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School ID Region

School Name

AGE as of 1st
Friday of June
NAME BIRTH DATE BIRTH PLACE
LRN Sex (M/F)
(Last Name, First Name, Middle Name) (mm/ dd/yy) (Province)
(nos. of years
as per last
birthday)
AGE as of 1st
Friday of June
NAME BIRTH DATE BIRTH PLACE
LRN Sex (M/F)
(Last Name, First Name, Middle Name) (mm/ dd/yy) (Province)
(nos. of years
as per last
birthday)
AGE as of 1st
Friday of June
NAME BIRTH DATE BIRTH PLACE
LRN Sex (M/F)
(Last Name, First Name, Middle Name) (mm/ dd/yy) (Province)
(nos. of years
as per last
birthday)
AGE as of 1st
Friday of June
NAME BIRTH DATE BIRTH PLACE
LRN Sex (M/F)
(Last Name, First Name, Middle Name) (mm/ dd/yy) (Province)
(nos. of years
as per last
birthday)
AGE as of 1st
Friday of June
NAME BIRTH DATE BIRTH PLACE
LRN Sex (M/F)
(Last Name, First Name, Middle Name) (mm/ dd/yy) (Province)
(nos. of years
as per last
birthday)
AGE as of 1st
Friday of June
NAME BIRTH DATE BIRTH PLACE
LRN Sex (M/F)
(Last Name, First Name, Middle Name) (mm/ dd/yy) (Province)
(nos. of years
as per last
birthday)
AGE as of 1st
Friday of June
NAME BIRTH DATE BIRTH PLACE
LRN Sex (M/F)
(Last Name, First Name, Middle Name) (mm/ dd/yy) (Province)
(nos. of years
as per last
birthday)

List and code of Indicators under REMARK column


Indicator Code Required Information Indicator
Transferred Out T/O Name of Public (P) Private (PR) School & Effectivity Date CCT Recipient

Transferred IN T/I Name of Public (P) Private (PR) School & Effectivity Date Balik-Aral
Dropped DRP Reason and Effectivity Date Learner With Dissability
Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) Accelarated
School Form 1 (SF 1) School Register
(This replaced Form 1, Master List & STS Form 2-Family Background and Profile)

Division

School Year G

ADDRESS
IP
MOTHER
(Specify Ethnic RELIGION
TONGUE
Group)
House # / Street/Sitio/
Barangay Municipality/ City Province
Purok
ADDRESS
IP
MOTHER
(Specify Ethnic RELIGION
TONGUE
Group)
House # / Street/Sitio/
Barangay Municipality/ City Province
Purok
ADDRESS
IP
MOTHER
(Specify Ethnic RELIGION
TONGUE
Group)
House # / Street/Sitio/
Barangay Municipality/ City Province
Purok
ADDRESS
IP
MOTHER
(Specify Ethnic RELIGION
TONGUE
Group)
House # / Street/Sitio/
Barangay Municipality/ City Province
Purok
ADDRESS
IP
MOTHER
(Specify Ethnic RELIGION
TONGUE
Group)
House # / Street/Sitio/
Barangay Municipality/ City Province
Purok
ADDRESS
IP
MOTHER
(Specify Ethnic RELIGION
TONGUE
Group)
House # / Street/Sitio/
Barangay Municipality/ City Province
Purok
ADDRESS
IP
MOTHER
(Specify Ethnic RELIGION
TONGUE
Group)
House # / Street/Sitio/
Barangay Municipality/ City Province
Purok

Code Required Information


CCT CCT Control/reference number & Effectivity Date MALE

B/A Name of school last attended & Year FEMALE

ith Dissability LWD Specify


TOTAL
ACL Specify Level & Effectivity Data
District

Grade Level Section

NAME OF PARENTS GUARDIAN (If not Parent)

Contact Number
(Parent /Guardian)
Father (1st name only if family Mother (Maiden: 1st Name, Middle &
Name Relationship
name identical to learner) Last Name)
NAME OF PARENTS GUARDIAN (If not Parent)

Contact Number
(Parent /Guardian)
Father (1st name only if family Mother (Maiden: 1st Name, Middle &
Name Relationship
name identical to learner) Last Name)
NAME OF PARENTS GUARDIAN (If not Parent)

