School Form 1 (SF1)School Form 1 (SF 1) School Register(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)

School ID102152Region VIIIDivisionDAGUPANDistrictI

School NameWEST CENTRAL ES ISchool Year2014-2015Grade LevelISectionONE

LRNNAME(Last Name, First Name, Middle Name) Sex (M/F)BIRTH DATE (mm/dd/ yyyy)AGE as of 1st Friday June BIRTH PLACE (Province)MOTHER TONGUEIP (Ethnic Group)RELIGIONADDRESSPARENTSGUARDIAN (If not Parent)Contact Number of Parent or GuardianREMARKSHouse #/ Street/ Sitio/PurokBarangayMunicipality/ City ProvinceFather's Name (Last Name, First Name, Middle Name) Mother's Maiden Name (Last Name, First Name, Middle Name)NameRelation-ship(Please refer to the legend on last page)SANIO, MARILOU O.10/4/086/6/20145MEJIA, RODA C.11/11/085javier, chanielou11/7/8429

List and Code of Indicators under REMARKS columnPrepared by:Certified Correct:IndicatorCodeRequired InformationIndicatorCodeRequired InformationREGISTEREDBoSYEoSYTransferred OutT/OName of Public (P) Private (PR) School & Effectivity DateCCT RecipientCCTCCT Control/reference number & Effectivity DateMALETransferred INT/IName of Public (P) Private (PR) School & Effectivity DateBalik-AralB/AName of school last attended & YearFEMALE(Signature of Adviser over Printed Name)(Signature of School Head over Printed Name)DroppedDRPReason and Effectivity DateLearner With DissabilityLWDSpecifyTOTALLate EnrollmentLEReason (Enrollment beyond 1st Friday of June)AccelaratedACLSpecify Level & Effectivity DataBoSY Date: EoSYDate:BoSY Date: EoSYDate: