOTAL FOR GRADE 11

TOTAL FOR GRADE 12

GRAND TOTAL

Prepared and Submitted By:

Signature of School Head over Printed Name

SF4-SHS)

Region

SHIFTED OUT SHIFTED IN

(A+B) (A) (A+B)

Cumulative Cumulative Cumulative
(B) Total for (B) Total for
Number as of Number as Number as of
the Month the Month
End of the of Previous End of the
Month Month Month

F T M F T M F T M F T M F T
 School Form 5A End of Semester and School Year Status of Learners for Senior High School (SF5A-SHS)

CALASIAO COMPREHENSIVE
School Name NATIONAL HIGH SCHOOL School ID 300183 District CALASIAO I Division PANGASINAN I Region I

Semester SECOND SEMESTER School Year 2021-2022 Grade Level 12

Section ODL STEM 12A

Track and Strand ACADEMIC - STEM Course/s (only for TVL)

BACK SUBJECT/S END OF

LEARNER'S NAME END OF SCHOOL
No. LRN List down subjects where learner obtained a rating SEMESTER
(Last Name, First Name, Name Extension, Middle Name) YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)

MALE
1 101422120363 Andaya, Harchelo Robert Francisco COMPLETE REGULAR SUMMARY TABLE 1ST SEM

2 101427100005 Baldevia, John Benedict Aquino COMPLETE REGULAR STATUS MALE FEMALE TOTAL
3 101429100026 Bulatao, John Mark Peralta COMPLETE REGULAR COMPLETE 36 13 49
4 101422100047 Bunoan, Andrew Roque COMPLETE REGULAR INCOMPLETE 0 0 0
5 102154100017 Caballero, Hans Idos COMPLETE REGULAR TOTAL 36 13 49
6 102151100030 Calimlim, Jace Asdren Claveria COMPLETE REGULAR
7 102155100026 Casequin, Carlos Daniel Jr Gutierrez COMPLETE REGULAR SUMMARY TABLE 2ND SEM

8 101422100109 Duque, Mj Quebec COMPLETE REGULAR STATUS MALE FEMALE TOTAL

9 411554150067 Fernandez, Miro Raphael Namias COMPLETE REGULAR COMPLETE 36 13 49
10 101432100032 Ferrer, Jhon Michael Lopez COMPLETE REGULAR INCOMPLETE 0 0 0
11 101432100031 Ferrer, John Lloyd Ong COMPLETE REGULAR TOTAL 36 13 49
12 101422100151 Garcia, Roderick Cerineo COMPLETE REGULAR
13 101425100030 Jovero, James Aficial COMPLETE REGULAR SUMMARY TABLE (End of the School Year Only)

14 101439090015 Layno, Mark Jayson Embuido COMPLETE REGULAR STATUS MALE FEMALE TOTAL
15 101428120133 Lopez, Quintz Beaver Bautista COMPLETE REGULAR REGULAR 36 13 49
16 101422090191 Mamaradlo, Sharwin Soriano COMPLETE REGULAR IRREGULAR 0 0 0
17 101422130278 Matsuzaki, Kentaro De Vera COMPLETE REGULAR TOTAL 36 13 49
18 101417100028 Maure, John Salvador Agustin COMPLETE REGULAR
19 101429100112 Maynigo, Kevin Peralta COMPLETE REGULAR
20 101910100063 Ochoco, John Paul Solomon COMPLETE REGULAR
21 101422100216 Orienza, Mark Carlo Refuerzo COMPLETE REGULAR
22 101426100066 Pasaoa, Hari Andrew Idos COMPLETE REGULAR
23 101426100069 Prado, John Zeus Quinto COMPLETE REGULAR
24 411553150090 Quinto, John Carl COMPLETE REGULAR
25 101439100024 Ramos, Jayson Bogs Jimenez COMPLETE REGULAR
26 101429100144 Roque, Ken Tyrone Hart Macaraeg COMPLETE REGULAR
27 136413120262 Soriano, Railey Dacanay COMPLETE REGULAR
28 101432100082 Ticman, Kenny Orlan Santilian COMPLETE REGULAR
29 400309150478 Untalan, Cedrick Andrei Ison COMPLETE REGULAR
30 101422130179 Velasco, Gabriel Raul Daliposa COMPLETE REGULAR
31 0 0 COMPLETE REGULAR
32 0 0 COMPLETE REGULAR
 BACK SUBJECT/S END OF
LEARNER'S NAME END OF SCHOOL
No. LRN List down subjects where learner obtained a rating SEMESTER
(Last Name, First Name, Name Extension, Middle Name) YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)