Contact Number
(Parent /Guardian)
Father (1st name only if family Mother (Maiden: 1st Name, Middle &
Name Relationship
name identical to learner) Last Name)
NAME OF PARENTS GUARDIAN (If not Parent)

Contact Number
(Parent /Guardian)
Father (1st name only if family Mother (Maiden: 1st Name, Middle &
Name Relationship
name identical to learner) Last Name)
NAME OF PARENTS GUARDIAN (If not Parent)

Contact Number
(Parent /Guardian)
Father (1st name only if family Mother (Maiden: 1st Name, Middle &
Name Relationship
name identical to learner) Last Name)
NAME OF PARENTS GUARDIAN (If not Parent)

Contact Number
(Parent /Guardian)
Father (1st name only if family Mother (Maiden: 1st Name, Middle &
Name Relationship
name identical to learner) Last Name)
NAME OF PARENTS GUARDIAN (If not Parent)

Contact Number
(Parent /Guardian)
Father (1st name only if family Mother (Maiden: 1st Name, Middle &
Name Relationship
name identical to learner) Last Name)

Prepared by: Certified Correct:


BoSY EoSY

(Signature of Adviser over Printed Name) (Signature of School Head

BoSY Date: EoSYDate: BoSY Date: Eo


REMARK/S

(Please refer to the legend on


last page)
REMARK/S

(Please refer to the legend on


last page)
REMARK/S

(Please refer to the legend on


last page)
REMARK/S

(Please refer to the legend on


last page)
REMARK/S

(Please refer to the legend on


last page)
REMARK/S

(Please refer to the legend on


last page)
REMARK/S

(Please refer to the legend on


last page)

ect:

of School Head over Printed Name)

EoSYDate:
School Form 2 (SF2) Daily Attenda
(This replaced Form 1, Form 2 & STS Form 4 - Abs

School ID School Year

Name of School

(1st row for date, 2nd row for Day: M,T


LEARNER'S NAME
(Last Name, First Name, Middle Name)
(1st row for date, 2nd row for Day: M,T
LEARNER'S NAME
(Last Name, First Name, Middle Name)

MALE | TOTAL Per Day


(1st row for date, 2nd row for Day: M,T
LEARNER'S NAME
(Last Name, First Name, Middle Name)

FEMALE | TOTAL Per Day


Combined TOTAL PER DAY

GUIDELINES: 1. CODES F

1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
blank- Prese
2. Dates shall be written in the preceding columns beside Learner's Name.
Commer, Lo
3. To compute the following:
Registered Learner as of End of the Month 2. REASON
a. Percentage of Enrolment = x 100
Enrolment as of 1st Friday of June a. Domestic
Total Daily Attendance a.1. Had to t
b. Average Daily Attendance =
Number of School Days in reporting month a.2. Early m
Average daily attendance a.3. Parents
c. Percentage of Attendance for the month = x 100
Registered Learner as of End of the month a.4. Family p

b. Individua
4. Every End of the month, the class adviser will submit this form to the office of the principal for recording of b.1. Illness
summary table into the School Form 4. Once signed by the principal, this form should be returned to the adviser.
(1st row for date, 2nd row for Day: M,T
LEARNER'S NAME
(Last Name, First Name, Middle Name)
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 the School Form 4. Once signed by the principal, this form should be returned to the adviser. b.2. Overage
5. The adviser will extend neccessary intervention including but not limited to home visitation to learner/s that committed 5 consecutive days of absences or those with b.3. Death
potentials of dropping out b.4. Drug Ab
6. Attendance performance of learner is expected to reflect in Form 137 and Form 138 every grading period b.5. Poor ac
* Beginning of School Year cut-off report is every 1st Friday of School Calendar Days b.6. Lack of
b.7. Hunger/
c. School-R
c.1. Teacher
c.2. Physica
c.3. Peer inf
d. Geograph
d.1. Distance

d.2. Armed c

d.3. Calamit
e. Financial
e.1. Child lab
School Form 2: Page 2 of ________ f. Others
endance Report of Learners
4 - Absenteeism and Dropout Profile)

Report for the Month of

Grade Level Section

ay: M,T,W,TH,F) Total for the Month


REMARK/S (If DROPPED OUT, state reason, please refer to
legend number 2.
ABSENT TARDY If TRANSFERRED IN/OUT, write the name of School.)
ay: M,T,W,TH,F) Total for the Month
REMARK/S (If DROPPED OUT, state reason, please refer to
legend number 2.
ABSENT TARDY If TRANSFERRED IN/OUT, write the name of School.)
ay: M,T,W,TH,F) Total for the Month
REMARK/S (If DROPPED OUT, state reason, please refer to
legend number 2.
ABSENT TARDY If TRANSFERRED IN/OUT, write the name of School.)

