Abm 12-17 Sf1.xls

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

Region VIII

School ID School Name

1 2 3 4

Cli

Division School Year

Polytechnic University of the Philippines

LRN

NAME (Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE (mm/dd/ yyyy)

136891050013 136639050020 136554050005 136557050014 100895050006 320101120029 108489050016 136461050137 136512050066 305463120011 13650605015

ABONITA, HOPE LOVE B. ADLAWAN, JOHN CLINFORD P. ALFONSO, JANE EUNICE S. ALTAREJOS, JEAN VANESSA S ARTOCILLA, CARLA GRACE P. BEGONIA, ARYANN S. BERGANTINOS, AIVIE S. BERNIDO, CHRISTIAN JOSEPH T. BURZON, KIMBERLY A. CABALLERO, SHERLYN F. CANILANG, CRISZEL MAE D.G

F M F F F F F M F F F

01/04/00 11/28/99 09/15/99 11/27/99 09/07/99 01/21/00 04/08/00 08/17/00 04/07/00 02/07/00

223503050043 305332120718 136431050261 402976151914 136915050051 106970050038 136534050184 407178150445 136741050258 305315140030 136461050451 105269050074 136509050298 305355140022 136543050387 403455151049 109316050050 305332121231 136669050442 406873151688 406480152137 104906050189 136659050259 136720040305 136669050502 136665050162

CARDILLO, JAY LEI E. CRUZ, JEFFERSON D. DELA CRUZ, JANZELLE IVY P. DELOS SANTOS, ROSE ANN R. DIAMPOC, RUSHIEL J. DIESMA, MICHELLE ANGELA F. DURAN, DIANE MAE M. FERNANDEZ, KYLA KATHRINE C. FERNANDEZ, MHILBRAY B. GIALOGO, JESSIELYN DC. GO, MIKA ELLA G. ICALLA, ALLYSSA A. LAPITAN, VANESSA JOY N. LAZARTE, ARMAE FRANZ THERESE S. MADRIGAL, RONA Z. MALAY, ZARENA JANE I. MALLILLIN, MYRA L. ODO, JANPERSON S. PILOS, JONATHAN D. QUINDAO, GAILE DENISSE R. REGIDOR, NICOLE MARIE B. RENTOSA, AILA MARIE B. REPANCOL, ALAYSSA GRACE T. REYES, ZAIRA ERIKA D. SANCHEZ, MARY JANE B. SANTOS, JAN ERICKA V.

F M F F F F F F M F F F F F F F F M M F F F F F F F

12/12/99 10/07/98 05/07/00 12/08/99 04/13/00 09/03/99 12/29/99 02/18/00 12/06/99 06/29/00 08/30/99 10/07/99 07/04/99 02/05/00 09/13/00 01/09/99 08/24/99 11/22/99 08/26/99 04/22/00 07/08/00 07/08/99 07/13/00 08/06/99 07/15/99

01/14/00

AGE as of 1st Friday June 16 16 16 16 16 16 16 15 16 16 16

District 2017-2018

Grade Level

ADDRESS

MOTHER TONGUE

IP (Ethnic Group)

RELIGION

Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino

Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog

Roman Catholic Roman Catholic Roman Catholic Roman Catholic Roman Catholic Roman Catholic Roman Catholic Catholic Roman Catholic Catholic Roman Catholic

16 17 16 16 16 16 16 16 16 15 16 16 16 16 16 17 16 16 16 16 15 16 15 16 16 16

Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino

Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog

16

Filipino

Tagalog

Roman Catholic

9 Guyabano St.

Brgy. North Signal Village

16

Filipino

Tagalog

Roman Catholic

#587 Luwasan St.

Brgy. Bantog

16 16 16 16 16 16 16 15

Filipino Filipino Filipino Filipino Filipino Filipino Filipino Filipino

Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog

Roman Catholic Roman Catholic Born Again Christian Born Again Christian Born Again Christian Catholic Roman Catholic Roman Catholic

House #/ Street/ Sitio/ Purok Purok 7, Sitio Imelda Phase 4 Pacakage 3 Block 4 Lot 15 38 A P.Mejia Lot 3 IISt. 1227 Gumamela St. 32 Almon St. #70 A. Bonifacio St. #15 Manunggal St. 114 3-C Loans St. 162 St. Luke 2-D Alley 1 St.

