School Form 1 (SF 1) School Register

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

School ID Region VIII Division District

School Name School Year Grade Level 11 Section HUMSS-B

GUARDIAN
ADDRESS PARENTS REMARKS
(If not Parent)
AGE as of IP
NAME Sex BIRTH DATE MOTHER Contact Number of
LRN 1st Friday (Ethnic RELIGION House #/ Street/ Father's Name (Last Name, Mother's Maiden Name (Please refer to the
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy) TONGUE Municipality/ Relation Parent or Guardian
June Group) Sitio/ Barangay Province First Name, Middle Name) (Last Name, First Name, Name legend on last
City -ship
Purok Middle Name) page)

1000132080001 Abes, John Lauren M. M 12/20/2002 16 Iloko Roman Catholic Purok 4 Lumbad Dingras Ilocos Norte Abes, John Parcasio Ragojo, Ellena Mosuela 09566337898

100130080005 Alop, Lexus Den H. M 03/19/2003 16 Iloko Iglesia ni Cristo Sitio 3 Medina Dingras Ilocos Norte Dumlao, Eden Alop, Mhe Erline 09159729693

100123080008 Apostol, Christian Mark P. M 02/21/2003 16 Iloko Roman Catholic Purok 5 Parado Dingras Ilocos Norte APostol, Crispin Tolentino Peros, Madeline Torreno 09369676407

Baptista, Lowell Auldrey B. M 09/04/2003 16 Iloko Roman Catholic Purok 3 Bungcag Dingras Ilocos Norte Baptista, Elmer Batallones, Eivy

100131080004 Batinga, Edmar L. M 03/09/2001 17 Iloko 4P's Pentecost Sitio Nabukel Espiritu Dingras Ilocos Norte Batinga, Elmer Munoz Llantada, Zenaida Tolentino 09484123486

100132080014 Batuyong KIng Charles L. M 04/20/2002 17 Iloko Roman Catholic Purok 3 Foz Dingras Ilocos Norte Batuyong, Aldrin Llanes Lanuza, Laurence Villaluz 09501074844

100124080009 Braceros, Winnie Jake R. M 05/27/2003 15 Iloko Roman Catholic Purok Swerte Valdez Marcos Ilocos Norte Braceros, Willie Braceros, Annie 09353915827

300373150012 Calapao, Wendell Ryan V. M 09/16/2002 16 Iloko Roman Catholic Sitio Nabukel Espiritu Dingras Ilocos Norte Calapao, Ryan Ubay, Haydee Ramos 09772137369

100121080005 Corpuz, Myk Diether D. M 08/28/2002 16 Iloko Pentecost Purok 1 Lanas Dingras Ilocos Norte Corpuz, Dexter Miguel Dela Cruz, Margie Guianan 09777213872

100130080029 Dela Cruz, David Allen R. M 02/01/2003 16 Iloko 4P's Roman Catholic House #21 Albano Dingras Ilocos Norte Dela Cruz Ludwig Romero, Mariegrace Dela 09555283043
Ferdinand Cruz
103902200212 Diamsay, Carlos C. M 03/21/2003 16 Iloko Iglesia ni Cristo Purok 1 Dancel Dingras Ilocos Norte Diamsay, Cesar P. Cabradilla, Carolina S. 09161389110

100152130004 Emnace, Carl Jerdine S. M 03/13/2003 16 Iloko Iglesia ni Cristo Sitio Parola Lydia Marcos Ilocos Norte Emnace, Meejert Tuliao Duelto, Geraldine 09279225413
Sambrano
100123080023 Ganitano, MIzen C. M 10/05/2003 15 Iloko Roman Catholic Purok 1 Parado Dingras Ilocos Norte Ganitano, Miguel Campano, Zenaida 09157628473