33 0 0 COMPLETE REGULAR
34 0 0 COMPLETE REGULAR
35 0 0 COMPLETE REGULAR
COMPLETE REGULAR Prepared By:
36 0 0
FEMALE
1 101426070015 DELA CRUZ, DAISSIE ANNE, SATURNINO COMPLETE REGULAR MERIAN D. GALANG
Signature of Class Adviser over Printed Name
2 300183140122 DION, JOANNE GWYNETH, NIPAL COMPLETE REGULAR
3 101436070037 FRANCISCO, LOREN, MAMARADLO COMPLETE REGULAR
4 101415070035 GABIS, MICHELLE ANGELA, CABRERA COMPLETE REGULAR
5 151512070017 GONZALES, BIANCA, BARBERAN COMPLETE REGULAR
Certified Correct By:
6 109438070088 JUNIO, ALECZHYA JOYCE, NATALIO COMPLETE REGULAR
7 101428070032 MABUTI, CRISHA MAE, SOLOMON COMPLETE REGULAR CHONA C. SAMSON, EdD
8 101422070183 MONTEMAYOR, KIMBERLY ALLYSON, FERRER COMPLETE REGULAR PRINCIPAL IV
Signature of School Head over Printed Name
9 300183140132 PASAOA, MIKHAELLA, RAMOS COMPLETE REGULAR
10 101429070103 PERALTA, KRISSA JOY, MONDERIN COMPLETE REGULAR
11 101953070169 REFUGIO, SARAH KATE, DOLLENTE COMPLETE REGULAR
Reviewed By:
12 101422070247 TARROZA, KYARRA DEANISEE, MALLO COMPLETE REGULAR
13 300183140136 VILORIA, CAMILLE ANDREA, VINOYA COMPLETE REGULAR DR. ROBERTO Z. BARONGAN
PUBLIC SCHOOLS DISTRICT SUPERVISOR
Signature of Division Representative over Printed Name

GUIDELINES:

This form shall be accomplished after each semester in a school year, leaving the End of School Year Status Column and Summary Table for End of School Year Status blank/unfilled at the end of the 1st Semester. These
data elements shall be filled up only after the 2nd semester or at the end of the School Year.

INDICATORS:
End of Semester Status
Complete - number of learners who completed/satisfied the requirements in all subject areas (with grade of at least 75%)
Incomplete - number of learners who did not meet expectations in one or more subject areas, regardless of number of subjects failed (with grade less than 75%)
Note: Do not include learners who are No Longer in School (NLS)

End of School Year Status

Regular - number of learners who completed/satisfied requirements in all subject areas both in the 1st and 2nd semester
Irregular - number of learners who were not able to satisfy/complete requirements in one or both semesters
 School Form 5B List of Learners with Complete SHS Requirements (SF5B-SHS)
CALASIAO COMPREHENSIVE
School Name School ID 300183 District CALASIAO I Division PANGASINA Region I
NATIONAL HIGH SCHOOL
Semester SECOND School Year 2021-2022 Section ODL STEM 12A
Track and Strand ACADEMIC/STEM Course/s (only for TVL)

Completed SHS in
2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification Level
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)

MALE

1 101422120363 Andaya, Harchelo Robert Francisco Y SUMMARY TABLE A

2 101427100005 Baldevia, John Benedict Aquino Y STATUS MALE FEMALE TOTAL
3 101429100026 Bulatao, John Mark Peralta Y Learners who
4 101422100047 Bunoan, Andrew Roque Y completed SHS
Program within 2 17 12 29
5 102154100017 Caballero, Hans Idos Y SYs or 4
6 102151100030 Calimlim, Jace Asdren Claveria Y semesters