ODES FOR CHECKING ATTENDANCE Month: Summary for the Month


No. of Days of Classes:
M F TOTAL
k- Present; (x)- Absent; Tardy (half shaded= Upper for Late
mer, Lower for Cutting Classes) * Enrolment as of (1st Friday of June)
EASONS/CAUSES OF DROP-OUTS Late Enrollment during the month
omestic-Related Factors (beyond cut-off)
Had to take care of siblings
Registered Learner as of end of the month
Early marriage/pregnancy
Parents' attitude toward schooling Percentage of Enrolment as of end of the month
Family problems

dividual-Related Factors Average Daily Attendance


Illness
Percentage of Attendance for the month
ay: M,T,W,TH,F) Total for the Month
REMARK/S (If DROPPED OUT, state reason, please refer to
legend number 2.
ABSENT TARDY If TRANSFERRED IN/OUT, write the name of School.)
Percentage of Attendance for the month
Overage
Death
Number of students with 5 consecutive days of absences:
Drug Abuse
Poor academic performance
Drop out
Lack of interest/Distractions
Hunger/Malnutrition
Transferred out
chool-Related Factors
Teacher Factor
Transferred in
Physical condition of classroom
Peer influence
eographic/Environmental I certify that this is a true and correct report.
Distance between home and school

Armed conflict (incl. Tribal wars & clanfeuds)


(Signature of Teacher over Printed Name)
Calamities/Disasters
nancial-Related Attested by:
Child labor, work
hers (Signature of School Head over Printed Name)
School Form 3 (SF3) Books Issued
(This replaced Form 1 & Inventory of Text B

School ID School Year

School Name Grade Level


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

LEARNER'S NAME
NO.
(Last Name, First Name, Middle Name)
Date Date Date Date
Issued Returned Issued Returned Issued Returned Issued
Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

LEARNER'S NAME
NO.
(Last Name, First Name, Middle Name)
Date Date Date Date
Issued Returned Issued Returned Issued Returned Issued

TOTAL FOR MALE | TOTAL COPIES


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

LEARNER'S NAME
NO.
(Last Name, First Name, Middle Name)
Date Date Date Date
Issued Returned Issued Returned Issued Returned Issued
Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

LEARNER'S NAME
NO.
(Last Name, First Name, Middle Name)
Date Date Date Date
Issued Returned Issued Returned Issued Returned Issued

TOTAL FOR FEMALE | TOTAL COPIES

TOTAL LEARNERS | TOTAL COPIES


GUIDELINES: In case of losses/unreturned, please provide information w
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,
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
prepared letter/report duly noted by School Head for submissio
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14, 2

5. All textbooks being used must be included. Additional copy/ies of this form may use if needed.
oks Issued and Returned
& Inventory of Text Book)

Section
ct Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date Date Date Date Date
Returned Issued Returned Issued Returned Issued Returned Issued Returned
ct Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date Date Date Date Date
Returned Issued Returned Issued Returned Issued Returned Issued Returned
ct Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date Date Date Date Date
Returned Issued Returned Issued Returned Issued Returned Issued Returned
ct Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date Date Date Date Date
Returned Issued Returned Issued Returned Issued Returned Issued Returned

ovide information with the following code: Prepared By:

FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence


are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code FM), TLTR=Teacher (Signature over printed name)
l Head for submission to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code
25, s.2003, DO#14, 2.2012. Date BoSY:____________ Date EoSY: ___________

School Form 3: Page 2 of ________


School Form 4 (SF4) Monthly Learner's
(This replaced Form 3 & STS Form 4-Absenteeis

Region Division
School ID

School Name

ATTENDANCE DROPPED OUT


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

M F T M F T M F T M F T M F
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:
1. This forms 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 copy to Division Office: a week after June 30, October 30 & March 31
3. Only teachers who are handling advisory class shall be reported. May use additional copy/ies of this form if needed.

