School Form 1 School Register for

School Name PIÑAPLATA INTEGRATED SCHOOL School ID 313712 District

Semester 2ND School Year 2017-2018
Section MARS Course (For TVL Only)

COMPLETE ADDRESS

Sex (M/F)
LRN NAME BIRTHDATE AGE Religious
(Last Name, First Name, Name Extension, Middle Name) (mm/dd/yyyy) Affiliation House No./ Municipality/
Street/ Sitio/ Barangay
Purok City

124001060041 ELIZALDE, ANDREW, VIÑAR M 9/20/2000 17

ROMAN
CATHOLIC
PUROK 3 PIÑAPLATA GANDARA

123862060017 ELIZALDE, DARYLL, VELASCO M 4/6/2000 17

ROMAN
CATHOLIC
TAWIRAN GANDARA

123552060014 PASIMOS, BENEDICTO, SERRANO JR. M 6/26/1997 20

ROMAN
CATHOLIC
PUROK 3 PIÑAPLATA GANDARA

3 <=== TOTAL MALE

ROMAN
121036060033 FLORDELIZA, JAMIE, GOLDO F 11/27/1999 18
CATHOLIC
SAN JOSE GANDARA

BORN AGAIN
123522060009 GOLONDRINA, MAILA, ANGELIO F 10/3/1999 18
CHRISTIAN
PUROK 4 NALIHUGAN GANDARA

REFUNCION, REALYN, DEALAGDON

ROMAN
123552060018 F 8/21/2000 17
CATHOLIC
TAWIRAN GANDARA

3 <=== TOTAL FEMALE

6 <=== COMBINED

Legend: List and Code of Indicators under REMARKS column

Indicator Code Required Information Indicator Code Required Information REGISTERED

Transferred T/O CCT Recipient CCT CCT Control/reference

Out number & Effectivity Date MALE
Balik Aral B/A Name of school last
Transferred attended & Year
In T/I
Specify Exceptionality of the
Name of School, Date of 1st Attendance and Date Learner With LWE Learner FEMALE
of Last Attendance if Transferred Out Exceptionality Specify Level & Effectivity
Accelerated ACL Date

TOTAL

SFRT 2017
 for Senior High School (SF1-SHS)
GANDARA II- MATUGUINAO Division SAMAR Region
Grade Level 11 Track and Strand GENERAL ACADEMIC STRAND

RESS PARENTS GUARDIAN

(if learner is not Living with Parent) Contact REMARKS
Mother's Maiden Number of
Name (Please refer to the legend)
Father's Name Name (Last Name, First Name, Parent/
Province (Last Name, First Name, Name (Last Name, First Name, Name Extension, Middle
Relationship
Guardian
Extension, Middle Name) Name Extension, Middle Name)
Name)
ELIZALDE,
SAMAR VIÑAR, ANABEL, E. VIÑAR, ANABEL, E. MOTHER
FERNANDO,L.

SAMAR VELASCO, DONNA, VELASCO, DONNA, MOTHER

PASIMOS, BENEDICTO,
SAMAR SERRANO, ERLINDA, C. PEROCHO, JOY, P. SISTER
J. SR.

SAMAR MARABE, JOHNNY FLORDELIZA, JOVELYN MARABE, JOHNNY FATHER

GOLONDRINA, ALLAN, GOLONDRINA,

SAMAR ANGELIO, MAILEEN, C. MOTHER
O. MAILEEN, E.

REFUNCION, DEALAGDON, DEALAGDON,

SAMAR MOTHER
WILFREDO, ELIZABETH ELIZABETH

Beginning of the Prepared By:

End of the Semester
Semester

3 3
ROGIE O. NAVARRA
Signature of Adviser over Printed Name
3 3

Beginning of the Semester Date: End of the Semester Date:

6 6 NOVEMBER 6, 2017 APRIL 6, 2018

SFRT 2017
 VIII
IC STRAND

REMARKS
lease refer to the legend)

e:
APRIL 6, 2018

SFRT 2017
 School Form 2 Daily Attendance Report of Learners for Senio
School Name School ID District

Semester School Year Grade Level

Section Course/s (only for TVL)

DATE
NAME
No. (Last Name, First Name, Name Extension, Middle
Name) M T W TH F S M T W TH F S M T W TH F S M T W TH F S M T
1 ELIZALDE, ANDREW, VIÑAR
2 ELIZALDE, DARYLL, VELASCO
3 PACIMOS, BENEDICTO JR.,SERRANO
4

10

11

12

13

14

15

16

17

<=== MALE | TOTAL Per Day ===>

1 FLORDELIZA, JAMIE, GOLDO

2 GOLONDRINA, MAILA, ANGELIO

3 REFUNCION, REALYN, DEALAGDON

10

11

12

13
Senior High School (SF2-SHS)
Division Region

Track and Strand

Month of

Total for the Month REMARKS

1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If
TRANSFERRED IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).
W TH F S ABSENT TARDY
 DATE
NAME
No. (Last Name, First Name, Name Extension, Middle
Name) M T W TH F S M T W TH F S M T W TH F S M T W TH F S M T
14

15

16

17

18

19

20

21

22

23

24

25

26

27

<=== FEMALE | TOTAL Per Day ===>

Combined TOTAL Per Day

GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE

1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance (blank) - Present; (x) - Absent; Tardy (half shaded = U
2. To compute the following: for Late Comer, Lower for Cutting Classes)

