(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)

School ID 301602 Region IV-B Division Occidental Mindoro

School Name San Vicente NHS - Yapang Annex School Year 2020 - 2021 Grade Level Grade 10 Section DIOPSIDE

GUARDIAN
AGE ADDRESS PARENTS Contact REMARKS
(if Not Parent)
as of MOTHER Number

Sex (M/F)
IP of
NAME BIRTH DATE 1st TONGUE RELIGIO Learning
LRN (Ethnic Mother's Maiden Parent
(Last Name, First Name, Middle Name) (mm/dd/yyyy) Frida (Grade 1 Group)
N House #/ Father's Name (Last or
Modality (Please refer to
y to 3 Only) Municipalit Name (Last Name, Relati
Street/ Sitio/ Barangay Province Name, First Name, Name the legend on last
y/ City First Name, Middle onship Guardia
June Purok Middle Name)
Name) n page)

ALARMA,
Christiani BATONG SABLAY OCCIDENTAL BIOY,ISIDORA, Modular
110243100001 ALARMA,SAMUEL JAY, BIOY M 11-19-2004 15 Tagalog RAMON
ty BUHAY AN MINDORO MADERA, (print)
VARGAS
CANIBAN, CADUGO,EVAN
CANIBAN,NELVIN JAY, Christiani BATONG SABLAY OCCIDENTAL Modular
110229100021 M 07-24-2005 14 Tagalog NESTOR GELINE,TALA
CADUGO ty BUHAY AN MINDORO (print)
TALHA MAN,

Christiani SAN SABLAY OCCIDENTAL CHICO, LARRY SISON,JENELY Modular

110218070021 CHICO,LARRY, JR SISON M 11-29-2000 19 Tagalog
ty FRANCISCO AN MINDORO BUTULAN N,MASAGNAY, (print)

Christiani BATONG SABLAY OCCIDENTAL ELEUTERIO, SALGADO,BELI Modular

110248080017 ELEUTERIO,ROBIN, SALGADO M 03-27-2002 18 Tagalog
ty BUHAY AN MINDORO ROLIEBEN S NDA,G, (print)

Alangan Christiani SAN SABLAY OCCIDENTAL Modular

110213090010 FLORES,ALVIN, URIETA M 09-03-2002 17 Tagalog FLORES, SORO - URIETA,LITA,-,
Mangyan ty AGUSTIN AN MINDORO (print)

MAGRAMO, GATDULA,LEA
Christiani BATONG SABLAY OCCIDENTAL Modular
110243100017 MAGRAMO,RYAN, GATDULA M 12-13-2003 16 Tagalog REDENTOR LIEZEL,FRANCI
ty BUHAY AN MINDORO (print)
RICO SCO,

Christiani BATONG SABLAY OCCIDENTAL MARTIN, RUBY SRAPION,ANIT Modular CCT

110243100019 MARTIN,HAROLD, SERAPION M 09-28-2004 15 Tagalog
ty BUHAY AN MINDORO ACOSTA A,CATAYAZ, (print)

MELITAR,
Christiani BATONG SABLAY OCCIDENTAL FLORES,ARLY Modular
110233100045 MELITAR,MAC DALIN, FLORES M 09-10-2005 14 Tagalog MANNY
ty BUHAY AN MINDORO N,BAUTISTA, (print)
MANDAL
PADASNA, NARCIDA,LUZ
Christiani BATONG SABLAY OCCIDENTAL Modular
110243090010 PADASNA,JOVEN, NARCEDA M 06-11-2002 17 Tagalog CONRADO VIMINDA,PABL
ty BUHAY AN MINDORO (print)
BACLAYO SR O,
REVILLAS, MUNEZ,FLORD
Christiani BATONG SABLAY OCCIDENTAL Modular
110248100021 REVILLAS,LLOYD, MUÑEZ M 05-05-2003 17 Tagalog VIRGILIO ELIZA,ESTEBA
ty BUHAY AN MINDORO (print)
SARDA N,
RIVERA, BARRIENTOS,J
RIVERA,MAN VINCENT, Christiani BATONG SABLAY OCCIDENTAL Modular
110243100022 M 08-31-2004 15 Tagalog NORMAN ULIETA,ORDEN
BARRIENTOS ty BUHAY AN MINDORO (print)
RIANA ES,