7 102155100026 Casequin, Carlos Daniel Jr Gutierrez Y Learners who

8 101422100109 Duque, Mj Quebec Y completed SHS
Program in more 0 1 1
9 411554150067 Fernandez, Miro Raphael Namias Y than 2 SYs or 4
10 101432100032 Ferrer, Jhon Michael Lopez Y semesters

11 101432100031 Ferrer, John Lloyd Ong Y TOTAL 17 13 30

12 101422100151 Garcia, Roderick Cerineo Y
13 101425100030 Jovero, James Aficial Y
14 101439090015 Layno, Mark Jayson Embuido Y
15 101428120133 Lopez, Quintz Beaver Bautista Y SUMMARY TABLE B
16 101422090191 Mamaradlo, Sharwin Soriano Y STATUS MALE FEMALE TOTAL
17 101422130278 Matsuzaki, Kentaro De Vera Y NC III 0 0 0
18 101417100028 Maure, John Salvador Agustin Y NC II 0 0 0
19 101429100112 Maynigo, Kevin Peralta Y NC I 0 0 0
20 101910100063 Ochoco, John Paul Solomon Y TOTAL 0 0 0
21 101422100216 Orienza, Mark Carlo Refuerzo Y
Note: NCs are recorded here for documentation but is not a
requirement for graduation.
 Completed SHS in
2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification Level
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)
Note: NCs are recorded here for documentation but is not a
Y requirement for graduation.
22 101426100066 Pasaoa, Hari Andrew Idos
23 101426100069 Prado, John Zeus Quinto Y
24 411553150090 Quinto, John Carl Y
25 101439100024 Ramos, Jayson Bogs Jimenez Y
26 101429100144 Roque, Ken Tyrone Hart Macaraeg Y GUIDELINES:
27 136413120262 Soriano, Railey Dacanay Y
1. This form should be accomplished by the Class Adviser at End of
Y School Year.
28 101432100082 Ticman, Kenny Orlan Santilian 2. It should be compiled and checked by
Y the School Head and passed to the Division Office before graduation.
29 400309150478 Untalan, Cedrick Andrei Ison
30 101422130179 Velasco, Gabriel Raul Daliposa Y

31 0 0 Y Reviewed By:
32 0 0 Y
33 0 0 Y MERIAN D. GALANG
34 0 0 Y Signature of Class Adviser over Printed Name

35 0 0 Y
36 0 0 N
FEMALE
1 101426070015 DELA CRUZ, DAISSIE ANNE, SATURNINO Y Certified Correct & Submitted By:

2 300183140122 DION, JOANNE GWYNETH, NIPAL Y CHONA C. SAMSON, EdD

3 101436070037 FRANCISCO, LOREN, MAMARADLO Y PRINCIPAL IV
4 101415070035 GABIS, MICHELLE ANGELA, CABRERA Y Signature of School Head over Printed Name

5 151512070017 GONZALES, BIANCA, BARBERAN Y

6 109438070088 JUNIO, ALECZHYA JOYCE, NATALIO
7 101428070032 MABUTI, CRISHA MAE, SOLOMON
8 101422070183 MONTEMAYOR, KIMBERLY ALLYSON, FERRER
9 300183140132 PASAOA, MIKHAELLA, RAMOS
10 101429070103 PERALTA, KRISSA JOY, MONDERIN
Y
Y Reviewed By:
Y DR. ROBERTO Z. BARONGAN
Y PUBLIC SCHOOLS DISTRICT SUPERVISOR
Y Signature of Division Representative over Printed Name

11 101953070169 REFUGIO, SARAH KATE, DOLLENTE Y

12 101422070247 TARROZA, KYARRA DEANISEE, MALLO Y
 Completed SHS in
2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification Level
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)

13 300183140136 VILORIA, CAMILLE ANDREA, VINOYA Y

 School Form 6 Summarized Report of Learner Status as of End of Semester and School Year for Senior High School (SF6-SHS)

School Name School ID District Division

Semester School Year

END OF SCHOOL YEAR

END OF SEMESTER STATUS
(Fill up only at the end of the second se

GRADE LEVEL
COMPLETE INCOMPLETE TOTAL REGULAR IRREGULAR

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE

GRADE 11
TRACK/STRAND/COURSE

SUB TOTAL
GRADE 12
TRACK/STRAND/COURSE

SUB TOTAL
TOTAL

Prepared and Submitted By: Reviewed & Validated By: Noted By:
Signature of School Head over Printed Name Signature of Division Representative over Printed Name Signature of Divisio
GUIDELINES:
1. After receiving and validating the report on Status of Learners submitted by the Class Adviser, the School Head shall compute the grade level total per track/strand/course and school t
2. This report shall be forwarded to the Division Office by the end of the semester.
3. Column for End of School Year shall be accomplished at the end of SY or every after the 2nd semester
4. Protocols of validation & submission are under the discretion of the Schools Division Superintendent.
6-SHS)

Region

OOL YEAR
the second semester.)