100118080029 Labutong, Nick Vincent A. M 11/03/2003 15 Iloko Roman Catholic Purok 6 Baresbes Dingras Ilocos Norte Labuton, Jovito Barangay Ancheta, Lericelle 09177449866
Rasquero
400011150189 Marcelino, Christian Leonard M. M 04/08/2004 15 Iloko Roman Catholic Villanueva Street Peralta Dingras Ilocos Norte Marcelino, Leonart Manangan, Carol 09152750091

100132080033 Matalubos, John Rod M. M 04/05/2003 16 Iloko 4P's Independente Purok 5 Lumbad Dingras Ilocos Norte Matalubos, Rodney Mariano, Joan 09550881540

100123080031 Miguel, Clarence S. M 09/10/2002 17 Iloko Iglesia ni Cristo Purok 7 Parado Dingras Ilocos Norte Miguel, Norman Samson, Sheryle 09483494744

100134120053 Monte, Justine Marc M. M 03/28/2002 15 Iloko Pentecost Sitio Nasalucag Saludares Dingras Ilocos Norte Monte, Macario Manuel Miguel, Christine 09777189930

100123080034 Pastor, Michael C. M 03/27/2003 16 Iloko Roman Catholic Purok 5 Parado Dingras Ilocos Norte Pastor, Nestor Coma Cabading, Leonyda Alfredo

100123080034 Ramos, John Clifford R. M 05/01/2002 17 Iloko Roman Catholic Purok 2 Sulquino Dingras Ilocos Norte Ramos, Westan Solanoy Regidor, Renabeth

1400025150084 Ramos, Jhon Mark M 05/31/2000

100132080024 Sambrano, Amiel Van E. M 09/24/2002 16 Iloko Roman Catholic Purok 6 Lumbad Dingras Ilocos Norte Sambrano, Adonis Andres Escasinas, Marichelle
Butac
10013008058 Tagle, Richlloyd D. M 09/18/2001 17 Iloko 4P's Roman Catholic Puruganan Dingras Ilocos Norte Tagle, William Ycas Datucan, Marites 09217064708

40631515002 Uy, Harvey D. M 09/24/2001 17 Iloko Roman Catholic Purok Narang-ay Guerrero Dingras Ilocos Norte Queenie, Marie Delos
Reyes
 100125070080 Ventura, Neil John F. M 06/13/2002 16 Iloko Roman Catholic Baresbes Dingras Ilocos Norte Ventura, NIck Paguirigan Foronda, Ela Duldulao 09157628375

100134080001 Ababao, Justine Claire A. F 10/31/2002 16 Iloko Roman Catholic Purok 5 Peralta Dingras Ilocos Norte Ababao, Limuel Lacuesta Apostol, Liwliwa Calaogan 09203401830

100124080002 Agnes, Angelica Joyce R. F 10/31/2003 16 Iloko 4P's Roman Catholic Purok Nasaldet Cali Dingras Ilocos Norte Agnes, Eduardo, Rios Ruiz, Lavenia Juan 09954384953

100130080003 Agulay, Katrina C. F 07/19/2002 16 Iloko Roman Catholic #25, Purok 1 Albano Dingras Ilocos Norte Agulay, Romy Ramrez Calibuyot, Phelga Albano 09100745621

100130120090 Albano, Christine Jhoice B. F 05/27/2003 15 Iloko Pentecose Purok 3 Albano Dingras Ilocos Norte Albano, Christian John Sto. Buanavente, JAnice Aolin 09108886506
Domingo
100127080003 Alejandro, Nathalie Jane D. F 01/25/2003 16 Iloko Igkesia ni Cristo Sitio San Jose Ver Dingras Ilocos Norte Alejandro, Javelino Dacuyag, Delia 09468557918

100120080009 Cabildo, Charmaine Joyce T. F 08/25/2003 15 Iloko Roman Catholic Purok 2 Medina Dingras Ilocos Norte Cabildo, Gilbert Uman LAstimosa, Glenda Tadena 09174891807