4. Small school that has one section per grade/year level is not required to fill the columns "Name of Adviser, Grade/Year Level & Section". Instead, they will only accomplish the summary column per grad
rner's Movement and Attendance
4-Absenteeism and Dropout Profile)

District

School Year Report for the Month of

OPPED OUT TRANSFERRED OUT TRANSFERRED IN

(A+B) Cumulative as of (A) Cumulative as of (A+B) Cumulative as of (A) Cumulative as of (A+B) Cumulative as
For the Month (B) For the Month (B) For the Month
End of the Month Previous Month End of the Month Previous Month of End of the Month

T M F T M F T M F T M F T M F T M F T M F T
Prepared and Submitted by:

(Signature of School Head over Printed Name)

umn per grade/year level.


School Form 5 (SF 5) Report on Promotion & Le
(This replaced Forms 18-E1, 18-E2, 18A and List of Graduate

Region Division

School ID School Year

School Name

INCOMPLETE SUBJECT/
(This column is for K to 1
GENERAL AVERAGE
(Numerical Value in 3
ACTION TAKEN: Elementary grades level
LEARNER'S NAME (Last Name, PROMOTED,
LRN decimal places for honor
First Name, Middle Name) *IRREGULAR or
learner, 2 for non-honor &
RETAINED
Descriptive Letter)
Completed as of end of
INCOMPLETE SUBJECT/
(This column is for K to 1
GENERAL AVERAGE
(Numerical Value in 3
ACTION TAKEN: Elementary grades level
LEARNER'S NAME (Last Name, PROMOTED,
LRN decimal places for honor
First Name, Middle Name) *IRREGULAR or
learner, 2 for non-honor &
RETAINED
Descriptive Letter)
Completed as of end of

TOTAL MALE
INCOMPLETE SUBJECT/
(This column is for K to 1
GENERAL AVERAGE
(Numerical Value in 3
ACTION TAKEN: Elementary grades level
LEARNER'S NAME (Last Name, PROMOTED,
LRN decimal places for honor
First Name, Middle Name) *IRREGULAR or
learner, 2 for non-honor &
RETAINED
Descriptive Letter)
Completed as of end of
INCOMPLETE SUBJECT/
(This column is for K to 1
GENERAL AVERAGE
(Numerical Value in 3
ACTION TAKEN: Elementary grades level
LEARNER'S NAME (Last Name, PROMOTED,
LRN decimal places for honor
First Name, Middle Name) *IRREGULAR or
learner, 2 for non-honor &
RETAINED
Descriptive Letter)
Completed as of end of

TOTAL FEMALE

COMBINED
otion & Level of Proficiency
and List of Graduates)

District

Curriculum

Grade Level Section

LETE SUBJECT/S
olumn is for K to 12 Curriculum and remaining RBEC in High School.
tary grades level that still implementing RBEC need not to fill up this
column)

eted as of end of current SY as of End of the current SY

SUMMARY TABLE

STATUS MALE FEMALE TOTAL

PROMOTED

*IRREGULAR

RETAINED

LEVEL OF PROFICIENCY
LETE SUBJECT/S
olumn is for K to 12 Curriculum and remaining RBEC in High School.
tary grades level that still implementing RBEC need not to fill up this
column)

eted as of end of current SY as of End of the current SY

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)

PREPARED BY:

Class Adviser

(Name and Signature)


LETE SUBJECT/S
olumn is for K to 12 Curriculum and remaining RBEC in High School.
tary grades level that still implementing RBEC need not to fill up this
column)

eted as of end of current SY as of End of the current SY

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 teacher. The class adviser should
make the computation of 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
LETE SUBJECT/S
olumn is for K to 12 Curriculum and remaining RBEC in High School.
tary grades level that still implementing RBEC need not to fill up this
column)

eted as of end of current SY as of End of the current SY

4. Must tallied with the total enrollment report as of End of School Year
GESP /GSSP (BEIS)

5. Protocols of validation & submission will remain under the discretion


of the Schools Division Superintendent

School Form 5: Page 2 of ________


School Form 6 (SF6) Summarized Report on Prom
and Level of Proficiency
(This replaced Form 20)

School ID Region Division

School Name District

GRADE 1 /GRADE 7 GRADE 2 / GRADE 8 GRADE 3 / GRADE 9 GRADE 4 / GRADE 10


SUMMARY TABLE

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

Nos. of BEGINNNING (B:


74% and below)

Nos. of DEVELOPING (D:


75%-79%)

Nos. of APPROACHING
PROFICIENCY
(AP: 80%-84%)

Nos. of PROFICIENT (P:


85% -89%)

Nos. of ADVANCED (A:


90% and above)
TOTAL

Prepared and Submitted by: Reviewed & Validated by: Noted by:
SCHOOL HEAD DIVISION REPRESENTATIVE
GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the Total for Grade Level in order to reflect the result in each data field.
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 will remain under the discretion of the Schools Division Superintendent
Promotion

School Year

GRADE 5 / GRADE 11 GRADE 6 / GRADE 12 TOTAL

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL


SCHOOLS DIVISION SUPERINTENDENT

d.
School Form 7 (SF7) School Personnel Assignment List and Basic P
(This replaced 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

(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non Teaching Items

Title of Designation
Title of Plantilla Position (as Title of Plantilla Position (as Number of (Designation as ap
Number of Incumbent
appeared in the appointment document/PSIPOP) appeared in the appointment document/PSIPOP) Incumbent contract/document: Teacher, C
Guard, Driver etc.)

EDUCATIONAL QUALIFICATION

Employee No. Name of School Personnel Nature of


(or Tax Position/
(Arrange by Position, Descending) Sex Fund Source Appointment/
Identification Designation Degree / Post
Number -T.I.N.) Employment Status Major/ Specialization Minor
Graduate
EDUCATIONAL QUALIFICATION

Employee No. Name of School Personnel Nature of


(or Tax Position/
(Arrange by Position, Descending) Sex Fund Source Appointment/
Identification Designation Degree / Post
Number -T.I.N.) Employment Status Major/ Specialization Minor
Graduate
EDUCATIONAL QUALIFICATION

Employee No. Name of School Personnel Nature of


(or Tax Position/
(Arrange by Position, Descending) Sex Fund Source Appointment/
Identification Designation Degree / Post
Number -T.I.N.) Employment Status Major/ Specialization Minor
Graduate

GUIDELINES:

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 SY, updated Form 19 must submit 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. This form shall also serve as inventory list of
personnel.
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.
and Basic Profile
ent List,
s)

School Year

(C ) Other Appointments and Funding Sources

ation Number of Incumbent


Appointment:
(Designation as appeared in the Fund Source
(Contractual, Substitute,
cument: Teacher, Clerk, Security Volunteer, others specify) (SEF, PTA, NGO's etc.) Non-
Driver etc.) Teaching
Teaching

* Daily Program (time duration)

Subject Taught (include Remark/s (For Detailed


Grade & Section), Advisory Total Actual Items, Indicate name of
Class & Other Ancillary DAY
From Teaching Minutes school/office, For IP's
Assignment (M/T/W/TH/ To (00:00) -Ethnicity)
(00:00) Assignment per
F)
Week

Ave. Minutes per Day


* Daily Program (time duration)

Subject Taught (include Remark/s (For Detailed


Grade & Section), Advisory Total Actual Items, Indicate name of
Class & Other Ancillary DAY
From Teaching Minutes school/office, For IP's
Assignment (M/T/W/TH/ To (00:00) -Ethnicity)
(00:00) Assignment per
F)
Week

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day


* Daily Program (time duration)

Subject Taught (include Remark/s (For Detailed


Grade & Section), Advisory Total Actual Items, Indicate name of
Class & Other Ancillary DAY
From Teaching Minutes school/office, For IP's
Assignment (M/T/W/TH/ To (00:00) -Ethnicity)
(00:00) Assignment per
F)
Week

Ave. Minutes per Day

Ave. Minutes per Day

Submitted by:

o the Division Office .

as inventory list of school (Signature of School Head over Printed Name)

Updated as of: ___________________________

School Form 7, Page 2 of ________

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