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Region VIII

School ID
School Name

LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/dd/ yyyy)

AGE as of 1st
Friday June

LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/dd/ yyyy)

AGE as of 1st
Friday June

LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/dd/ yyyy)

AGE as of 1st
Friday June

LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/dd/ yyyy)

AGE as of 1st
Friday June

LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/dd/ yyyy)

AGE as of 1st
Friday June

NAME
(Last Name, First Name, Middle Name)

LRN

Sex (M/F)

BIRTH DATE
(mm/dd/ yyyy)

List and Code of Indicators under REMARKS column


Indicator

Code

Required Information

AGE as of 1st
Friday June

NAME
(Last Name, First Name, Middle Name)

LRN

Sex (M/F)

BIRTH DATE
(mm/dd/ yyyy)

Transferred Out

T/O

Name of Public (P) Private (PR) School & Effectivity Date

Transferred IN

T/I

Name of Public (P) Private (PR) School & Effectivity Date

Dropped
Late Enrollment

DRP
LE

Reason and Effectivity Date


Reason (Enrollment beyond 1st Friday of June)

AGE as of 1st
Friday June

School Form 1 (SF 1) School Register


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

Division

Dis
School Year

Grade L
ADDRESS

MOTHER TONGUE

IP
(Ethnic Group)

RELIGION

House #/ Street/
Sitio/
Purok

Barangay

Municipality/ City

Province

ADDRESS
MOTHER TONGUE

IP
(Ethnic Group)

RELIGION

House #/ Street/
Sitio/
Purok

Barangay

Municipality/ City

Province

ADDRESS
MOTHER TONGUE

IP
(Ethnic Group)

RELIGION

House #/ Street/
Sitio/
Purok

Barangay

Municipality/ City

Province

ADDRESS
MOTHER TONGUE

IP
(Ethnic Group)

RELIGION

House #/ Street/
Sitio/
Purok

Barangay

Municipality/ City

Province

ADDRESS
MOTHER TONGUE

IP
(Ethnic Group)

RELIGION

House #/ Street/
Sitio/
Purok

Barangay

Municipality/ City

Province

ADDRESS
MOTHER TONGUE

IP
(Ethnic Group)

Code

RELIGION

House #/ Street/
Sitio/
Purok

Required Information

Barangay

Municipality/ City

Province

REGISTERED

ADDRESS
MOTHER TONGUE

IP
(Ethnic Group)

RELIGION

House #/ Street/
Sitio/
Purok

Barangay

CCT

CCT Control/reference number & Effectivity Date

B/A

Name of school last attended & Year

LWD
ACL

Specify
Specify Level & Effectivity Data

Municipality/ City

Province

MALE

FEMALE

TOTAL

District
Section

Grade Level
PARENTS
Father's Name (Last Name, First
Name, Middle Name)

Mother's Maiden Name (Last Name,


First Name, Middle Name)

GUARDIAN

(If
not Parent)

Name

Relation-ship

Contact Number of
Parent or Guardian

PARENTS
Father's Name (Last Name, First
Name, Middle Name)

Mother's Maiden Name (Last Name,


First Name, Middle Name)

GUARDIAN

(If
not Parent)

Name

Relation-ship

Contact Number of
Parent or Guardian

PARENTS
Father's Name (Last Name, First
Name, Middle Name)

Mother's Maiden Name (Last Name,


First Name, Middle Name)

GUARDIAN

(If
not Parent)

Name

Relation-ship

Contact Number of
Parent or Guardian

PARENTS
Father's Name (Last Name, First
Name, Middle Name)

Mother's Maiden Name (Last Name,


First Name, Middle Name)

GUARDIAN

(If
not Parent)

Name

Relation-ship

Contact Number of
Parent or Guardian

PARENTS
Father's Name (Last Name, First
Name, Middle Name)

Mother's Maiden Name (Last Name,


First Name, Middle Name)

GUARDIAN

(If
not Parent)

Name

Relation-ship

Contact Number of
Parent or Guardian

PARENTS
Father's Name (Last Name, First
Name, Middle Name)

