English 5

Quarter 1 module 1

Name: ____________________________________________________Grade & Section: ________________________

I. Directions: Fill out the form below. Complete it by using the possible answers found inside the box. Use the form
provided to you.

Student Personal Information

Name: ____________________________________________________________

Grade & Section: ___________________Age: _____ Sex: _______________

Teacher: __________________________________________________________

Address: __________________________________________________________

Birthday: __________________________ Country: _____________________

School: ___________________________________________________________

II. Directions: Fill out a withdrawal slip using the suggested information found in the box. Use the form provided to you.

Date: August 31, 2022

Account number: 1234567891

Account Name: (write your full name)

Amount in words: Ten Thousand Pesos

In figures: P 10,000.00