2. REASONS/CAUSES FOR NO LONGER I

a. Percentage of Enrolment = x 100 SCHOOL (NLS)
Registered Learners as of end of the month
Enrolment as of 1st Friday of the school year
a. Domestic-Related Factors
a.1. Had to take care of siblings
Total Daily Attendance a.2. Early marriage/pregnancy
b. Average Daily Attendance =
Number of School Days in reporting month a.3. Parents' attitude toward schooling
a.4. Family problems

Average daily attendance

c. Percentage of Attendance for the month = x 100
Registered Learners as of end of the month
b. Individual-Related Factors
3. Every end of the month, the Class Adviser will submit this form to the Office of the Principal for recording of summary table into School Form 4. Once b.1. Illness
signed by the School Head, this form should be returned to the Class Adviser. b.2. Overage
b.4. Drug Abuse
4. The Class Adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive
b.5. Poor Academic Performance
days and/or those at risk of dropping out. b.6. Lack of Interest/Distractions
5. Attendance performance of learners will be reflected in the SF9-SHS of every grading period. b.7. Hunger/Malnutrition

c. School-Related Factors
c.1. Teacher Factor
c.2. Physical Condition of Classroom
c.3. Peer Influence

d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. tribal wars & clan feuds)
d.3. Calamities/Disasters

e. Financial-Related
e.1. Child labor, work
 Total for the Month REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If
TRANSFERRED IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).
W TH F S ABSENT TARDY

No. of Days of Classes:

ENDANCE Month: Summary
f shaded = Upper
M F TOTAL
g Classes)
* Enrolment (as of 1st Friday of the semester)

LONGER IN Late Enrolment during the month (beyond cut-off)

Registered Learners as of end of the month

Percentage of Enrolment as of end of the month

Average Daily Attendance

Percentage of Attendance for the month

Number of students absent for 5 consecutive days

No Longer in School (NLS)

Transferred Out

Transferred In

Shifting Out

Shifting In

I certify that this report is true and correct:

feuds)
Signature of Class Adviser over Printed Name

Attested By:
 DATE
NAME
No. (Last Name, First Name, Name Extension, Middle
Name) M T W TH F S M T W TH F S M T W TH F S M T W TH F S M T
f. Others (Specify)
a. Death
b. Transferred to School Abroad
c. Transferred to International School
d. Transferred to ALS
 Total for the Month REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If
TRANSFERRED IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).
W TH F S ABSENT TARDY
Signature of School Head over Printed Name
 School Form 1 School Register for Senior High School (S
School Name PIÑAPLATA INTEGRATED SCHOOL School ID 313712 District GANDARA II- MATUGUINAO Division
Semester SECOND School Year 2017-2018 Grade Level 11 Track and S
Section EARTH Course (For TVL Only) COOKERY NC II

COMPLETE ADDRESS PARENTS GUA

Sex (M/F)
(if learner is not
NAME BIRTHDATE Religious Mother's Maiden
LRN (Last Name, First Name, Name Extension, AGE Name
(mm/dd/yyyy) Affiliation House No./ Municipality/ Father's Name Name (Last Name, First Na
Middle Name) Street/ Sitio/ Barangay Province (Last Name, First Name, Name (Last Name, First Name,
Purok City Extension, Middle Name) Name Extension, Middle
Name Extension, M
Name)
Name)
ROMAN ARAGON, DANILO, F.
123552060002 ARAGON, JEFFREY, ALPEZ M 5/12/1997 20
CATHOLIC
PIÑAPLATA GANDARA SAMAR
SR.
ALPEZ, JOSEPHINE, A. ALPEZ, JOSEPHINE

ROMAN IDAGO, ANGELITO, DE ABELLA, NANCY, ABELLA, NANCY,

305443110756 IDAGO, MARK KENNETH, ABELLA M 6/7/1999 18
CATHOLIC
NALIHUGAN GANDARA SAMAR
BELEN VENCIO VENCIO

ROMAN FLORDELIZA, ZOSIMO, PACUNDO, NENITA, PACUNDO, NENITA

123558050015 FLORDELIZA, JONATHAN, PACUNDO M 5/24/1999 18
CATHOLIC
SAN JOSE GANDARA SAMAR
GULDO ESTRELLES ESTRELLES

6 MAÑOZO, FRANCISCO, E.

7 PACIMOS,BENEDICTO S.

8 PEDRAZA, MARGARITO JR., E.

10

11

12

SFRT 2017
ool (SF1-SHS)
SAMAR Region VII
Track and Strand TECHNICAL-VOCATIONAL-LIVELIHOOD TRACK

GUARDIAN
(if learner is not Living with Parent) Contact REMARKS
Name Number of
(Please refer to the legend)
st Name, First Name, Parent/
Relationship
me Extension, Middle Guardian
Name)

EZ, JOSEPHINE, A. MOTHER

LLA, NANCY,
MOTHER
CIO

UNDO, NENITA,
MOTHER
RELLES

SFRT 2017
 COMPLETE ADDRESS PARENTS GUA

Sex (M/F)
(if learner is not
NAME BIRTHDATE Religious Mother's Maiden
LRN (Last Name, First Name, Name Extension, AGE Name
(mm/dd/yyyy) Affiliation House No./ Municipality/ Father's Name Name (Last Name, First Na
Middle Name) Street/ Sitio/ Barangay Province (Last Name, First Name, Name (Last Name, First Name,
Purok City Extension, Middle Name) Name Extension, Middle
Name Extension, M
Name)
Name)