100130080017 Calibuyot, Lyca Khryzelle C. F 12/16/2002 16 Iloko Roman Catholic #28 Namnama Madamba Dingras Ilocos Norte Camposano, Desiree Ting 09480998633

100130080020 Castro, Angelica Faye D. F 09/16/2003 15 Iloko Roman Catholic #05 Albano Dingras Ilocos Norte Castro, Benigno Ignacio Pistor, Luzviminda 09193803657

100120080011 Corrales, Alaine C. F 09/03/2003 15 Iloko Pentecose Guerrero Guerrero Dingras Ilocos Norte

100779130003 Delos Reyes, Erica L. F 07/03/2003 16 Iloko Roman Catholic Purok 1 Lumbad Dingras Ilocos Norte Delos Reyes, Amando Ibus, Rosemarie Icat 09388028476
Isguerra
100120080019 Duldulao, April F 04/21/2003 16 Iloko 4P's Igkesia ni Cristo Purok Narang-ay Guerrero Dingras Ilocos Norte Duldulao, Virgilio Root Duldulao, Cristina Mateo 09668618146

100158080014 Dumlao, Cathlyne F 09/01/2002 16 Iloko Igkesia ni Cristo Madamba Dingras Ilocos Norte Caeredon, Salmer Castro Dumalao, Myrna Casabay 09268233889

136524080382 Espejo, Frencis, Yvonne F 09/18/2002 16 Iloko Roman Catholic Sitio Naregta Madamba Dingras Ilocos Norte Espejo, Rovellie Pabantosa 09121831214

100131080007 Juni, Catherine Yvonne L. F 11/20/2002 16 Iloko 4P's Roman Catholic Purok Namnama Espiritu Dingras Ilocos Norte 09950458252

100130080040 Lumbes, Jennie Shechina U. F 01/01/2003 16 Iloko Roman Catholic Madamba Dingras Ilocos Norte Lumbes, Sonny Ubay, Babyln Ramos 09561046586

100120080029 Mabini, Freisha Lei C. F 08/24/2003 15 Iloko 4P's Roman Catholic House #21 Dancel Dingras Ilocos Norte Mabini, Frederick Flordeliza Castaneda, Shaleemar 09454593077
Barbero
100130080041 Macarobo, Kylie B. F 07/31/2003 15 Iloko Roman Catholic Purok Namnama Madamba Dingras Ilocos Norte Macarobo, ROland Ballesteros, Mylan Philip 09301991440
Tolentino
150021080005 Manuel, Syrine Hart G. F 11/22/2002 16 Iloko 4P's Pentecose San Rafael Fransisco Dingras Ilocos Norte Manuel, Villauel Pagay Gamayon, Crelimay 09487114732
Abanillia
100118080038 Rosqueta, Princess Altheya A. F 09/16/2003 15 Iloko Roman Catholic San Carlos Baresbes Dingras Ilocos Norte Rosqueta, Rommel Villaluz Alonzo, Donalyn Alipio 09397938531

100126080026 Saludares, Reina Camille R. F 01/06/2003 16 Iloko Pentecose Purok 1 Sulquinao Dingras Ilocos Norte Saludares, Albert Ricotoso 09663428052

100138080020 Tagalicud, Zyryll Khyle F 07/30/2003 15 Iloko Roman Catholic Purok 5 Suyo Dingras Ilocos Norte Banut, Julius Agdeppa Tagalicud, Clerielyn Villaluz 09127417786

100134080040 Tolentino, Aubrey Jheanne V. F 04/05/2003 16 Iloko Roman Catholic 122, Purok 5 Puruganan Dingras Ilocos Norte Tolentino, Amor Dancel Villaruz, Catherine Pasion 09485544355

100129080011 Ucol, Shaira Jane E. F 09/22/2003 15 Iloko 4P's Roman Catholic 107 Abkir St. Suyo Dingras Ilocos Norte Ucol, James Earl Fernando Estrells, Shirlyn Motilla 09163694517

