FORM 2: LAC Facilitator Information Sheet

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

Region: VIII

Division: SOUTHERN LEYTE

NAME: Male/Female: Date of Birth: Age: 30

Prenciss M. Ochia Female 09-10-1992

Contact details: Email: Mobile Number: Facebook Name:

prenciss.ochia@depe 09069641406 PrencissBalingcosMal
d.gov.ph akiOchia

Preferred contact (Indicate all: email, phone, Skype, Viber, WhatsApp, Zoom,
mode: Googlemeet, FB, Messenger, etc.)
Cellphone 09069641406
Messenger PrencissBalingcosMalakiOchia
FB PrencissBalingcosMalakiOchia