BoSY

EoSY

Mother's Maiden Name (Last Name,


First Name, Middle Name)

Prepared by:

GUARDIAN

(If
not Parent)

Name

Relation-ship

Contact Number of
Parent or Guardian

Certified Correct:

GUARDIAN

PARENTS
Father's Name (Last Name, First
Name, Middle Name)

(If
not Parent)

Mother's Maiden Name (Last Name,


First Name, Middle Name)

Name

(Signature of Adviser over Printed Name)

BoSY Date:

EoSYDate:

Relation-ship

Contact Number of
Parent or Guardian

(Signature of School Head over Printed Nam

BoSY Date:

EoSYDate:

REMARKS
(Please refer to the legend
on last page)

REMARKS
(Please refer to the legend
on last page)

REMARKS
(Please refer to the legend
on last page)

REMARKS
(Please refer to the legend
on last page)

REMARKS
(Please refer to the legend
on last page)

ect:

REMARKS
(Please refer to the legend
on last page)

REMARKS
(Please refer to the legend
on last page)

School Head over Printed Name)

EoSYDate:

School Form 2 (SF2) Daily Attendance Report of L


(This replaces Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

School ID

124569

Name of School

School Year

3 ELARCOSA, JONILO SANGO


4 EMBOR, ALJOHN SALAZAR
5 FEROLIN, WILLY ORQUILLANO
6 LIMBAGA, RINANTE BANQUIL
7 PIZON, JOHN REY RODRIGO
8 RATIFICAR, REMSAR MAGSANAY
9 SABADO, JOSEPH DALOGDOG
10 SONOR, NESTOR BELARMINO JR
11 SUMINGUIT, RAMIL TAGUIBOLOS

Grade Le
(1st row for date)

1
M

2 ELARCOSA, FEDERICO CAPUTOL JR

Report for the Month

ANASTACIO ELEMENTARY SCHOOL

LEARNER'S NAME
(Last Name, First Name, Middle Name)
1 DONGGO, RAMON BALOTIC

2014-2015

2
T

3
W

4
TH

5
F

8
M

9
T

10
W

11
TH

12
F

15
M

16
T

17
W

18
TH

19
F

22
M

23
T

24
W

(1st row for date)

LEARNER'S NAME
(Last Name, First Name, Middle Name)

1
M

MALE | TOTAL Per Day


1 CALALANG, GECEN JOY LAGUITAO
2 DIMPASO, JENILYN CALDOSA
3 DUMAPIG, GEMMA DAMPAYLA
4 ESTEBAT, REALYN RATIFICAR
5 FLORES, IVY GLEEN MACAYLE
6 GALABIN, MICHEL ARBOIZ
7 GERZON, ALTHEA NIKKA ADRIAS
8 MAGCANTA, JESSA MARIE SANTE
9 MAHUSAY, JASU FERNANDEZ
10 MAMINTAS, KIMBERLY CACHO

2
T

3
W

4
TH

5
F

8
M

9
T

10
W

11
TH

12
F

15
M

16
T

17
W

18
TH

19
F

22
M

23
T

24
W

(1st row for date)

LEARNER'S NAME
(Last Name, First Name, Middle Name)

1
M

11 MORAS, CRISTINE ELLO


12 OCAMIA, REGELINE VARGAS

2
T

3
W

4
TH

5
F

8
M

9
T

10
W

11
TH

12
F

15
M

16
T

17
W

18
TH

19
F

22
M

23
T

24
W

port of Learners

ropout Profile)

r the Month of
Grade Level

Sep-14
FIVE

Section
Total for the Month

25
TH

26
F

29
M

30
T

TH

ABSENT

TARDY

REMARKS (If DROPPED OUT, state reason, please refer to legend


number 2.
If TRANSFERRED IN/OUT, write the name of School.)

Total for the Month


25
TH

26
F

29
M

30
T

TH

ABSENT

TARDY

REMARKS (If DROPPED OUT, state reason, please refer to legend


number 2.
If TRANSFERRED IN/OUT, write the name of School.)