13

14

15

16

17

18

19

20

21

22

23

24

25

SFRT 2017
 GUARDIAN
(if learner is not Living with Parent) Contact REMARKS
Name Number of (Please refer to the legend)
st Name, First Name, Parent/
Relationship
me Extension, Middle Guardian
Name)

SFRT 2017
 COMPLETE ADDRESS PARENTS GUA

Sex (M/F)
(if learner is not
NAME BIRTHDATE Religious Mother's Maiden
LRN (Last Name, First Name, Name Extension, AGE Name
(mm/dd/yyyy) Affiliation House No./ Municipality/ Father's Name Name (Last Name, First Na
Middle Name) Street/ Sitio/ Barangay Province (Last Name, First Name, Name (Last Name, First Name,
Purok City Extension, Middle Name) Name Extension, Middle
Name Extension, M
Name)
Name)

26

27

28

29

30

31

32

33

34

35

36

37

38

SFRT 2017
 GUARDIAN
(if learner is not Living with Parent) Contact REMARKS
Name Number of (Please refer to the legend)
st Name, First Name, Parent/
Relationship
me Extension, Middle Guardian
Name)

SFRT 2017
 COMPLETE ADDRESS PARENTS GUA

Sex (M/F)
(if learner is not
NAME BIRTHDATE Religious Mother's Maiden
LRN (Last Name, First Name, Name Extension, AGE Name
(mm/dd/yyyy) Affiliation House No./ Municipality/ Father's Name Name (Last Name, First Na
Middle Name) Street/ Sitio/ Barangay Province (Last Name, First Name, Name (Last Name, First Name,
Purok City Extension, Middle Name) Name Extension, Middle
Name Extension, M
Name)
Name)

39

40

<=== TOTAL MALE

ROMAN ALEGRIA, MANUEL, NUEVA, JENNIFER, NUEVA, JENNIFER,

123552060001 ALEGRIA, MARGIE, NUEVA F 4/11/2001 17 CATHOLIC
PIÑAPLATA GANDARA SAMAR
CAILO ARBOLIDA ARBOLIDA

ROMAN ARAGON, DANILO,

123552060002 ARAGON,PILAR, ALPEZ F 10/12/1999 18 CATHOLIC
PIÑAPLATA GANDARA SAMAR
FESTIJO
ALPEZ, JOSEPHINE, A. ALPEZ, JOSEPHINE

ROMAN ELIZALDE, ARTEMIO, VIÑAR, EMMA,

123552060009 ELIZALDE, AINE, VIÑAR F 3/1/2000 18
CATHOLIC
PIÑAPLATA GANDARA SAMAR
LUMTAO
VIÑAR, EMMA, MAÑOZO
MAÑOZO

MAÑOZO, CHRISTINE MAE, PIÑA

PASIMOS, LUZ,
123552060012 PACIMOS F 2/17/2000 18
ROMAN
CATHOLIC
PLAT GANDARA SAMAR MAÑOZO, JESSIE, R.
PASIMOS, LUZ,
PAJARITO PAJARITO
A

PACIMOS,MARY-ANN, PIÑA
123419060082 ALBULARIO F 4/4/1999 18
ROMAN
CATHOLIC
PLAT GANDARA SAMAR
PACIMOS, REY,
LOZADA
FABILLAR, MERLE,
ALBULARIO
PEROCHO, JOY,
PACIMOS
A

DELEQUEÑA, VIVENCIA, PIÑA

DIAZ, DOMINGA,
12355206008 DIAZ F 1/28/1999 19
ROMAN
CATHOLIC
PLAT GANDARA SAMAR
DELEQUEÑA,
ROBERTO,
DIAZ, DOMINGA,
DELEQUEÑA DELEQUEÑA
A

JAMORAWON, MA. PIÑA

123552060011 MARIZA, ELIZALDE F 3/11/2000 18
ROMAN
CATHOLIC
PLAT GANDARA SAMAR
JAMORAWON,
ALFREDO,JR.
ELIZALDE, NELIA,
ATRAGENIO
ELIZALDE, NELIA,
ATRAGENIO
A

MAÑOZO, LIEZEL,
ROMAN MAÑOZO, FLURO, BALINGBINGAN, BALINGBINGAN,
123544060011 BALINGBINGAN F 9/3/1999 18
CATHOLIC
HAMPTON GANDARA SAMAR
ABELLANO CECILIA, ELIZALDE CECILIA, ELIZALDE

DELA TORRE, RONABELLE,

ROMAN
123558050008 OGACHO F 4/11/1999 18
CATHOLIC
SAN JOSE GANDARA SAMAR DELA TORRE, RICKY

10

SFRT 2017
 GUARDIAN
(if learner is not Living with Parent) Contact REMARKS
Name Number of (Please refer to the legend)
st Name, First Name, Parent/
Relationship
me Extension, Middle Guardian
Name)