Christiani BATONG SABLAY OCCIDENTAL ROCO, SANNY CAMILAN,MAR Modular

110248080030 ROCO,MARK JAY, CAMILAN M 08-09-2001 18 Tagalog
ty BUHAY AN MINDORO FUERTE ICEL,TABUGA, (print)

Christiani BATONG SABLAY OCCIDENTAL ROCO, SANNY CAMILAN,MAR Modular

110248100022 ROCO,MARVIN, CAMILAN M 01-09-2004 16 Tagalog
ty BUHAY AN MINDORO FUERTE ICEL,TABUGA, (print)

SABLUDEN,
Christiani BATONG SABLAY OCCIDENTAL MUNEZ,LETECI Modular
110248100023 SABLUDEN,JOHN REY, MUÑEZ M 02-19-2003 17 Tagalog GEORGE
ty BUHAY AN MINDORO A,ESTEBAN, (print)
TAYABEN
SORIANO,
SORIANO,JHON DIXTER, Pangasina Christiani SABLAY OCCIDENTAL LEONISA,SARD Modular
101637140222 M 10-27-2005 14 TUBAN EFREN
SARDIÑA n ty AN MINDORO INA,TULOSA, (print)
CALUBAT
 TAÑEDO,
Christiani BATONG SABLAY OCCIDENTAL PATRICIO,ELVI Modular
110248100028 TAÑEDO,ELFRENCE, PATRICIO M 08-26-2004 15 Tagalog ALFREN
ty BUHAY AN MINDORO E,LLAMO, (print)
ALFARO

16 <=== TOTAL MALE

Cebuano /
AVENIDO,
Sinugbua Christiani BATONG SABLAY OCCIDENTAL ZUBIRI,JOLLY, Modular
121655100007 AVENIDO,JELLY, ZUBIRI F 12-07-2004 15 JERRY
nong ty BUHAY AN MINDORO CAMILAN, (print)
MONTAJES
Binisay

BALBIN, RIVERA,ROSE
Christiani BATONG SABLAY OCCIDENTAL Modular
110243100004 BALBIN,CHERILYN, RIVERA F 12-10-2004 15 Tagalog JOSELITO MARIE,UBALD
ty BUHAY AN MINDORO (print)
VERGARA E,
CASIDSID,ROS
Christiani BATONG SABLAY OCCIDENTAL CAOILI, JIMMY Modular
110229100024 CAOILI,JIMROSE, CASIDSID F 05-09-2004 16 Tagalog ALIE,ENDENCI
ty BUHAY AN MINDORO RIVERA SR (print)
A,
CASTILLO, DELA
CASTILLO,JULIE ANN, DELA Christiani BATONG SABLAY OCCIDENTAL Modular
110248100007 F 07-29-2004 15 Tagalog ANASTACIO CRUZ,LINA,AC
CRUZ ty BUHAY AN MINDORO (print)
FARINAS ENAS,

DORADO, MAHINAY,MEN
DORADO,ERICKA MITCH, Christiani BATONG SABLAY OCCIDENTAL Modular
136517100042 F 12-04-2004 15 Tagalog RODIL CHU,ASTRONO
MAHINAY ty BUHAY AN MINDORO (print)
SANTILLAN MO,

Christiani BATONG SABLAY OCCIDENTAL GAJO, JERRY GARBANZOS,H Modular

110229100039 GAJO,KYLA MAE, GARBANZOS F 08-22-2004 15 Tagalog
ty BUHAY AN MINDORO CANTERAS ERMA,TAGON, (print)

CASTILLO,GLE
GONZALES,
GONZALES,LENY MAE, Christiani BATONG SABLAY OCCIDENTAL NY Modular
110221100038 F 05-15-2005 15 Tagalog WILMAR
CASTILLO ty BUHAY AN MINDORO MARCY,DELA (print)
MIRAS
CRUZ,
GREGORIO,
Christiani BATONG SABLAY OCCIDENTAL ABLAZA,MARI Modular
110248100010 GREGORIO,MICHAELA, ABLAZA F 03-19-2005 15 Tagalog LANDRE
ty BUHAY AN MINDORO TES,UBALDO, (print)
ARTUCILLA

Alangan Christiani SAN SABLAY OCCIDENTAL TOMAR, DOMENG,SANT Modular

110213150022 KASISON,AILA, DOMENG F 04-12-2005 15 Tagalog
Mangyan ty AGUSTIN AN MINDORO KASISON - IYO,-, (print)

KASISON, BALDO,DOMEL
Alangan Christiani SAN SABLAY OCCIDENTAL Modular
110213120030 KASISON,DANELYN, BALDO F 12-17-2005 14 Tagalog ROMEO YN,BALASUNG
Mangyan ty AGUSTIN AN MINDORO (print)
ZUZUKI AN,