100132080046 Vicente, Venish Anne Quinne G. F 10/07/2001 16 Iloko Roman Catholic Lumbad Dingras Ilocos Norte Vicente, Roberto Ambrocio Pascua, Nicetas Gilo 09087816667
Purok 1

List and Code of Indicators under REMARKS column

Prepared by: Certified Correct:
Indicator Code Required Information Code Required Information REGISTERED BoSY EoSY

Transferred Out T/O Name of Public (P) Private (PR) School & Effectivity Date CCT CCT Control/reference number & Effectivity Date MALE
Maryrose T. Vasquez Jennifer Corpuz
(Signature of Adviser over Printed Name) (Signature of School Head over Printed Name)
Transferred IN T/I Name of Public (P) Private (PR) School & Effectivity Date B/A Name of school last attended & Year FEMALE

Dropped DRP Reason and Effectivity Date LWD Specify

TOTAL
 TOTAL
Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) ACL Specify Level & Effectivity Data BoSY Date: EoSYDate: BoSY Date: EoSYDate:
 School Form 2 (SF2) Daily Attendance Report of Learners
(This replaces Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

School ID 300015 School Year 2019-2020 Report for the Month of JUNE

Name of School Dingras National High School -Poblacion Campus Grade Level 11 Section Obsidian
LEARNER'S NAME (1st row for date) Total for the
(Last Month REMARKS (If DROPPED OUT, state reason, please
3 4 5 6 7 10 11 12 13 14 17 18 19 20 21 24 25 26 27 28 refer to legend number 2.
Name, First Name, Middle Name) If TRANSFERRED IN/OUT, write the name of School.)
M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F ABSENT TARDY
1 Aguinaldo, Philip Christian Alibuyog E H H X 1

2 Aguinaldo, Pritz Carlo Alibuyog E O O 0

3 Aquino, Ryan Gallardo E L L 0

4 Ballesteros, Lester Curading E I I 0

5 Bonifacio, Jhon Benedick E D X D X X X X X 6

6 Brigado, John Clifford Bareng E A A 0

7 Cabilangan, Ryan Rafales E Y Y 0

8 Espiritu, Jhon Carlo Ramos E 0

9 Hernandez, Joefort Balila E

X 1

10 Manlapaz, Junior Julius E

X X X X 4

11 Maravilla, Terrence Jay Anno E 0

12 Naim, Carlos Miguel e 0

13 Pasion,Roel Jr. Agcanas E 0

14 Picoc, Nell Allan Dumlao E 0

15 Ramos, Justin Rafael Dancel E X X 2

16 Saces, Marc John Canino E X 1

17 Santos, Jhay Wistley Arellano E 0

18 Terrado, Rhaymong John Agustin E 0

19 Tutop, Andrick Asuncion E 0

20 Valendia, Nick Lorenz Ignacio E X 1

16

MALE | TOTAL Per Day 19 19 0 19 19 17 19 0 18 17 19 19 17 18 17 18 19 20 18 19 331