Total for the Month


25
TH

26
F

29
M

30
T

TH

ABSENT

TARDY

REMARKS (If DROPPED OUT, state reason, please refer to legend


number 2.
If TRANSFERRED IN/OUT, write the name of School.)

School Form 3 (SF3) Books Issued

(This replaces Form 1 & Inventory of Textb

School ID

School Year

School Name

NO.

Grade Level
Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Date

Date

Date

Date

LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued

Returned

Issued

Returned

Issued

Returned

Issued

NO.

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Date

Date

Date

Date

LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued

TOTAL FOR MALE | TOTAL COPIES

Returned

Issued

Returned

Issued

Returned

Issued

NO.

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Date

Date

Date

Date

LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued

Returned

Issued

Returned

Issued

Returned

Issued

NO.

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Date

Date

Date

Date

LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued

Returned

Issued

Returned

Issued

Returned

Issued

TOTAL FOR FEMALE | TOTAL COPIES


TOTAL LEARNERS | TOTAL COPIES
GUIDELINES:
1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form.
5. All textbooks being used must be included. Additional copies of this form may be used if needed.

In case of lost/unreturned books, please provide informatio

A. In Column Date Returned, codes are: FM=Force Majeure, T


B. In Column Remark/Action Taken, codes are: LLTR=Secured
prepared letter/report duly noted by School Head for submissio
NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14, 2

oks Issued and Returned

& Inventory of Textbooks)

Section

ct Area & Title

Subject Area & Title

Date

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

REMARKS/ACTION TAKEN
(Please refer to the legend on last page)

Date
Returned

Issued

Returned

ct Area & Title

Subject Area & Title

Date

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

REMARKS/ACTION TAKEN
(Please refer to the legend on last page)

Date
Returned

Issued

Returned

ct Area & Title

Subject Area & Title

Date

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

REMARKS/ACTION TAKEN
(Please refer to the legend on last page)

Date
Returned

Issued

Returned

ct Area & Title

Subject Area & Title

Date

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

REMARKS/ACTION TAKEN
(Please refer to the legend on last page)

Date
Returned

e provide information with the following code:

M=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence


are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code FM), TLTR=Teacher
l Head for submission to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code
25, s.2003, DO#14, 2.2012.

Issued

Returned

Prepared By:

(Signature over printed name)


Date BoSY:____________ Date EoSY: ___________

School Form 4 (SF4) Monthly Learner's Movement and At


(This replaces Form 3 & STS Form 4-Absenteeism and Dropout Profile)

School ID
School Name

124569

Region

IX

Division

ZAMBOANGA DEL NORTE

ANASTACIO ELEMENTARY SCHOOL

Scho

ATTENDANCE
GRADE/ YEAR
LEVEL

SECTION

NAME OF ADVISER

REGISTERED
LEARNERS
(As
of End of the Month)
M

Percentage for the


Month

Daily Average
M

DROPPED OUT

(A) Cumulative as of
Previous Month

(A+B) Cumulative as of
End of the Month

(B) For the Month

KINDER

REY C. MARATAS

12

12

100

100

100

GRADE 1

ELLEN A. GERZON

13

20

33

12

19

31

92

95

94

GRADE 2

LEONIDEZ P.ENOY II

13

18

31

13

18

31

100

100

100

GRADE 3

MELANI B. INFANTE

14

20

34

14

20

34

100

100

100

GRADE 4

JOVENTINA R.DALUMPINES

11

10

21

11

10

21

100

100

100

GRADE 5

JOAN C. ELNAS

11

15

26

11

15

26

100

100

100

GRADE 6

LUCILA E. CAMAHALAN

15

24

15

24

100

100

100

RUBEN C. ENOY

SCHOOL PRINCIPAL 1 / DISTRICT PESS COORDINATOR

ELEMENTARY/SECONDARY:
KINDER

12

12

100

100

100

GRADE 1/GRADE 7

13

20

33

12

19

31

92

95

94

GRADE 2/GRADE 8

13

18

31

13

18

31

100

100

100

GRADE 3/GRADE 9

14

20

34

14

20

34

100

100

100

GRADE 4/GRADE 10

11

10

21

11

10

21

100

100

100

GRADE 5/GRADE 11

11

15

26

11

15

26

100

100

100

GRADE 6/GRADE 12

15

24

15

24

100

100

100

TOTAL FOR NON-GRADED

TOTAL

81

100

181

80

99

179

99

99

99

GUIDELINES:
1. This form shall be accomplished every end of the month using the summary box of SF2 submitted by the teachers/advisers to update figures for the month.
2. Furnish the Division Office with a copy a week after June 30, October 30 & March 31
Page _____ of _____ pages

