Republic of the Philippines

CITY OF TARLAC
GRADE 4-6

Name of School: SAN SEBASTIAN ELEMENTARY SCHOOL Grade Level: SIX Section: VENUS

10pcs-Writing Notebook (80’s, 30x14.8x0.81cm) 1pc-Pencil, 1pc-Black Ballpen, 1pc-red Ballpen, 1pc-Rubber Eraser, 1box-Crayon
(24 pcs), 1pc-Sharpener, 1 Pad Paper- Grade Pad/80’s, 1pc-Correction Tape, 1pc-Math Notebook, 1pc-Spelling Booklet, 1pc-
Pencil Case (17mmx210mm), 1pc- Short Brown envelope, 10pcs-Short Bond Paper, 1pc-Drawing Book (20’s/A4Size) 1pack-
Colores Paper (Assorted/Short), 1pc-Scissors (minimum 4-inch size), 1pc- Glue, 1pc-Ruler, 1pc-Bag

This is to certify that we have received the following items:

LIST OF BENEFICIARIES

NAME NAME
(Male) (Female)
1. ANTONIO,JAYLORD ANDREI, ABIT 1. BAKING , ROCHELLE, CACHO
2. CERCADO,NESTLE JWACKEE, ROXAS 2. BALTAZAR, JUSMINE KATE, GUZMAN
3. DAVID,RHEONE LEI, TACLIAD 3. DELA CRUZ, ROMCHEL, NADORES
4. EVANGELISTA,HONORIO, III MACAHILIG 4. DELA CRUZ, FRANCHESKA ANGELA,
GAMBOA
5. FINULIAR,ANTHONY, BEATINGO 5. DIZON, ANGELA, PUANGCO
6. GOROSPE,RAIN, GUADAMOR 6. DOMINGO, RISH MICHELLE
7. ILAGAN,RAVEN, PEREZ 7. ESPINOSA , ROBINA JOY, RAMIREZ
8. MALONZO,JIZAM, SICAT 8. ESTOLA, ALYSSA, PITOLAN
9. MANALO, ELLERY 9. FRUTO, JAQUELINE, BALAGSO
10. MANGUNE, MARK SAMUEL 10. GUMAMIT, SOPHIA NICOE
11. MANIPON,DARREL, JAUCIAN 11. JARABEJO, BIANCA, CANDELARIA
12. NOCETE,JOHN JUSTIN, DELOS SANTOS 12. LUETE, ROELLA FRANCHESKA
13. OFIANA,JOSHTINO, GARCIA 13. LUGTU, RAFAELA MAE , BEQUIN
14. PAGARIGAN,RAFAEL MARTIN, VIRAY 14. MACAPULAY, JACKIELYN, BAENTO
15. PAREDO,ALEXANDER, ANQUILAN 15. MORALES, JAHARA KEI, CASENAS
16. PONCEJA,ALLEN BERNZ, MIRANDA 16. NUMOS, XYRA JADE, MIGUEL
17. PUANGCO,BERNARDO, JR GONZAGA 17. ODA, SHALANIE LORAINE, QUIETA
18. ROLDAN,MACKLIE WAINE, ALCANTARA 18. PACANAS, KATE JASMIN, AYAPANA
19. TOLENTINO,AKIRO, LEJANO 19. RAMOS, ARIANNE JOY , CALUBIRAN
20. TUAZON,CHRAZE ARCAI, DELA CRUZ 20. RIMANDO, LORAINE, CATACUAN
21. TACLIAD,GABRIEL, DULAY 21. RIMANDO, ROWENA, ESGUERRA
22. YUMUL, HARON JOSH 22. SABADO, ANGELIE NICOLE
23. 23. SALMAZAN, YHURI MENCH , GARIANDO
24. 24. SANTIAGO, IZZY MHAE, MANGUILA
25. 25. SUERTE, RAMIELLA KEITH
26. 26.
27. 27.
28. 28.
29. 29.
30. 30.
TOTAL TOTAL

Total no. of Enrollees: 47 Total no. of Kits Received: __________

Certified Correct by:

_____________________________________
Printed Name and Signature

_____________________________________
Contact Number

______________________________________
 Date

Grades 4-6 (2023)

10 pcs Writing Notebook, (80’s,

30x14.8x0.81cm)
1 pc Pencil
1 pc Ballpen Black
1 pc Ballpen Red
1 pc Rubber Eraser
1 box Crayon (24’s)
1 pc Sharpener
1 pad Paper (Grade pad/80’s)
1 pc Correction Tape
1 pc Math Notebook
1 pc Spelling Booklet
1 pc Pencil Case (70mmx210mm)
1 pc Short Brown Envelope
10 pcs Short Bond Paper
1 pc Drawing Book (20’s/A4 size)
1 pack Colored Paper (Assorted/Short)
1 pc Scissors (minimum 4-inch size)
1 pc Glue
1 pc Ruler
1 pc Bag