Name of School: SAN GREGORIO ANNEX ES Name of School Head: MARIA ELAINE P.

DE CASTRO
District: LAUREL DISTRICT Officer-In-Charge
Date Accomplished:

EARLY REGISTRATION FORM

Kindergarten / Grade

Category of Registrant Name and Address

No: Name Sex Age Birthdate Address Child / Youth with of School Last Remarks*
Regular IP OSC / Y Attended
Disability **

Remarks*:
1. For Grade 1 Registrants: has attended / not attended Kindergarten class
2. For ALS: information whether the child / youth prefers to learn through the ADM - Alternative delivery mode (MISOSA, e-IMPACT, DORP) or ALS - Alternative Learning System

Category of Child / Youth with Disability**: Visual Impairment (VI), Hearing Impairment (HI), Intellectual Disability (ID), Learning Disability (LD). Speech / Language Impairment (S/LI),
Serious Emotional Disturbance (SED), Autism, Orthopedic Impairment (OI), Special Health Problem (SHP), Multiple Disability (MD)