VA, JENNIFER,
MOTHER
OLIDA

EZ, JOSEPHINE, A. MOTHER

AR, EMMA,
MOTHER
ÑOZO

MOS, LUZ,
MOTHER
RITO

OCHO, JOY,
AUNTIE
IMOS

Z, DOMINGA,
MOTHER
EQUEÑA

ALDE, NELIA,
MOTHER
AGENIO

INGBINGAN,
MOTHER
ILIA, ELIZALDE

SFRT 2017
 COMPLETE ADDRESS PARENTS GUA

Sex (M/F)
(if learner is not
NAME BIRTHDATE Religious Mother's Maiden
LRN (Last Name, First Name, Name Extension, AGE Name
(mm/dd/yyyy) Affiliation House No./ Municipality/ Father's Name Name (Last Name, First Na
Middle Name) Street/ Sitio/ Barangay Province (Last Name, First Name, Name (Last Name, First Name,
Purok City Extension, Middle Name) Name Extension, Middle
Name Extension, M
Name)
Name)

11

12

13

14

15

16

17

18

19

20

21

22

23

SFRT 2017
 GUARDIAN
(if learner is not Living with Parent) Contact REMARKS
Name Number of (Please refer to the legend)
st Name, First Name, Parent/
Relationship
me Extension, Middle Guardian
Name)

SFRT 2017
 COMPLETE ADDRESS PARENTS GUA

Sex (M/F)
(if learner is not
NAME BIRTHDATE Religious Mother's Maiden
LRN (Last Name, First Name, Name Extension, AGE Name
(mm/dd/yyyy) Affiliation House No./ Municipality/ Father's Name Name (Last Name, First Na
Middle Name) Street/ Sitio/ Barangay Province (Last Name, First Name, Name (Last Name, First Name,
Purok City Extension, Middle Name) Name Extension, Middle
Name Extension, M
Name)
Name)

24

25

26

27

28

29

30

31

32

33

34

35

36

SFRT 2017
 GUARDIAN
(if learner is not Living with Parent) Contact REMARKS
Name Number of (Please refer to the legend)
st Name, First Name, Parent/
Relationship
me Extension, Middle Guardian
Name)

SFRT 2017
 COMPLETE ADDRESS PARENTS GUA

Sex (M/F)
(if learner is not
NAME BIRTHDATE Religious Mother's Maiden
LRN (Last Name, First Name, Name Extension, AGE Name
(mm/dd/yyyy) Affiliation House No./ Municipality/ Father's Name Name (Last Name, First Na
Middle Name) Street/ Sitio/ Barangay Province (Last Name, First Name, Name (Last Name, First Name,
Purok City Extension, Middle Name) Name Extension, Middle
Name Extension, M
Name)
Name)

37

38

39

40

<=== TOTAL FEMALE

<=== COMBINED

Legend: List and Code of Indicators under REMARKS column

Beginning of the Prepared By:
Indicator Code Required Information Indicator Code Required Information REGISTERED End of the Semester
Semester
Transferred T/O CCT Recipient CCT CCT Control/reference
Out number & Effectivity Date MALE
Balik Aral B/A Name of school last
Transferred attended & Year
In T/I
Name of School, Date of 1st Learner With LWE
Specify Exceptionality of the
Attendance and Date of Last Learner FEMALE
Exceptionality Specify Level & Effectivity
Attendance if Transferred Out Accelerated ACL Date
Beginning of the Semester Dat
TOTAL

SFRT 2017
 GUARDIAN
(if learner is not Living with Parent) Contact REMARKS
Name Number of (Please refer to the legend)
st Name, First Name, Parent/
Relationship
me Extension, Middle Guardian
Name)

Signature of Adviser over Printed Name

Semester Date: End of the Semester Date:

SFRT 2017
 School Form 1 School Register for
School Name PIÑAPLATA INTEGRATED SCHOOL School ID 313712 District
Semester 2ND School Year 2017-2018
Section MARS Course (For TVL Only)

COMPLETE ADDRESS

Sex (M/F)
LRN NAME BIRTHDATE AGE Religious
(Last Name, First Name, Name Extension, Middle Name) (mm/dd/yyyy) Affiliation House No./ Municipality/
Street/ Sitio/ Barangay
Purok City

124001060041 ELIZALDE, ANDREW, VIÑAR M 9/20/2000 17

ROMAN
CATHOLIC
PUROK 3 PIÑAPLATA GANDARA

123862060017 ELIZALDE, DARYLL, VELASCO M 4/6/2000 17

ROMAN
CATHOLIC
TAWIRAN GANDARA

123552060014 PASIMOS, BENEDICTO, SERRANO JR. M 6/26/1997 20

ROMAN
CATHOLIC
PUROK 3 PIÑAPLATA GANDARA

3 <=== TOTAL MALE

ROMAN
121036060033 FLORDELIZA, JAMIE, GOLDO F 11/27/1999 18
CATHOLIC
SAN JOSE GANDARA

BORN AGAIN
123522060009 GOLONDRINA, MAILA, ANGELIO F 10/3/1999 18
CHRISTIAN
PUROK 4 NALIHUGAN GANDARA

REFUNCION, REALYN, DEALAGDON

ROMAN
123552060018 F 8/21/2000 17
CATHOLIC
TAWIRAN GANDARA

3 <=== TOTAL FEMALE

6 <=== COMBINED

Legend: List and Code of Indicators under REMARKS column

Indicator Code Required Information Indicator Code Required Information REGISTERED