ULAR TOTAL

TOTAL MALE FEMALE TOTAL

ature of Division Superintendent over Printed Name

e and school total.

 School Form 7 School Personnel Basic Profile and Assignment for Senior High School (SF7-SHS)
School Name School ID District Division
Semester School Year
(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non-Teaching Items (C ) Other Appointments and Funding

Appointment:
Title of Plantilla Position Title of Plantilla Position Title of Designation (Contractual,
Number of Number of
(as it appears in the appointment (as it appears in the appointment (as it appears in the contract/document: Teacher, Substitute,
Incumbent Incumbent
document/PSIPOP) document/PSIPOP) Clerk, Security Guard, Driver etc.) Volunteer, Others
specify)

EDUCATIONAL QUALIFICATION Daily Program (ti

Nature of
Employee Appointment/
Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory
Sections
Identification (Arrange by Sex Status Class & Other Ancillary DAY
Source Designation Degree/ Specialization/ (Enumerate
Number - Position, Descending) (Regular/ Minor Assignments sections taught) (M/T/W/T
T.I.N.) Probationary/ Postgraduate Specialized
H/F)
Part Time) Training Attended

First Semester:
GENERAL PHYSICS 1 12-STEM B M-TH
GENERAL PHYSICS 1 12-STEM A M-TH
GENERAL MATHEMATICS 11-ABM D M-TH
GENERAL MATHEMATICS 11-ABM E M-TH

CONTROL SYSTEMS
GENERAL MATHEMATICS 11-ABM F M-TH
PE 12-STEM B T
ICL 12-STEM A&B M & TH
PROBATIONA
MT-I

Second Semester:
ABALOS F BSECE/MS ECE
RY

Advisory: 12-STEM B
Ancillary Assignment/s: 12-ICT COORDINATOR
Ave. Minutes p
First Semester:

Second Semester:
CALANGIAN

Advisory:
Ancillary Assignment/s:
Ave. Minutes p
First Semester:

Second Semester:
GALANG

Advisory:
Ancillary Assignment/s:
Ave. Minutes p
First Semester:

Second Semester:
EVANGELISTA

Advisory:
Ancillary Assignment/s:
Ave. Minutes p
First Semester:
 EDUCATIONAL QUALIFICATION Daily Program (ti
Nature of
Employee Appointment/
Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory
Sections
Identification (Arrange by Sex Status Class & Other Ancillary DAY
Source Designation Degree/ Specialization/ (Enumerate
Number - Position, Descending) (Regular/ Minor Assignments sections taught) (M/T/W/T
T.I.N.) Probationary/ Postgraduate Specialized
H/F)
Part Time) Training Attended

Second Semester:
MANANGAN

Advisory:
Ancillary Assignment/s:
Ave. Minutes p
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes p

GUIDELINES:
1. This form shall be accomplished at the beginning of each semester by the School Head and is submitted to the Division Office. In case of movement of teachers and other
personnel during the semester, an updated SHSF-7 must be submitted to the Division Office at the end of the semester.
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank to the lowest.
3. Please reflect subjects being taught including advisory class or ancillary assignment (if any). Other administrative duties must also be reported.
4. Daily Program Column is for teaching personnel only.
SF7-SHS)
Region

ments and Funding Sources

ppointment: Number of Incumbent

Contractual, Fund Source
Substitute, (SEF, PTA,
nteer, Others NGO's etc.) Teaching Non-Teaching
specify)

Remarks:
Daily Program (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
From To Teaching JHS- please indicate the number
(00:00) (00:00) Minutes per of teaching minutes per week)
Week

