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LIS Data Request Form for Schools

This document is a request form from the Planning and Research Section of the Schools Division of Batangas in the Philippines Department of Education. The form is used to request changes to learner information in the Learners Information System (LIS) for issues such as learner profile corrections, grade level changes, or temporary enrollments. The form collects details of the learner, school, and type of request. It requires supporting documents and must be filled out by the requesting school and approved by Planning and Research personnel.

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Maria naizeth c. ilao
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156 views1 page

LIS Data Request Form for Schools

This document is a request form from the Planning and Research Section of the Schools Division of Batangas in the Philippines Department of Education. The form is used to request changes to learner information in the Learners Information System (LIS) for issues such as learner profile corrections, grade level changes, or temporary enrollments. The form collects details of the learner, school, and type of request. It requires supporting documents and must be filled out by the requesting school and approved by Planning and Research personnel.

Uploaded by

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

Republic of the Philippines

Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OF BATANGAS

PLANNING AND RESEARCH SECTION

REQUEST FORM
Learners Information System (LIS) Data Issues

***To be filled up by the requesting school.

DATE: _________________________
SCHOOL ID: ____________________
NAME OF SCHOOL: _____________________________________________________________
NAME: _________________________________________ SIGNATURE: ________________________
CONTACT NUMBER: ______________________ E-MAIL ADD: ______________________________
TYPE OF REQUEST:
LRN APPROVAL CORRECTION OF GRADE LEVEL
ENROLMENT OF INELIGIBLE CORRECTION OF LEARNER BASIC PROFILE
ENROLMENT WITH GAP TEMPORARY ENROLMENT

LEARNER’S DETAILS
LRN (if applicable): __________________________
NAME: _________________________ _________________________ ______________________
(Last Name) (First Name) (Middle Name)
DATE OF BIRTH: _______________________
GRADE LEVEL: ________________________

***Required Documents
LRN Approval/Enrolment of Ineligible/with Gap
1. SF 9 / SF 10 / ECCD Checklist (incoming Grade 1)
2. Birth Certificate
Correction of Grade Level
1. SF 9 / SF 10 / ECCD Checklist (incoming Grade 1)
Correction of Learner Basic Profile
1. Birth Certificate
Temporary Enrolment
1. Affidavit of Undertaking

***To be filled up by the Planning and Research personnel.

Received by: __________________________________________ Date: ___________________


Documents Submitted: Complete With System Request: YES
Incomplete NO
Status of Request: For Approval Pending
For Disapproval No Action
REMARKS: ______________________________________________

Evaluated by: ___________________________________________ Date: ___________________

Approved by:____________________________________________ Date: ___________________

DEPEDBATS-PAR-F-023/R3/07-15-2020

Address: Provincial Sports Complex, Bolbok, 4200 Batangas City


(043)722-1840 / 722-1796 / 722-1437 / 722-2675 / 722-1662
[email protected]
www.depedbatangas.org

CRN 44 100 18 93 0045

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