School Form 1 (SF1)School Form 1 (SF 1) School Register(This replaced Form 1, Master List & STS Form 2-Family Background and Profile)

School IDRegionDivisionDistrict

School NameSchool YearGrade LevelSection

LRNNAME(Last Name, First Name, Middle Name) Sex (M/F)BIRTH DATE (mm/ dd/yy)AGE as of 1st Friday of June BIRTH PLACE (Province)MOTHER TONGUEIP (Specify Ethnic Group)RELIGIONADDRESSNAME OF PARENTSGUARDIAN (If not Parent)Contact Number (Parent /Guardian)REMARK/S(nos. of years as per last birthday)House # / Street/Sitio/PurokBarangayMunicipality/ City ProvinceFather (1st name only if family name identical to learner) Mother (Maiden: 1st Name, Middle & Last Name)NameRelationship(Please refer to the legend on last page)12/24/776/6/1436.4490075291366/7/14114.43394934981146/8/14114.43668720051146/9/14114.43942505131146/10/14114.44216290211146/11/14114.44490075291146/12/14114.44763860371146/13/14114.45037645451146/14/14114.45311430531146/15/14114.45585215611146/16/14114.45859000681146/17/14114.46132785761146/18/14114.46406570841146/19/14114.46680355921146/20/14114.469541411146/21/14114.47227926081146/22/14114.47501711161146/23/14114.47775496241146/24/14114.48049281311146/25/14114.48323066391146/26/14114.48596851471146/27/14114.48870636551146/28/14114.49144421631146/29/14114.49418206711146/30/14114.49691991791147/1/14114.49965776871147/2/14114.50239561941147/3/14114.50513347021147/4/14114.5078713211147/5/14114.51060917181147/6/14114.51334702261147/7/14114.51608487341147/8/14114.51882272421147/9/14114.52156057491147/10/14114.52429842571147/11/14114.52703627651147/12/14114.52977412731147/13/14114.53251197811147/14/14114.53524982891147/15/14114.53798767971147/16/14114.54072553051147/17/14114.54346338121147/18/14114.5462012321147/19/14114.54893908281147/20/14114.55167693361147/21/14114.55441478441147/22/14114.5571526352114 List and code of Indicators under REMARK columnPrepared by:Certified Correct:IndicatorCodeRequired InformationIndicatorCodeRequired InformationBoSYEoSYTransferred OutT/OName of Public (P) Private (PR) School & Effectivity DateCCT RecipientCCTCCT Control/reference number & Effectivity DateMALETransferred INT/IName of Public (P) Private (PR) School & Effectivity DateBalik-AralB/AName of school last attended & YearFEMALE(Signature of Adviser over Printed Name)(Signature of School Head over Printed Name)DroppedDRPReason and Effectivity DateLearner With DissabilityLWDSpecifyTOTALLate EnrollmentLEReason (Enrollment beyond 1st Friday of June)AccelaratedACLSpecify Level & Effectivity DataBoSY Date: EoSYDate:BoSY Date: EoSYDate: