Republic of the Philippines

Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OF STO. TOMAS CITY
STO. TOMAS SOUTH DISTRICT
SAN JOSE NATIONAL HIGH SCHOOL
BRGY. SAN JOSE, CITY OF STO. TOMAS, BATANGAS

Grade _9___ Section ___Loyalty____

NO. ID CODE LRN NAME OF LEARNER Parent/ Guardian Name Contact Number
(First Name, Middle Initial, (First Name, Middle Initial, Present Address
Last Name) Last Name)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
 Republic of the Philippines
Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OF STO. TOMAS CITY
STO. TOMAS SOUTH DISTRICT
SAN JOSE NATIONAL HIGH SCHOOL
BRGY. SAN JOSE, CITY OF STO. TOMAS, BATANGAS
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.

Prepared by:
Name of Adviser
 Republic of the Philippines
Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OF STO. TOMAS CITY
STO. TOMAS SOUTH DISTRICT
SAN JOSE NATIONAL HIGH SCHOOL
BRGY. SAN JOSE, CITY OF STO. TOMAS, BATANGAS