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Early Registration Form for Grade V

Two teachers from Rosario Elementary School in Region 1, Philippines prepared an early registration form for 50 students entering Grade 5. The form collects each student's name, sex, age, birthdate, address, and any relevant remarks about prior schooling or disability status. It will be used to register students for the upcoming school year.

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Winny Felipe
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334 views2 pages

Early Registration Form for Grade V

Two teachers from Rosario Elementary School in Region 1, Philippines prepared an early registration form for 50 students entering Grade 5. The form collects each student's name, sex, age, birthdate, address, and any relevant remarks about prior schooling or disability status. It will be used to register students for the upcoming school year.

Uploaded by

Winny Felipe
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd

Enclosure No. 2 to DepED Order No. 4, s.

2012
Form 1

DEPARTMENT OF EDUCATION
EARLY REGISTRATION FORM

School ID: 101511 Region: I


School Name: ROSARIO ELEMENTARY SCHOOL Division: SDO1 PANGASINAN
School District: LINGAYEN III

GRADE V
Grade Level
CATEGORY OF C/Y WITH
DISABILITY** (for Children
NAME SEX AGE BIRTHDATE ADDRESS Remarks*
& Youth with Disabilities
only)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
Prepared by:
JELLY JOY R. FERNANDEZ EDUARDO M. CASTRO JR.
Teacher Teacher
Remarks:*
1. For Grade 1 Registrants: Has attended/not attended Kindergarten Class
2. For ALS: Information whether the child/youth prefers to learn through the ADM = Alternative delivery mode
( MISOSA, e-IMPACT, DORP) or ALS = Alternative learning system
Category of C/Y with Disability** : Visual Impairment, Hearing Impairment, Intellectual Disability, Learning Disability/Language Impairment, Serious Emotional Disturbance, Autism, Orthopedic

Impairment, Special Health Problem, Multiple Disabilities.


1. For Grade 1 Registrants: Has attended/not attended Kindergarten Class
2. For ALS: Information whether the child/youth prefers to learn through the ADM = Alternative delivery mode
( MISOSA, e-IMPACT, DORP) or ALS = Alternative learning system
Category of C/Y with Disability** : Visual Impairment, Hearing Impairment, Intellectual Disability, Learning Disability/Language Impairment, Serious Emotional Disturbance, Autism, Orthopedic

Impairment, Special Health Problem, Multiple Disabilities.

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