Transferred T/O CCT Recipient CCT CCT Control/reference

Out number & Effectivity Date MALE
Balik Aral B/A Name of school last
Transferred attended & Year
In T/I
Specify Exceptionality of the
Name of School, Date of 1st Attendance and Date Learner With LWE Learner FEMALE
of Last Attendance if Transferred Out Exceptionality Specify Level & Effectivity
Accelerated ACL Date

TOTAL

SFRT 2017
 for Senior High School (SF1-SHS)
GANDARA II- MATUGUINAO Division SAMAR Region
Grade Level 11 Track and Strand GENERAL ACADEMIC STRAND

RESS PARENTS GUARDIAN

(if learner is not Living with Parent) Contact REMARKS
Mother's Maiden Number of
Name (Please refer to the legend)
Father's Name Name (Last Name, First Name, Parent/
Province (Last Name, First Name, Name (Last Name, First Name, Name Extension, Middle
Relationship
Guardian
Extension, Middle Name) Name Extension, Middle Name)
Name)
ELIZALDE,
SAMAR VIÑAR, ANABEL, E. VIÑAR, ANABEL, E. MOTHER
FERNANDO,L.

SAMAR VELASCO, DONNA, VELASCO, DONNA, MOTHER

PASIMOS, BENEDICTO,
SAMAR SERRANO, ERLINDA, C. PEROCHO, JOY, P. SISTER
J. SR.

SAMAR MARABE, JOHNNY FLORDELIZA, JOVELYN MARABE, JOHNNY FATHER

GOLONDRINA, ALLAN, GOLONDRINA,

SAMAR ANGELIO, MAILEEN, C. MOTHER
O. MAILEEN, E.

REFUNCION, DEALAGDON, DEALAGDON,

SAMAR MOTHER
WILFREDO, ELIZABETH ELIZABETH

Beginning of the Prepared By:

End of the Semester
Semester

3 3
ROGIE O. NAVARRA
Signature of Adviser over Printed Name
3 3

Beginning of the Semester Date: End of the Semester Date:

6 6 JUNE 5, 2017 OCTOBER 23, 2017

SFRT 2017
 VIII
IC STRAND

REMARKS
lease refer to the legend)

e:
OCTOBER 23, 2017

SFRT 2017
 School Form 2 Daily Attendance Report of Learne
School Name PIÑAPLATA INTEGRATED SCHOOL School ID 313712 District

Semester 1ST School Year 2017-2018 Gra

Section MARS Course/s (only for TVL)

DATE
NAME
No. (Last Name, First Name, Name Extension, Middle
Name) M T W TH F S M T W TH F S M T W TH F S M
1 ELIZALDE, ANDREW, VIÑAR

2 ELIZALDE, DARYLL, VELASCO

3 PASIMOS, BENEDICTO, SERRANO

3 <=== MALE | TOTAL Per Day ===>

1 FLORDELIZA, JAMIE, GOLDO

2 GOLONDRINA, MAILA, ANGELIO

3 REFUNCION, REALYN, DEALAGDON

3 <=== FEMALE | TOTAL Per Day ===>

6 Combined TOTAL Per Day

GUIDELINES: 1. CODES
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance (blank) - Pre
2. To compute the following: for L

2. REASO
a. Percentage of Enrolment = x 100 SCHOOL (
Registered Learners as of end of the month
Enrolment as of 1st Friday of the school year
a. Domest
a.1. Had to ta
Total Daily Attendance a.2. Early ma
b. Average Daily Attendance =
Number of School Days in reporting month a.3. Parents'
a.4. Family p

Average daily attendance

c. Percentage of Attendance for the month = x 100
Registered Learners as of end of the month
b. Individu
3. Every end of the month, the Class Adviser will submit this form to the Office of the Principal for recording of summary table into School Form 4. Once b.1. Illness
signed by the School Head, this form should be returned to the Class Adviser. b.2. Overage
b.4. Drug Abu
4. The Class Adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive
b.5. Poor Aca
days and/or those at risk of dropping out. b.6. Lack of I
5. Attendance performance of learners will be reflected in the SF9-SHS of every grading period. b.7. Hunger/M

c. School-
c.1. Teacher
c.2. Physical
c.3. Peer Infl

d. Geograp
d.1. Distance
d.2. Armed c
d.3. Calamitie

e. Financia
e.1. Child lab
Report of Learners for Senior High School (SF2-SHS)
District GANDARA II- MATUGUINAO Division SAMAR Region VIII

Grade Level 11 Track and Strand GENERAL ACADEMIC STRAND

Month of JANUARY
DATE
Total for the Month REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If
TRANSFERRED IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).
T W TH F S M T W TH F S ABSENT TARDY

No. of Days of Classes:

1. CODES FOR CHECKING ATTENDANCE Month: Summary
(blank) - Present; (x) - Absent; Tardy (half shaded = Upper
M F TOTAL
for Late Comer, Lower for Cutting Classes)
* Enrolment (as of 1st Friday of the semester)

2. REASONS/CAUSES FOR NO LONGER IN Late Enrolment during the month (beyond cut-off)
SCHOOL (NLS)
Registered Learners as of end of the month

a. Domestic-Related Factors Percentage of Enrolment as of end of the month

a.1. Had to take care of siblings Average Daily Attendance
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling Percentage of Attendance for the month
a.4. Family problems
Number of students absent for 5 consecutive days

b. Individual-Related Factors
b.1. Illness
No Longer in School (NLS)
b.2. Overage
b.4. Drug Abuse
b.5. Poor Academic Performance
Transferred Out
b.6. Lack of Interest/Distractions
b.7. Hunger/Malnutrition Transferred In