7:30 8:30 240

8:30 9:30 240
10:00 11:00 240
1:00 2:00 240
2:00 3:00 240
4:00 5:00 60
4:00 5:00 120

12-ICT COORDINATOR
Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

 Remarks:
Daily Program (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
From To Teaching JHS- please indicate the number
(00:00) (00:00) Minutes per of teaching minutes per week)
Week

Ave. Minutes per Day

Ave. Minutes per Day

Signature of School Head over Printed Name

Updated as of:

School Form 7, Page ___ of ________

SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report for Senior High School (SF8-SHS)
(For All Grade Levels)

CALASIAO COMPREHENSIVE
District CALASIAO I Division PANGASINAN I Region I
School Name NATIONAL HIGH SCHOOL

School ID 300183 Grade 11 Section HUMSS 11-D Track/Strand (SHS) ACADEMIC School Year 2021-2022

Learner's Name Nutritional Status

Birthdate Weight Height Height² Height for
No. LRN (Last Name, First Name, Name Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category Age (HFA)
Extension, Middle Name) (kg/m²)
MALE
1 400154150118 Acuna, John Brix Vallo 2/2/2005 17 51.2 1.71 2.9 17.6551724 WASTED NORMAL
2 101422120225 Aoanan, John Kyle Lumacad 8/3/2005 17 62.1 1.71 2.9241 21.2373038 NORMAL NORMAL
3 101433110005 Basto, Johnmelbert Gonzales 11/30/1999 22 69.3 1.68 2.8224 24.5535714 NORMAL NORMAL
4 101426120002 Bolinas, Joward Parayno 5/16/2005 17 64.6 1.8 3.24 19.9382716 NORMAL NORMAL
5 101439120268 Bravo, Jayvee Balgos 3/7/2005 17 62 1.8 3.24 19.1358025 NORMAL NORMAL
6 101422120287 Canilang, Alexis Gonzales 8/24/2005 17 69.4 1.79 3.2041 21.6597484 NORMAL NORMAL
7 101418120071 Calimquim, Jz Adamz Casilang 7/22/2005 17 47.6 1.56 2.4336 19.5595003 NORMAL STUNTED
8 101829120106 Cantong, Jhan Rhae Suratos 7/20/2005 17 42.5 1.64 2.6896 15.8016062 WASTED NORMAL
9 101415110041 De Guzman, Russelle Garcia 11/30/1999 22 63 1.69 2.8561 22.0580512 NORMAL NORMAL
10 101437110040 Dela Cruz, Adolf Zurc Aled Lopez 12/31/2004 17 46.9 1.71 2.9241 16.0391231 WASTED NORMAL
11 101422110122 Diaz, Wilson Espinoza 11/30/1999 22 0 #DIV/0! #DIV/0! STUNTED

12 101422110152 Estrada, Zander Tantay 11/30/1999 22 49 0 #DIV/0! #DIV/0! STUNTED

13 101423120025 Estrada, Jobert Gonzales 3/29/2005 17 60.9 1.71 2.9241 20.8269211 NORMAL NORMAL

14 101422 120330 Fernandez, Eric Bautista 3/28/2005 17 47 1.71 2.9241 16.0733217 WASTED NORMAL

