Department of Education

MIMAROPA REGION
SCHOOLS DIVISION OF PALAWAN
District of
Address

LIST OF IDENTIFIED LEARNERS WITH DISABILITIES

School I. D

Type of Disability (Please refer to LIS Record)

Name of Learners with Disability Learners Reference Present Grade
No. Gender Date of Birth
(Surname, First Name and Middle ) Number Level
SPED Tagged With Manifestation

Prepared by:

School LIS Coordinator

Checked and Approved:

School Principal