nd Attendance
District

POLANCO 1

School Year

2014-2015

Report for the Month of

TRANSFERRED OUT
(A) Cumulative as of
Previous Month
M

TRANSFERRED IN
(A+B) Cumulative as of
End of the Month

(B) For the Month


T

SEPTEMBER

(A) Cumulative as of
Previous Month
M

(A+B) Cumulative as of
End of the Month

(B) For the Month

0
0
1
1
Prepared and Submitted by:

RUBEN C. ENOY
(Signature of School Head over Printed Name)

School Form 5 (SF 5) Report on Promotion & Lev

(This replaces Forms 18-E1, 18-E2, 18A and List of Graduates

Region

Division

School ID

School Year

School Name

LRN

LEARNER'S NAME

(Last Name,
First Name, Middle Name)

GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)

ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED

INCOMPLETE SUBJECT
column is for K to 12 Curricu
level that are still im

From previous school years


of end of current Sch

LRN

LEARNER'S NAME

(Last Name,
First Name, Middle Name)

TOTAL MALE

GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)

ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED

INCOMPLETE SUBJECT
column is for K to 12 Curricu
level that are still im

From previous school years


of end of current Sch

LRN

LEARNER'S NAME

(Last Name,
First Name, Middle Name)

GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)

ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED

INCOMPLETE SUBJECT
column is for K to 12 Curricu
level that are still im

From previous school years


of end of current Sch

LRN

LEARNER'S NAME

(Last Name,
First Name, Middle Name)

TOTAL FEMALE
COMBINED

GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)

ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED

INCOMPLETE SUBJECT
column is for K to 12 Curricu
level that are still im

From previous school years


of end of current Sch

ion & Level of Proficiency

List of Graduates)

District
Curriculum
Grade Level

Section

LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)

ous school years completed as


nd of current School Year

As of end of current School Year


SUMMARY TABLE
STATUS

MALE

FEMALE

PROMOTED

IRREGULAR

RETAINED

LEVEL OF PROFICIENCY

TOTAL

LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)

ous school years completed as


nd of current School Year

As of end of current School Year


MALE

FEMALE

BEGINNNING
(B: 74% and below)

DEVELOPING (D: 75%79%)


APPROACHING
PROFICIENCY
(AP: 80%-84%)
PROFICIENT
(P:
85% -89%)

ADVANCED
(A: 90%
and above)

PREPARED BY:

Class Adviser
(Name and Signature)

TOTAL

LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)

ous school years completed as


nd of current School Year

As of end of current School Year


CERTIFIED CORRECT & SUBMITTED:

School Head
(Name and Signature)

REVIEWED BY:

(Name and Signature)


Division Representative

GUIDELINES:
1. For All Grade/Year Levels
2. To be prepared by the Adviser. Final rating per subject area should
be taken from the record of subject teachers. The class adviser should
compute for the General Average.
3. On the summary table, reflect the total number of learners
promoted, retained and *irregular (*for grade 7 onwards only) and the
level of proficiency according to the individual General Average.

LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)

ous school years completed as


nd of current School Year

As of end of current School Year

4. Must tally with the total enrollment report as of End of School Year
GESP /GSSP (EBEIS)
5. Protocols of validation & submission is under the discretion of the
Schools Division Superintendent
School Form 5: Page ____ of ________

School Form 6 (SF6)

Summarized Report on Promotion and Level of Prof


(This replaces Form 20)

School ID

Region

Division

School Name

District

GRADE 1 /GRADE 7

GRADE 2 / GRADE 8

GRADE 3 / GRADE 9

GRADE 4 / GRADE 10

SUMMARY TABLE
MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY

BEGINNNING
74% and below)
DEVELOPING
75%-79%)

(B:
(D:

APPROACHING PROFICIENCY
(AP: 80%-84%)
PROFICIENT

(P: 85%
-89%)

ADVANCED
90% and above)

(A:

TOTAL

Prepared and Submitted by:

Reviewed & Validated by:


SCHOOL HEAD

Noted by:
DIVISION REPRESENTATIVE

GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the grade level total and school total.
2. This report together with the copy of Report for Promotion submitted by the class adviser shall be forwarded to the Division Office by the end of the school year.
3. The Report on Promotion per grade level is reflected in the End of School Year Report of GESP/GSSP.
4. Protocols of validation & submission is under the discretion of the Schools Division Superintendent.

f Proficiency

School Year

GRADE 5 / GRADE 11

GRADE 6 / GRADE 12

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

SCHOOLS DIVISION SUPERINTENDENT

School Form 7 (SF7) School Personnel Assignment List and


(This replaces Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)

School ID

Region

Division

School Name

District

(A) Nationally-Funded Teaching & Teaching Related Items

(B) Nationally-Funded Non Teaching Items


Title of Designation

Title of Plantilla Position


(as it
Number of Incumbent
appears in the appointment document/PSIPOP)

Title of Plantilla Position


(as it
appears in the appointment document/PSIPOP)

Number of
Incumbent

(as it ap
contract/document: Teach
Guard, Driver etc.)

EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)

Sex

Fund Source

Position/
Designation

Nature of
Appointment/
Employment Status

Degree / Post
Graduate

Major/ Specialization

Minor

EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)

Sex

Fund Source

Position/
Designation

Nature of
Appointment/
Employment Status

Degree / Post
Graduate

Major/ Specialization

Minor

EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)

Sex

Fund Source

Position/
Designation

Nature of
Appointment/
Employment Status

Degree / Post
Graduate

Major/ Specialization

Minor

GUIDELINES:

1. This form shall be accomplished at the beginning of the school year by the school head. In case of movement of teachers and other personnel during the school year, an updated Form 19 must be subm
Office .
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank down to the lowest.
3. Please reflect subjects being taught and if teacher handling advisory class or Ancillary Assignment. Other administrative duties must also reported.
4. Daily Program Column is for teaching personnel only.

t List and Basic Profile

Assignment List,
Teachers)

School Year
(C ) Other Appointments and Funding Sources

esignation

(as it appears in the


ct/document: Teacher, Clerk, Security
uard, Driver etc.)

Appointment:
(Contractual, Substitute, Fund Source
Volunteer, others
(SEF, PTA, NGO's etc.)
specify)

Number of Incumbent

Teaching

NonTeaching

Daily Program (time duration)


Subject Taught (include
Grade & Section), Advisory
Class & Other Ancillary
Assignments

DAY
(M/T/W/TH/
F)

From
(00:00)

Remarks (For Detailed


Items, Indicate name of
Total Actual
school/office, For IP's
To (00:00) Teaching Minutes
-Ethnicity)
per Week

Ave. Minutes per Day

Daily Program (time duration)


Subject Taught (include
Grade & Section), Advisory
Class & Other Ancillary
Assignments

DAY
(M/T/W/TH/
F)

From
(00:00)

Remarks (For Detailed


Items, Indicate name of
Total Actual
school/office, For IP's
To (00:00) Teaching Minutes
-Ethnicity)
per Week

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Daily Program (time duration)


Subject Taught (include
Grade & Section), Advisory
Class & Other Ancillary
Assignments

DAY
(M/T/W/TH/
F)

From
(00:00)

Remarks (For Detailed


Items, Indicate name of
Total Actual
school/office, For IP's
To (00:00) Teaching Minutes
-Ethnicity)
per Week

Ave. Minutes per Day

Ave. Minutes per Day


Submitted by:

rm 19 must be submitted to the Division


(Signature of School Head over Printed Name)
Updated as of: ___________________________
School Form 7, Page ___ of ________

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