15 101430130099 Fontanilla, Marlo Daniel Galliguez 9/22/2004 18 1.64 2.6896 0 WASTED NORMAL
16 101914110033 Gangat, Rejieboy Quiambao 11/30/1999 22 1.71 2.9241 0 WASTED NORMAL
17 153506120006 Gonzales, Gerald Mondero 11/30/1999 22 1.74 3.0276 0 WASTED NORMAL
18 101417110037 Larioza, Melvin Balaa 10/11/2004 18 64.2 1.55 2.4025 26.7221644OVERWEIGHT STUNTED
19 101858110046 Latoja, Franzen Zoe Fernandez 7/26/2005 17 71.2 1.73 2.9929 23.7896355 NORMAL NORMAL
20 101422100065 Mapili, Jeffrey Monfero 9/16/2005 17 51 1.77 3.1329 16.2788471 WASTED NORMAL
21 411518150260 Manandeg, Jessie De Leon 11/30/1999 22 54.2 1.74 3.0276 17.9019686 WASTED NORMAL
22 101436110124 Mangampat, Joshua Punzalan 3/30/2005 17 54 1.68 2.8224 19.1326531 NORMAL NORMAL
23 101422110184 Maynigo, Ronald Baldueza 3/2/2005 17 64 1.78 3.1684 20.1994698 NORMAL NORMAL
24 010427110026 Monzon, Van Archie Villar 6/24/2005 17 54 1.71 2.9241 18.4672207 WASTED NORMAL
25 101428120069 Molina, Jeffrey B. 1/17/2005 17 0 #DIV/0! #DIV/0! STUNTED
26 101421110045 Navarro, Risty 2/4/2005 17 59.5 1.74 3.0276 19.6525301 NORMAL NORMAL
27 101438120113 Norada, Mark Joseph 11/30/1999 22 1.58 2.4964 0 WASTED STUNTED
28 101420100075 Paningbatan, Janrey Espinoza 9/6/2005 17 67.5 1.74 3.0276 22.294887 NORMAL NORMAL
29 101434120029 Paramio, Edrian Dela Rosa 4/11/2005 17 68.5 1.7 2.89 23.7024221 NORMAL NORMAL
30 101418110042 Robosa, Ramil Jr. Manzon 11/30/1999 22 50.6 1.72 2.9584 17.1038399 WASTED NORMAL
31 152501120092 Saplan, Mark Angelo Bandong 3/30/2005 17 54 1.68 2.8224 19.1326531 NORMAL NORMAL
32 101422110142 Semodio, Niel Yrvyne Macanlalay 3/2/2005 17 64 1.78 3.1684 20.1994698 NORMAL NORMAL
33 010143410078 Sindayen, Gabrielle Cruz 6/24/2005 17 54 1.71 2.9241 18.4672207 WASTED NORMAL
34 101418110042 Solayao, Aljon Francisco 1/17/2005 17 0 #DIV/0! #DIV/0! STUNTED
35 152501120092 Sorio, Mark Patrick 3/2/2005 17 64 1.78 3.1684 20.1994698 NORMAL NORMAL
36 101422110142 Valle, John Benedict Simbulan 6/24/2005 17 54 1.71 2.9241 18.4672207 WASTED NORMAL
37 10143410078 Abulencia, John Paul 1/17/2005 17 0 #DIV/0! #DIV/0! STUNTED
38 10427110026 Javier, Ross Anthony 2/4/2005 17 59.5 1.74 3.0276 19.6525301 NORMAL NORMAL

1 101430110003 Agsalud, Roma Quirmit 8/4/2004 18 1.71 2.9241 0 WASTED NORMAL

2 101425120051 Bauzon, Danica Rose Fortaleza 10/8/2004 18 41.9 1.52 2.3104 18.1353878 WASTED NORMAL
3 101638120150 Blanco, Jellian Gatan 6/3/2005 17 50.5 1.55 2.4025 21.0197711 NORMAL NORMAL
4 101422110034 Busel, Regine Austria 7/1/2005 17 43.8 1.5 2.25 19.4666667 NORMAL NORMAL
5 101422100064 Capito, Rica Mae Navarro 11/30/1999 22 47.8 1.52 2.3104 20.6890582 NORMAL NORMAL
6 101437110010 Caragay, Jesseca Sanchez 5/15/2005 17 43.9 1.65 2.7225 16.1248852 WASTED NORMAL
7 101422100074 Castro, Catherine Joy Carpiz 1/20/2005 17 48.3 1.52 2.3104 20.9054709 NORMAL NORMAL
8 101416110023 Damias,Jessebel Palaganas 11/18/2004 17 42.6 1.61 2.5921 16.4345511 WASTED NORMAL
9 152501120101 Decano, Jelaine Basa 12/13/2003 18 1.52 2.3104 0 WASTED NORMAL
10 101422120261 De Guzman, Hazel Mae Ora 11/28/2004 17 1.56 2.4336 0 WASTED NORMAL
11 101427110016 De Guzman , Noime Tagalisma 10/27/2005 16 1.52 2.3104 0 WASTED NORMAL

SFRT 2017
 Learner's Name Nutritional Status
Birthdate Weight Height Height² Height for
No. LRN (Last Name, First Name, Name Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category Age (HFA)
Extension, Middle Name) (kg/m²)
12 101540120087 Dela Cruz, Rubielyn Estanoctoc 4/29/2005 17 39.2 1.55 2.4025 16.3163371 WASTED NORMAL
13 101430110027 Doria, Aira Kim Villanueva 3/24/2005 17 45.2 1.62 2.6244 17.2229843 WASTED NORMAL
14 101435120006 Ferrer, Jessam Mae Agsalud 8/1/2004 18 46.7 1.64 2.6896 17.3631767 WASTED NORMAL
15 101422110123 Gonzales, Lexis Mae Erfelo 2/22/2005 17 37.8 1.55 2.4025 15.7336108 WASTED NORMAL
16 102154110027 Gonzales, Lovely Jane Alfonzo 6/3/2005 17 58.9 1.55 2.4025 24.516129 NORMAL NORMAL
17 101429110055 Jazmin, Crisha Mhir Aquino 8/14/2005 17 56.9 1.77 3.1329 18.1620862 WASTED NORMAL
18 117085110029 Jongco, Angelica C. 8/12/2004 18 39 1.55 2.4025 16.2330905 WASTED NORMAL
19 101422120319 Lopez, Galilee De Vera 12/4/2004 17 66.9 1.52 2.3104 28.9560249OVERWEIGHT NORMAL
20 101428120123 Macaraeg, Ma. Teresa Fernandez 7/8/2004 18 44.3 1.55 2.4025 18.4391259 WASTED NORMAL
21 101426120108 Macatbag, Princess Mae Pasco 2/19/2005 17 55.7 1.69 2.8561 19.5021183 NORMAL NORMAL
22 101429110073 Maramba, Dexie Ross De Vera 12/17/2004 17 55.4 1.52 2.3104 23.9785319 NORMAL NORMAL
23 101425120057 Muyrong, Mary Grace Nepales 9/15/2004 18 1.59 2.5281 WASTED NORMAL
24 101422120345 Nota, Lois Antoinette Soriano 1/29/2005 17 40.6 1.55 2.4025 16.8990635 WASTED NORMAL
25 101422110179 Padilla, Alexis Janine Barcelon 4/6/2005 17 39.6 1.58 2.4964 15.8628425 WASTED NORMAL
26 101428120081 Rosario, Ashlieh Bayudan 9/8/2005 17 46 1.55 2.4025 19.1467222 NORMAL NORMAL
27 101427120035 Roy, Gellian Briones 11/30/1999 22 1.65 2.7225 0 WASTED NORMAL
28 101426120086 Sico, Evelyn Penulliar 8/31/2005 17 52 1.55 2.4025 21.6441207 NORMAL NORMAL
29 101438120028 Sinlao, Jeanilyn Suliman 7/3/2005 17 50.1 1.55 2.4025 20.8532778 NORMAL NORMAL
30 101428130133 Tarlet, Mary Grace Tinte 2/26/2005 17 43 1.49 2.2201 19.3684969 NORMAL STUNTED
31 600116150529 Villa Verde, Nica Loraine C. 8/21/2004 18 46.2 1.71 2.9241 15.7997333 WASTED NORMAL
32 501042191308 Maningding, Jasmin 38402 17 55.7 1.69 2.8561 19.5021183 NORMAL NORMAL
33 152501120098 Abulencia, Ma. Janynn 38338 17 55.4 1.52 2.3104 23.9785319 NORMAL NORMAL

SFRT 2017
 Learner's Name Nutritional Status
Birthdate Weight Height Height² Height for
No. LRN (Last Name, First Name, Name Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category Age (HFA)
Extension, Middle Name) (kg/m²)

SUMMARY TABLE
Nutritional Status Height for Age (HFA)
Summary Table Summary Table
SEX Severely
Severely Wasted Wasted Normal Overweight Obese TOTAL Stunted Normal Tall Total
Stunted
MALE 0 8 9 1 0 18 0 8 30 0 38
FEMALE 0 15 13 1 0 29 0 0 23 0 23
TOTAL 0 23 22 2 0 47 0 8 53 0 61

Date of Assessment: Conducted/Assessed By: Certified Correct By: Reviewed By:

SFRT 2017

SFRT 2017