1 Alba, Angelika Talon

2 Ambanta, Jonabelle Rubio

3 Bareng, carmela Joyce Dancel

4 Bayudan, Jemaica Mateo

5 Corrales, Mylene Carpio

 6 Domingo, Mica Tutop

7 Fiesta, Ednalyn Aluag

8 Foronda, Febe Heart Salvador

9 Gante, Lizzie Aubrey Maningo

10 Guira, Jessa Delos Santos

11 Malvar, Gemma Rose Verdejo

12

FEMALE | TOTAL Per Day

Combined TOTAL PER DAY

GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE No. of Days of Summary

Month: Oct. 18
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance. (blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Classes: M F TOTAL
2. Dates shall be written in the columns after Learner's Name. Late Commer, Lower for Cutting Classes)
* Enrolment as of (1st Friday of June) 25 30 55
3. To compute the following: 2. REASONS/CAUSES FOR DROPPING OUT
Registered Learners as of end of the month a. Domestic-Related Factors Late Enrollment during the month
a. Percentage of Enrolment = x 100 0 0 0
Enrolment as of 1st Friday of the school year a.1. Had to take care of siblings (beyond cut-off)
Total Daily Attendance a.2. Early marriage/pregnancy
b. Average Daily Attendance = Registered Learners as of end of the month 25 30 55
Number of School Days in reporting month a.3. Parents' attitude toward schooling
Average daily attendance a.4. Family problems
c. Percentage of Attendance for the month = x 100 Percentage of Enrolment as of end of the month 100 100 100
Registered Learners as of end of the month b. Individual-Related Factors
b.1. Illness
Average Daily Attendance 23 29 53
4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summary table into b.2. Overage
School Form 4. Once signed by the principal, this form should be returned to the adviser. b.3. Death
Percentage of Attendance for the month 92% 97 96
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 b.4. Drug Abuse
consecutive days and/or those at risk of dropping out. b.5. Poor academic performance
Number of students absent for 5 consecutive days: 1 0 1
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period. b.6. Lack of interest/Distractions
* Beginning of School Year cut-off report is every 1st Friday of the School Year b.7. Hunger/Malnutrition
Drop out 0 0 0
c. School-Related Factors
c.1. Teacher Factor
Transferred out 0 0 0
c.2. Physical condition of classroom
 c.3. Peer influence
Transferred in 0 0 0
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds) I certify that this is a true and correct report.
d.3. Calamities/Disasters
e. Financial-Related KATHLEEN A. SACRAMENTO
e.1. Child labor, work (Signature of Teacher over Printed Name)
f. Others (Specify)
Attested by:
School Form 2 : Page ___ of ________ MARISALYN M. BUENO
(Signature of School Head over Printed Name)
 School Form 3 (SF3) Books Issued and Returned
(This replaces Form 1 & Inventory of Textbooks)

School ID School Year

School Name Grade Level Section

Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

LEARNER'S NAME REMARKS/ACTION TAKEN

NO. (Last Name, First (Please refer to the
Name, Middle Name) Date Date Date Date Date Date Date Date legend on last page)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned
 TOTAL FOR MALE | TOTAL COPIES

TOTAL FOR FEMALE | TOTAL COPIES

TOTAL LEARNERS | TOTAL COPIES

GUIDELINES: In case of lost/unreturned books, please provide information with the following code: Prepared By:
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. A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
3. The Total Number of Copies issued at BoSY shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for (Signature over printed name)
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. code FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Date BoSY:____________ Date EoSY: ___________
5. All textbooks being used must be included. Additional copies of this form may be used if needed. Custodian (for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003,
DO#14, 2.2012. School Form 3: Page ___ of ________
 School Form 4 (SF4) Monthly Learner's Movement and Attendance
(This replaces Form 3 & STS Form 4-Absenteeism and Dropout Profile)

School ID Region Division District

School Name School Year Report for the Month of

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN

REGISTERED
GRADE/ LEARNERS (A+B) Cumulative (A+B) Cumulative (A+B)
YEAR SECTION NAME OF ADVISER (As of End of the Daily Average Percentage for (A) Cumulative as (B) For the Month as of End of the (A) Cumulative as (B) For the Month as of End of the (A) Cumulative as (B) For the Month Cumulative as of
LEVEL Month) the Month of Previous Month
Month
of Previous Month
Month
of Previous Month
End of 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 M F T M F T M F T

ELEMENTARY/SECONDARY:
KINDER
GRADE 1/GRADE 7
GRADE 2/GRADE 8
GRADE 3/GRADE 9
GRADE 4/GRADE 10
GRADE 5/GRADE 11
GRADE 6/GRADE 12
TOTAL FOR NON-GRADED
TOTAL
GUIDELINES: Prepared and Submitted by:
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
 (Signature of School Head over Printed Name)
Page _____ of _____ pages
 School Form 5 (SF 5) Report on Promotion & Level of Proficiency
(This replaces Forms 18-E1, 18-E2, 18A and List of Graduates)

