Professional Documents
Culture Documents
Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110009
Permanent Residence:
24 Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Elizaldy Ramos BalinEduc’l Attainment: Elementary UndergraduateOccupation: House HusbandContact No.:
Mother:Violeta Gonzales BalinEduc’l Attainment: High School GraduateOccupation: Contact No.:
No. of children in the family: 7 Boy 4 Girl 3 Order in the family: Eldest/Youngest/Others Youngest
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110019
Permanent Residence:
99 Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Michael Reyes CalimlimEduc’l Attainment: Elementary GraduateOccupation: Boat DriverContact No.: 9123896374
Mother:Donna Ancheta CalimlimEduc’l Attainment: High School GraduateOccupation:House Wife Contact No.: 9123896374
No. of children in the family: 4 Boy 3 Girl 1 Order in the family: Eldest/Youngest/Others Second Born
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110001
Permanent Residence:
126 Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Dexter Remolar AcostaEduc’l Attainment: High School GraduateOccupation: BarberContact No.: 9121116471
Mother:Carmelita Gonzales AcostaEduc’l Attainment: High School UndegraduateOccupation:House Keeper Contact No.:
9121116471
No. of children in the family: 2 Boy 0 Girl 2 Order in the family: Eldest/Youngest/Others Eldest
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110057
Permanent Residence:
25 Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Allan Paragas LuatonEduc’l Attainment: High School GraduateOccupation: Boat DriverContact No.: 9090501545
Mother:Yolanda Valdez CerezoEduc’l Attainment: High School GraduateOccupation: Contact No.:
No. of children in the family: 6 Boy 5 Girl 1 Order in the family: Eldest/Youngest/Others Third Born
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110049
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Gerald Rosario HiterozaEduc’l Attainment: Elementary GraduateOccupation: Tricycle DriverContact No.: 9127910489
Mother:Mercy Palma HiterozaEduc’l Attainment: High School GraduateOccupation:Entreprenuer Contact No.: 9484284468
No. of children in the family: 3 Boy 1 Girl 2 Order in the family: Eldest/Youngest/Others Eldest
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110006
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Arnold Mendoza ArenasEduc’l Attainment: High School UndergraduateOccupation: Driver/EntreprenuerContact No.:
9852697159
Mother:Anne Marie Bautista ArenasEduc’l Attainment: High School UndergraduateOccupation:Entreprenuer Contact No.:
9852697159
No. of children in the family: 6 Boy 4 Girl 2 Order in the family: Eldest/Youngest/Others Fifth Born
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110060
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: 4 Boy 2 Girl 2 Order in the family: Eldest/Youngest/Others First Born
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102180120040
Permanent Residence:
54 Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: 10 Boy 7 Girl 3 Order in the family: Eldest/Youngest/Others 9th
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102152110006
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: 3 Boy 1 Girl 3 Order in the family: Eldest/Youngest/Others Eldest
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178120024
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: Boy Girl Order in the family: Eldest/Youngest/Others
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110020
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: 2 Boy 0 Girl 2 Order in the family: Eldest/Youngest/Others Eldest
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110028
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: Boy Girl Order in the family: Eldest/Youngest/Others
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178120006
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: 6 Boy 4 Girl 2 Order in the family: Eldest/Youngest/Others Eldest
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178120007
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: Boy Girl Order in the family: Eldest/Youngest/Others
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110075
Permanent Residence:
10 Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Bimbo Ventura RonderoEduc’l Attainment: High School GraduateOccupation: FishermanContact No.: 9389859197
Mother:Ezra C. RonderoEduc’l Attainment: Occupation: Contact No.: 9389859197
No. of children in the family: Boy Girl Order in the family: Eldest/Youngest/Others
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178100058
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Nelson Escosio FabiaEduc’l Attainment: High School GraduateOccupation: Boat DriverContact No.: 9500478687
Mother:Emy Jane Cardozo FabiaEduc’l Attainment: Elementary UndegraduateOccupation:Entreprenuer Contact No.:
9500478687
No. of children in the family: 5 Boy 4 Girl 1 Order in the family: Eldest/Youngest/Others Forth Born
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178100015
Permanent Residence:
105 Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Manuel BarrogaEduc’l Attainment: High School UndergraduateOccupation: ConstructionContact No.: 9816606720
Mother:Irene Calimlim BarrogaEduc’l Attainment: Elementary UndegraduateOccupation:OFW Contact No.: 9816606720
No. of children in the family: 4 Boy 2 Girl 2 Order in the family: Eldest/Youngest/Others Second Born
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178100136
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: 5 Boy 2 Girl 3 Order in the family: Eldest/Youngest/Others Fourth Born
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102180120038
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: Boy Girl Order in the family: Eldest/Youngest/Others
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102180100017
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: Boy Girl Order in the family: Eldest/Youngest/Others
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110077
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
No. of children in the family: Boy Girl Order in the family: Eldest/Youngest/Others
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110040
Permanent Residence:
Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Randy Daroya EstradaEduc’l Attainment: Elementary UndergraduateOccupation: FishermanContact No.: 9634804609
Mother:Emilita Maramba EstradaEduc’l Attainment: Elementary GraduateOccupation:House Wife Contact No.: 9634804609
No. of children in the family: 3 Boy 2 Girl 1 Order in the family: Eldest/Youngest/Others
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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Attached Documents: _____ Certified photocopy of Birth Certificate _____ SF 9 (Form 138) ____ ECCD
_____ Certificate of Good Moral Character _____ SF 10 (Form 137A)
Last School Grade Level School Year Section Adviser STATUS
Attended (Promoted,
Retained,
Dropped, Balik-
Aral)
LRN: 102178110023
Permanent Residence:
43 Pugaro Dagupan City Pangasinan
( No. of House ) (Barangay) (Town/City) (Province)
Father: Renante Melendez CamachoEduc’l Attainment: Elementary GraduateOccupation: FishermanContact No.: 9466036935
Mother:EvangelynEduc’l Attainment: Occupation: Contact No.: 9466036935
No. of children in the family: Boy Girl Order in the family: Eldest/Youngest/Others
Other observations (like distinct appearance or behavior, learning difficulty, etc.), please state.
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