Republic of the Philippines

DEPARTMENT OF EDUCATION
REGION X – NORTHERN MINDANAO
DIVISION OF LANAO DEL NORTE
SALVADOR NATIONAL HIGH SCHOOL
SCHOOL ID: 304023
Poblacion, Salvador, Lanao del Norte

MODULE DISTRIBUTION AND RETRIEVAL FORM

Week No. / Date: Learning Area:
Section Adviser: Grade & Section:
Date of Date of
Distribution Signature Retrieval Signature Remarks
Learners Name

Prepared by:

Subject Teacher

Approved by:

CHARLYN A. AYING
Principal I