Professional Documents
Culture Documents
Semester First Semester School Year 2022 - 2023 Grade Level Grade 12 Track and Strand
Sex (M/F)
NAME BIRTH DATE as of
LRN Religious Affilication Mother's Maid
(Last Name, First Name, Name Extension, Middle Name) (mm/dd/yyyy) Octob Father's Name (Last
er 31st Name (Last Na
House #/ Street/ Sitio/ Purok Barangay Municipality/ City Province Name, First Name, Middle
First Name, Mi
Name)
Name)
ALMAZAN,
FIESTA,BELIN
106514100002 ALMAZAN,JODEL FIESTA M 10/24/2005 17 Christianity MAMONIT MAYANTOC TARLAC ARMANDO
TOMAS,
AGDEPPA JR
NCR
LOWER EDILLO,MICH
136875090261 EDILLO,CHRISTIAN CARDENAS M 06/28/2003 19 Christianity TAGUIG CITY FOURTH
BICUTAN E,,
DISTRICT
GUILLERMO, AGUSTIN,PER
106514100019 GUILLERMO,JOART AGUSTIN M 10/03/2004 18 Christianity MAMONIT MAYANTOC TARLAC
ROSENDO PATRICIO A,DELA CRUZ
GUILLERMO, AGUSTIN,PER
106514100020 GUILLERMO,JONAHS AGUSTIN M 10/03/2004 18 Christianity MAMONIT MAYANTOC TARLAC
ROSENDO PATRICIO A,DELA CRUZ
BARAWID, RUEL
106514100006 BARAWID,KIMBERLY ROSAL F 09/11/2005 17 Christianity MAMONIT MAYANTOC TARLAC ROSAL,LYNIT
IBARRA
GUARDIAN
TS REMARKS
(if learner is not Living with Parent)
Contact
Number of Learning
Mother's Maiden Parent or Modality
Name
Name (Last Name, Guardian (Please refer to the
(Last Name, First Name, Relationship
First Name, Middle legend on last page)
Name Extension, Middle
Name)
FIESTA,BELINDA,
PARENT Modular (print)
TOMAS,
LORENZO,MARIC
PARENT Modular (print)
EL,BUMANGLAG,
EDILLO,MICHELL
PARENT Modular (print)
E,,
AGUSTIN,PERLIT
PARENT Modular (print)
A,DELA CRUZ,
AGUSTIN,PERLIT
PARENT Modular (print)
A,DELA CRUZ,
SALCEDO,MARIB
PARENT Modular (print)
EL,DELA CRUZ,
GARCIA,RUTH,DE
Modular (print)
LA CRUZ,
POBRE,PRECILA,
PARENT Face to Face
FELIX,
PAGADUAN,CYN
PARENT Modular (print)
THIA,SUMIBCAY,
JUSTO,LEONIDA,
PARENT Modular (print)
VILLEDAR,
LANUZA,AUROR
PARENT Modular (print)
A,DELA CRUZ,
POBLACION LUCILO, JOSEPH RAFOLS,MA,L
104958100057 LUCILO,JANESS ANGELINE SAMPILO F 06/15/2004 18 Christianity MAYANTOC TARLAC
NORTE PEDROSA ,SAMPILO
18 <=== COMBINED
Transfered Out T/O CCT Receipient CCT CCT Control/reference number &
Effectivity Date MALE 6
Name of School, Date of 1st Attendance and Balik Aral B/A Name of school last attended & Year
Date of Last Attendance if Transferred Out
Transfered In T/I Learner With LWE Specify Exceptionality of the Learner
FEMALE 12
Exceptionality Beginning of the Semeste
Accelerated ACL Specify Level & Effectivity Date
TOTAL 18
8/22/22 12:00 AM
FERNANDEZ,DIN
PARENT Modular (print)
A,TOMAS,
PIOQUINTO,EVIN
PARENT Modular (print)
G,C,
CABLILAN,MELI
Modular (print)
NDA,BAUTISTA,
BUMATAY,MARI
A
PARENT Modular (print)
LINA,SABALBAR
O,
SISON,MARIVIC,
RELATIVE Modular (print)
DAMIAN,
d by;