LANDICHO,MA
MANGUBAT,KRYZIA MAE, Christiani BATONG SABLAY OCCIDENTAL MANGUBAT, Modular
110243100018 F 06-06-2004 15 Tagalog RIA
LANDICHO ty BUHAY AN MINDORO RICO RIVERA (print)
FE,ALARMA,
MARTIN,
Christiani BATONG SABLAY OCCIDENTAL PLATA,OFHEL,J Modular
110222100046 MARTIN,ROSHEL, PLATA F 01-08-2005 15 Tagalog ROSAURO
ty BUHAY AN MINDORO ARABE, (print)
PERALTA
MENDOZA,
MENDOZA,PRINCESS ZYRA, Christiani BATONG SABLAY OCCIDENTAL MUÑEZ,IMELD Modular
110227100007 F 08-28-2005 14 Tagalog ALEJANDRE
MUÑEZ ty BUHAY AN MINDORO A,ESTEBAN, (print)
TIONGSON
MENDOZA,RUB
Christiani BATONG SABLAY OCCIDENTAL OBER, EDDIE Modular
110243100020 OBER,EDELIZA, MENDOZA F 05-20-2003 17 Tagalog IROSA,PADILL
ty BUHAY AN MINDORO BONA (print)
A,

MABUNGA,LOL
Alangan Christiani BATONG SABLAY OCCIDENTAL Modular
110233100050 PADILLA,JENIELYN, MABUNGA F 09-18-2002 17 Tagalog ITA,FERNANDE
Mangyan ty BUHAY AN MINDORO (print)
Z,

PAIGTING,DIANA, Alangan Christiani BATONG SABLAY OCCIDENTAL PAIGTING, HABANGBUHA Modular

110233100052 F 01-14-2004 16 Tagalog
HABANGBUHAY Mangyan ty BUHAY AN MINDORO KANTIYAW Y,MAYLYN,, (print)

PRADO,
PRADO,DIVINE KRIZZA GRACE, Christiani BATONG SABLAY OCCIDENTAL CALUB,MINA,P Modular
110248100020 F 12-28-2003 16 Tagalog BARTOLOME
CALUB ty BUHAY AN MINDORO ERALTA, (print)
ALPAS
 SOLASCO, SARABELLO,P
SOLASCO,ELIZABETH, Christiani BATONG SABLAY OCCIDENTAL Modular
110243100025 F 01-05-2005 15 Tagalog LUCIANO ASCUALA,SEQ
SARABELLO ty BUHAY AN MINDORO (print)
IBANEZ UELABON,

Christiani BATONG SABLAY OCCIDENTAL SONIO, PEDRO REFIL,EVELYN, Modular

110218120052 SONIO,MELO JANE, REFIL F 01-07-2004 16 Tagalog
ty BUHAY AN MINDORO VENTURA MUSICO, (print)

TABUGA, TONDING,GEN
Christiani BATONG SABLAY OCCIDENTAL Modular
110229100085 TABUGA,ROXANNE, TONDING F 07-17-2005 14 Tagalog PABLO ELYN,TANATO
ty BUHAY AN MINDORO (print)
TABUGA Y,

20 <=== TOTAL FEMALE

36 <=== COMBINED

List and Code of Indicators under REMARKS column

REGISTER Prepared by; Certified Correct:
Indicator Code Required Information Indicator Code Required Information BoSY EoSY
ED
Transfered Out T/O Name of Public (P) Private (PR) School & Effectivity CCT Receipient CCT CCT Control/reference number & Effectivity Date FELIX C. BAUTISTA JR.
Date MALE 16
Balik Aral B/A Name of school last attended & Year MARY JOY DELA CRUZ DAPITO (Signature of School Head over
Transfered In T/I Name of Public (P) Private (PR) School & Effectivity Printed Name)
Date Learner With LWD Specify (Signature of Adviser over Printed Name)
FEMALE 20
Disability
Dropped DRP Reason and Effectivity Date Accelerated ACL Specify Level & Effectivity Data
Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) BoSY Date: EoSY Date:
TOTAL 36
BoSY Date: EoSY Date:

Generated thru LIS

Generated on: Tuesday, May 4, 2021