Region Division District

School ID School Year Curriculum

School Name Grade Level Section

INCOMPLETE SUBJECT/S
GENERAL (This column is for K to 12 Curriculum and remaining
AVERAGE ACTION TAKEN: RBEC in High School. Elementary grades level that are still
LEARNER'S NAME (Numerical Value in 2 PROMOTED, implementing RBEC need not to fill up these columns)
LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
honor learners, and RETAINED From previous school years
Descriptive Letter) completed as of end of current As of end of current School Year
School Year

SUMMARY TABLE

STATUS MALE FEMALE TOTAL

PROMOTED

IRREGULAR

RETAINED

LEVEL OF PROFICIENCY
MALE FEMALE TOTAL

BEGINNNING
(B: 74% and
below)

DEVELOPING
(D: 75%-79%)

APPROACHING
PROFICIENCY
(AP:
80%-84%)

PROFICIENT
(P: 85% -89%)

ADVANCED
(A: 90% and
above)
 ADVANCED
(A: 90% and
TOTAL MALE above)

PREPARED BY:

Class Adviser

(Name and Signature)

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.

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
TOTAL FEMALE

COMBINED School Form 5: Page ____ of ________

 School Form 6 (SF6)
Summarized Report on Promotion and Level of Proficiency
(This replaces Form 20)

School ID Region Division

School Name District School Year

GRADE 1 /GRADE 7 GRADE 2 / GRADE 8 GRADE 3 / GRADE 9 GRADE 4 / GRADE 10 GRADE 5 / GRADE 11 GRADE 6 / GRADE 12 TOTAL
SUMMARY TABLE

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 MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL

BEGINNNING
(B: 74% and below)
DEVELOPING
(D: 75%-79%)

APPROACHING
PROFICIENCY
(AP: 80%-84%)

PROFICIENT
(P: 85% -89%)

ADVANCED
(A: 90% and above)

TOTAL

Prepared and Submitted by: Reviewed & Validated by: Noted by:
SCHOOL HEAD DIVISION REPRESENTATIVE SCHOOLS DIVISION SUPERINTENDENT
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.
 School Form 7 (SF7) School Personnel Assignment List and Basic Profile
(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 School Year

(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non Teaching Items (C ) Other Appointments and Funding Sources

Number of
Title of Designation Appointment:
Incumbent
Title of Plantilla Position Title of Plantilla Position (as it appears (Contractual, Fund Source
Number of Number of
(as it appears in the appointment (as it appears in the appointment in the contract/document: Teacher, Substitute, (SEF, PTA,
Incumbent Incumbent
document/PSIPOP) document/PSIPOP) Clerk, Security Guard, Driver etc.) Volunteer, others NGO's etc.) Teaching
specify) Non-
Teaching

EDUCATIONAL QUALIFICATION Daily Program (time duration)

Subject Taught
Employee Remarks (For
Nature of (include Grade &
No. (or Tax Name of School Personnel Fund Position/ Appointment/ Section), Advisory Total Actual
Detailed Items,
Identification (Arrange by Sex DAY Indicate name of
Source Designation Employment Degree / Post Major/ Class & Other From To Teaching
Number Position, Descending) Minor (M/T/W/ school/office, For
-T.I.N.) Status Graduate Specialization Ancillary (00:00) (00:00) Minutes per
TH/F) IP's -Ethnicity)
Assignments Week

Ave. Minutes per Day

Ave. Minutes per Day

 Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

GUIDELINES: Submitted by:

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 submitted to the Division 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. (Signature of School Head over Printed Name)
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. Updated as of: ___________________________
School Form 7, Page ___ of ________