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Republic of the Philippines

Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO ORIENTAL
LUZON NATIONAL HIGH SCHOOL
GOVERNOR GENEROSO SOUTH DISTRICT
Youth for Environment in Schools Organization
S.Y 2022 - 2023

I. General Information
1x1
Last Name First Name M.I Extension Name Picture
Nickname

LRN

Home Address

Facebook Account
Contact Number Email Address Name

Sex Nationality Age Date of Birth Place of Birth

Father’s Name Contact Number/s

Mother’s Name Contact Number/s

I. Educational Level
Grade/Year Level Section Class Adviser

Membership in other Organization/s Position/s Held Year

Other Co-Curricular Activities Available time Schedule for YES-O

Special Skills/Talents

Address: Luzon, Governor Generoso, Davao Oriental


Contact Number: 09104562219
E-mail Address: luzon.nhs@deped.gov.ph School ID: 304322
Republic of the Philippines
Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO ORIENTAL
LUZON NATIONAL HIGH SCHOOL
GOVERNOR GENEROSO SOUTH DISTRICT
PARENT'S/GUARDIAN’S PERMIT
I am fully aware that YES-O or its designated representative is
duty bound and obligated under the Data Privacy Act of 2012 to
protect all my personal and sensitive information that it collects,
processes, and retains upon my application and during my stay
in the ORGANIZATION

_______________________________
Signature of the Member
Parent/Guardian
(Signature Over Printed Name)
(Don not fill-up below this line)

(To be filled-up by the YES-O Adviser ONLY)

Recommending Approval: Approved:

MA. CONXEDES B. GUDES AGNES A. ARQUIZA


YES-O Adviser School Head

Address: Luzon, Governor Generoso, Davao Oriental


Contact Number: 09104562219
E-mail Address: luzon.nhs@deped.gov.ph School ID: 304322
Republic of the Philippines
Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO ORIENTAL
LUZON NATIONAL HIGH SCHOOL
GOVERNOR GENEROSO SOUTH DISTRICT

Youth for Environment in Schools Organization


REGISTRATION FORM
/
Type of School Elementary Secondary Public /
Integrated Stand Alone Private
Public SSH

Registration No.________

Contact Person Name Mobile No. Email Address Facebook Account

School Head Agnes A. Arquiza 09104562219 agnes.arquiza@ Agnes Alimangohan


deped.gov.ph Arquiza
YES-O Adviser Ma. Conxedes B. 09062517166 mariaconxedes. Maria Conxedes
Gudes gudes@deped.g Gudes
ov.ph
President Flordelin P. Estardo 09070161736 flordelinestardo Flordelin Pogoy
@gmail.com Estardo
Vice-President MJ John M. Ochia 09976308166 Ochiamjjhon77 MJ John Ped
@gmail.com Manda
Secretary Christine Z. Sostino 09466084110 sostinochristine Christine Sostino
@gmail.com
Treasurer Krixa Joyce B. Bangcot 09606495709 krixajoycebang Krixa Joyce Bangcot
cot@gmail.com
Auditor Fiona Mae E. Baldos 09478100313 fionab1202@g Fiona Mae Baldos
mail.com
Protocol Officer Kathleen Jade O. 09505999184 kathleenjadega Kathleen Jade
Galvan lvan@gmail.co Galvan
m
PIO Kierstine Jheinne C. 09679566219 destajoenen@ KJ Cabillada
Destajo gmail.com Destajo
Grade Level
/Strand
Representatives
Grade _8_ Nicole Formentera 09105884893 None Nicole Formentera
Wenceslao
Grade _9_ Alexysse Marie V. 09776660132 abriganaalexys Alexysse Marie
Abrigana se@gmail.com Vivas Abrigana

Address: Luzon, Governor Generoso, Davao Oriental


Contact Number: 09104562219
E-mail Address: luzon.nhs@deped.gov.ph School ID: 304322
Republic of the Philippines
Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO ORIENTAL
LUZON NATIONAL HIGH SCHOOL
GOVERNOR GENEROSO SOUTH DISTRICT

Grade _10_ Ven Laurence R. 09751374163 venlaurencelin VenLaurence


Linguaje guaje@gmail.c Linguaje
om
Grade _11_ Jamaica Mae D. Palma 09364234012 palmademerinj Jamaica Mae
amaicamae@g Demerin Palma
mail.com

Number of Male:______2_____ Female:____9______ TOTAL:__11____


Members:
Date Organized: June 7, 2022

Prepared by: Noted:


MA. CONXEDES B. GUDES AGNES A. ARQUIZA
YES-O Adviser School Head

Address: Luzon, Governor Generoso, Davao Oriental


Contact Number: 09104562219
E-mail Address: luzon.nhs@deped.gov.ph School ID: 304322

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