Shifting Out

c. School-Related Factors Shifting In

c.1. Teacher Factor
c.2. Physical Condition of Classroom
c.3. Peer Influence
I certify that this report is true and correct:
d. Geographic/Environmental
d.1. Distance between home and school ROGIE O. NAVARRA
d.2. Armed conflict (incl. tribal wars & clan feuds)
d.3. Calamities/Disasters Signature of Class Adviser over Printed Name

e. Financial-Related
e.1. Child labor, work Attested By:
MA. ELENA C. RESUELLO
 DATE
NAME
No. (Last Name, First Name, Name Extension, Middle
Name) M T W TH F S M T W TH F S M T W TH F S M
f. Others (
a. Death
b. Transferre
c. Transferre
d. Transferre
DATE
Total for the Month REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If
TRANSFERRED IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).
T W TH F S M T W TH F S ABSENT TARDY
f. Others (Specify) Signature of School Head over Printed Name
a. Death
b. Transferred to School Abroad
c. Transferred to International School
d. Transferred to ALS
 School Form 3 Books Issued and Returned for Senior High School (S
School Name PIÑAPLATA INTEGRATED SCHOOL School ID 313712 District GANDARA II- MATUGUINAO

Semester 2ND School Year 2017-2018 Grade Level 11 Track and

Section MARS Course/s (only for TVL)

Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

NAME
No. (Last Name, First Name, Name Extension,
Middle Name) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1 ELIZALDE, ANDREW, VIÑAR

2 ELIZALDE, DARYLL, VELASCO
3 PASIMOS, BENEDICTO, SERRANO

3 TOTAL MALE ===>

1 FLORDELIZA, JAMIE, GOLDO
2 GOLONDRINA, MAILA, ANGELIO
3 REFUNCION, REALYN, DEALAGDON

3 TOTAL FEMALE ===>

6 COMBINED ===>

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 shall be reflected in the form.
4. The Total Number of Copies of Books Returned shall 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 information with the following code:
Prepared By:
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code
FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian (for
code TDO), PTL=Paid by the Learner (for code NEG). References: DO No.23, s.2001, DO No.25, s.2003, DO No.14,
s.2012.
Si
School (SF3-SHS)
Division SAMAR Region VIII

Track and Strand GENERAL ACADEMIC STRAND

Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

REMARKS/ACTION TAKEN
(Please refer to the codes below)
Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Returned Issued Returned Issued Returned

epared By:

ROGIE O. NAVARRA
Signature of Class Adviser over Printed Name
 School Form 4 Monthly Learners' Movement and Attendanc

School Name District Division

School ID Semester School Ye

ATTENDANCE DROPPED OUT TRANSFERRED OUT

REGISTERED
LEARNERS (A) (A+B) (A) (A+B)
(As of End Cumulative Cumulative Cumulative Cumulative
TRACK STRAND Daily % for the
Number as
(B) Total for
Number as of Number as
(B) Total for
Number as
of the Month) Average Month the Month the Month
of Previous End of the of Previous of End of
Month Month Month the Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T

TOTAL FOR GRADE 11

TOTAL FOR GRADE 12

GRAND TOTAL
Prepared and Submitted By:

Signature of Sc
 ance for Senior High School (SF4-SHS)

Region

hool Year For the Month of

TRANSFERRED IN SHIFTED OUT SHIFTED IN

(A) (A+B) (A) (A+B) (A) (A+B)

Cumulative Cumulative Cumulative Cumulative Cumulative Cumulative
(B) Total for (B) Total for (B) Total for
Number as Number as of Number as Number as of Number as Number as
the Month the Month the Month
of Previous End of the of Previous End of the of Previous of End of the
Month Month Month Month Month Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T
re of School Head over Printed Name
 School Form 5A End of Semester and School Year Status

School Name PIÑAPLATA INTEGRATED SCHOOL School ID

Semester 1ST School Year 2016-201

Track and Strand GENERAL ACADEMIC STRAND

BACK SUBJECT/S
LEARNER'S NAME
No. LRN List down subjects where learner obta
(Last Name, First Name, Name Extension, Middle Name)
below 75%)

MALE
1 124001060041 ELIZALDE, ANDREW, VIÑAR
2 123862060017 ELIZALDE, DARYLL, VELASCO
3 123552060014 PASIMOS, BENEDICTO, SERRANO JR.

FEMALE
1 121036060033 FLORDELIZA, JAMIE, GOLDO
2 123522060009 GOLONDRINA, MAILA, ANGELIO
3 123552060018 REFUNCION, REALYN, DEALAGDON
 BACK SUBJECT/S
LEARNER'S NAME
No. LRN List down subjects where learner obta
(Last Name, First Name, Name Extension, Middle Name)
below 75%)

GUIDELINES:

This form shall be accomplished after each semester in a school year, leaving the End of School Year Status Column and Summary
data elements shall be filled up only after the 2nd semester or at the end of the School Year.

INDICATORS:
End of Semester Status
Complete - number of learners who completed/satisfied the requirements in all subject areas (with grade of at least 75%)
Incomplete - number of learners who did not meet expectations in one or more subject areas, regardless of number of sub
Note: Do not include learners who are No Longer in School (NLS)

End of School Year Status

Regular - number of learners who completed/satisfied requirements in all subject areas both in the 1st and 2nd semester
Irregular - number of learners who were not able to satisfy/complete requirements in one or both semesters
d School Year Status of Learners for Senior High School (SF5A-SHS)

313712 District GANDARA II- MATUGUINAO Division SAMAR

2016-2017 Grade Level 11

Section MARS

EMIC STRAND Course/s (only for TVL)

BACK SUBJECT/S END OF

END OF SCHOOL
List down subjects where learner obtained a rating SEMESTER
YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)

COMPLETE REGULAR SUMMARY TABLE 1ST SEM

COMPLETE REGULAR STATUS MALE FEMALE

COMPLETE REGULAR COMPLETE 3 3
INCOMPLETE

TOTAL 3 3

SUMMARY TABLE 2ND SEM

STATUS MALE FEMALE

COMPLETE 3 3
INCOMPLETE

TOTAL 3 3

SUMMARY TABLE (End of the School Year Only)

STATUS MALE FEMALE

REGULAR 3 3
IRREGULAR

TOTAL 3 3

COMPLETE REGULAR
COMPLETE REGULAR
COMPLETE REGULAR

Prepared By:

ROGIE O. NAVARRA
Signature of Class Adviser over Printed Name
 BACK SUBJECT/S END OF
END OF SCHOOL
List down subjects where learner obtained a rating SEMESTER
YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)

Certified Correct By:

MA. ELENA C. RESUELLO

Signature of School Head over Printed Name

Reviewed By:

Signature of Division Representative over Printed Name

ool Year Status Column and Summary Table for End of School Year Status blank/unfilled at the end of the 1st Semester. These

ct areas (with grade of at least 75%)

ect areas, regardless of number of subjects failed (with grade less than 75%)

eas both in the 1st and 2nd semester

one or both semesters
HS)

Region VIII

MARS

RY TABLE 1ST SEM

TOTAL
6

RY TABLE 2ND SEM

TOTAL
6

(End of the School Year Only)

TOTAL
6

E O. NAVARRA
ss Adviser over Printed Name
NA C. RESUELLO
hool Head over Printed Name

Representative over Printed Name

 School Form 5B List of Learners with Complete SHS Requirements (SF5B-SHS)
School Name PIÑAPLATA INTEGRATED SCHOOL School ID 313712 District SAMAR Division SAMAR Region VIII
Semester SECOND School Year Section
Track and Strand GENERAL ACADEMIC STRAND Course/s (only for TVL)

Completed SHS
in 2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Level Attained
(only if applicable)

MALE

1 124001060041 ELIZALDE, ANDREW, VIÑAR SUMMARY TABLE A

2 STATUS MALE FEMALE TOTAL
3 Learners who
completed SHS
Program within 2
SYs or 4
semesters

Learners who
completed SHS
Program in more
than 2 SYs or 4
semesters

TOTAL

SUMMARY TABLE B
STATUS MALE FEMALE TOTAL
NC III
NC II
NC I
TOTAL

Note: NCs are recorded here for documentation but is not a requirement for
graduation.
 Completed SHS
in 2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Level Attained
(only if applicable)
Note: NCs are recorded here for documentation but is not a requirement for
graduation.

GUIDELINES:
1. This form should be accomplished by the Class Adviser at End of School
Year.
2. It should be compiled and checked by the School Head and
passed to the Division Office before graduation.

FEMALE
Reviewed By:

Signature of Class Adviser over Printed Name

Certified Correct & Submitted By:

Signature of School Head over Printed Name

Reviewed By:

Signature of Division Representative over Printed Name

 Completed SHS
in 2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Level Attained
(only if applicable)
 School Form 6 Summarized Report of Learner Status as of End of Semester and Scho

School Name PIÑAPLATA INTEGRATED SCHOOL School ID 313712 District GANDARA II- MAT

Semester School Year 2017-2018

END OF SEMESTER STATUS

GRADE LEVEL
COMPLETE INCOMPLETE TOTAL

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL

GRADE 11
TRACK/STRAND/COURSE

SUB TOTAL
GRADE 12
TRACK/STRAND/COURSE

SUB TOTAL
TOTAL

Prepared and Submitted By: Reviewed & Validated By:

Signature of School Head over Printed Name Signature of Division Representative o
GUIDELINES:
1. After receiving and validating the report on Status of Learners submitted by the Class Adviser, the School Head shall comput
2. This report shall be forwarded to the Division Office by the end of the semester.
3. Column for End of School Year shall be accomplished at the end of SY or every after the 2nd semester
4. Protocols of validation & submission are under the discretion of the Schools Division Superintendent.
 and School Year for Senior High School (SF6-SHS)

DARA II- MATUGUINAO Division SAMAR Region VIII

END OF SCHOOL YEAR

(Fill up only at the end of the second semester.)

REGULAR IRREGULAR TOTAL

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL

Noted By:
presentative over Printed Name Signature of Division Superintendent over Printed Name
shall compute the grade level total per track/strand/course and school total.
 School Form 7 School Personnel Basic Profile and Assign
School Name School ID District
Semester School Year
(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non-Teaching Items

Title of Design
Title of Plantilla Position Title of Plantilla Position
Number of Number of (as
(as it appears in the appointment (as it appears in the appointment
Incumbent Incumbent Teacher, Clerk
document/PSIPOP) document/PSIPOP)

EDUCATIONAL QUALIFICATION
Nature of
Employee Appointment/
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Identification (Arrange by Sex Status
Source Designation Degree/ Specialization/
Number Position, Descending) (Regular/ Minor
-T.I.N.) Probationary/ Postgraduate Specialized
Part Time) Training Attended
 EDUCATIONAL QUALIFICATION
Nature of
Employee Appointment/
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Identification (Arrange by Sex Status
Source Designation Degree/ Specialization/
Number Position, Descending) (Regular/ Minor
-T.I.N.) Probationary/ Postgraduate Specialized
Part Time) Training Attended
 EDUCATIONAL QUALIFICATION
Nature of
Employee Appointment/
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Identification (Arrange by Sex Status
Source Designation Degree/ Specialization/
Number Position, Descending) (Regular/ Minor
-T.I.N.) Probationary/ Postgraduate Specialized
Part Time) Training Attended

GUIDELINES:
1. This form shall be accomplished at the beginning of each semester by the School Head and is submitted to the Division Office. In case of movemen
personnel during the semester, an updated SHSF-7 must be submitted to the Division Office at the end of the semester.
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank to the lo
3. Please reflect subjects being taught including advisory class or ancillary assignment (if any). Other administrative duties must also be reported.
4. Daily Program Column is for teaching personnel only.
ssignment for Senior High School (SF7-SHS)
Division Region

(C ) Other Appointments and Funding Sources

Appointment: Number of Incumbent

of Designation
(Contractual, Fund Source
(as it appears in the contract/document:
Substitute, (SEF, PTA,
her, Clerk, Security Guard, Driver etc.)
Volunteer, Others NGO's etc.) Teaching Non-Teaching
specify)

Remarks:
N Daily Program (time duration)
*For Detailed Items, Indicate
name of school/office,
Grade and *For IP - Ethnicity)
Subjects Taught, Advisory Sections
Class & Other Ancillary Total Actual *For additional loads from
(Enumerate DAY
Assignments sections From To Teaching JHS- please indicate the number
Minor (M/T/W/
taught) (00:00) (00:00) Minutes per of teaching minutes per week)
TH/F)
Week

First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Day
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Day
First Semester:
 Remarks:
N Daily Program (time duration)
*For Detailed Items, Indicate
name of school/office,
Grade and *For IP - Ethnicity)
Subjects Taught, Advisory Sections
Class & Other Ancillary Total Actual *For additional loads from
(Enumerate DAY
Assignments sections From To Teaching JHS- please indicate the number
Minor (M/T/W/
taught) (00:00) (00:00) Minutes per of teaching minutes per week)
TH/F)
Week

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Day
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Day
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Day
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Day
 Remarks:
N Daily Program (time duration)
*For Detailed Items, Indicate
name of school/office,
Grade and *For IP - Ethnicity)
Subjects Taught, Advisory Sections
Class & Other Ancillary Total Actual *For additional loads from
(Enumerate DAY
Assignments sections From To Teaching JHS- please indicate the number
Minor (M/T/W/
taught) (00:00) (00:00) Minutes per of teaching minutes per week)
TH/F)
Week

movement of teachers and other

k to the lowest. Signature of School Head over Printed Name

rted.
Updated as of:

School Form 7, Page ___ of ________

SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report for Senior High Sch
(For All Grade Levels)

School Name PIÑAPLATA INTEGRATED SCHOOL DistrictGANDARA II- MATUGUINAO Division SAMAE

School ID 313712 Grade 11 Section MARS Track/Strand (SHS) GENERAL ACADE

Learner's Name Nutritional Sta

Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age BMI
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name) (kg/m²)
MALE
1 124001060041 ELIZALDE, ANDREW, VIÑAR 9/20/2000 17 54 1.58 2.4964 21.631149
3 123862060017 ELIZALDE, DARYLL, VELASCO 4/6/2000 17 55 1.62 2.6244 20.957171
3 123552060014 PASIMOS, BENEDICTO, SERRANO 6/26/1997 20 57 1.68 2.8224 20.195578

FEMALE
1 121036060033 FLORDELIZA, JAMIE, GOLDO 11/27/1999 18 54 1.58 2.4964 21.631149
2 123522060009 GOLONDRINA, MAILA, ANGELIO 10/3/1999 18 56 1.51 2.2801 24.560326
3 123552060018 REFUNCION, REALYN, DEALAGDON 8/21/2000 17 56 1.47 2.1609 25.915128

SUMMARY TABLE
Nutritional Status Heig
Summary Table S
SEX Severely Severely
Wasted Normal Overweight Obese TOTAL Stunted Normal
Wasted Stunted
MALE
FEMALE
TOTAL

Date of Assessment: Conducted/Assessed By: Certified Correct By:

SFRT 2017
gh School (SF8-SHS)

SAMAE Region VIII

AL ACADEMICS School Year 2017-2018

ional Status
Height for
BMI Remarks
Age (HFA)
Category

Normal
Normal
Normal

Normal
Normal
Normal

Height for Age (HFA)

Summary Table
Tall Total

Reviewed By:

SFRT 2017

SFRT 2017