Barangay

Municipality/ City

Brgy. Upper Bicutan Bagong Silang St.Libis Damayang Lagi Commonwealth Sta. Lucia Halayhayin Brgy. Tatalon Sangandaan Central Signal Village Brgy. Bahay Toro

Taguig City Caloocan City Quezon City Quezon City Quezon City Pasig City Sinilioan Quezon City Quezon City Taguig City Quezon City

Roman Catholic 655 E Lapu-Lapu St. Brgy. 178 Born Again Christian Eagle St. Brgy. Bagong Silangan Roman Catholic Bldg. 15 Unit 101 Permanent Housing Brgy. 128 Roman Catholic Blk. 12 Lot 27 Mountainville Subdivision Brgy. Tatala Roman Catholic #0024 Zone 1.A Sitio Pagkakaisa Brgy. Sucat Catholic Coyacoy St. Patrocinio Roman Catholic 95B Brgy. Bagong Lipunan Roman Catholic 1100 Kabatuhan St. Mapulang Lupa Roman Catholic 169 Rosario Village Sta. Lucia Catholic 755 B Lacson St. Sampaloc Catholic Alley 2 St. Brgy. Sampaloc Roman Catholic Mabini St. Brgy. District 2 Catholic 7 Diamong Lane Brgy. Culiat Roman Catholic Manunggal St. Brgy. Tatalon Roman Catholic Blk 56 Lot 11 Samafa St. Fairview Roman Catholic Brgy. Poblacion Roman Catholic 3105 Sitio Mata Catholic 033 Gen. Mascardo St. Brgy. Bagong Silangan Roman Catholic #120 Blk.9 Welf Addition Hills Roman Catholic 030 Blk. 4 Rd.17 Planters Brgy. San Andres Roman Catholic Sitio Dagat-Dagatan Brgy. 178 Catholic Brgy. Hiyas Roman Catholic 915 I. Trinidad St. Brgy. Vergara Catholic 137 D Asuncion St. Brgy. San Miguel Catholic #42 Blk. 3 Brgy. Addition Hills Roman Catholic 337 l. Gonzales St. Brgy. Hagdan Bato, Libis

Province

Laguna

Caloocan City Quezon City Manila City Rizal Muntinlupa City San Narciso Quezon City Valenzuela City Pasig City Manila City Manila City Cuyapo Quezon City Quezon City Quezon City Gloria

Zambales *

Nueva Ecija

Oriental Mindoro Rizal

Quezon City Mandaluyong City Rizal Caloocan City Marilao Mandaluyong City Pasig City Mandaluyong City Mandaluyong City

Bulacan

12

PARENTS Father's Name (Last Name, First Name, Mother's Maiden Name (Last Name, First Name, Middle Name) Middle Name) Abonita, Roberto Rafales Abonita, Janet Baldomero Adlawan, Felipe Velbar Adlawan, Nora Pening Alfonso, Edgar Santos Alfonso, Arminda Sison Altarejos, Romualdo Bonggot Altarejos, Geraldine Segarino Artocilla, Carlito Macayan Artocilla, Rosie Patnongon Begonia, Garry Masinna Begonia, Anna Liza Santos Bergantinos, Victor Lamina Bergantinos, Ailen Salay Bernido, Renato Ganot Bernido, Theresa Tabangay Burzon, Gilberto Barcelona Burzon, Rowena Alba Caballero, Dominico Jr. Labrador Caballero, Vilma Fenis Canilang, Cipriano Rosario Canilang, Lolita De Guzman Cardillo, Jorge Catigum Cruz, Genaro Cuaresma Dela Cruz, Jesus Manay Delos Santos, Alejandro Maño Diampoc, Dan Bello Diesma, John Renante Manlutac Duran, Teodoro Junsay Fernandez, Billy Montero Fernandez, Marvin Villaruel Gialogo, Allan Gimeno Go, Reynaldo Dela Pena Icalla, John Sobredo Lapitan, Rodrigo Hernandez Lazarte, Armando Canilao Madrigal, Jerry Maming Malay, Gregorio Uy Mallillin, Eulalio Guingab Odo, Silverio Salonga Pilos, Jonathan Dela Cruz Quindao, Dante Tuñacao Regidor, Nicolas Bravo Rentosa, Altair Uno Repancol, Bryan Repalda Reyes, Paolo Palero Sanchez, Marvic Cano Santos, Victor Santos

17

Section GUARDIAN (If not Parent) Name

Relationship

Abonita, Janet Baldomero Adlawan, Nora Pening Alfonso, Arminda Sison Altarejos, Geraldine Segarino Artocilla, Rosie Patnongon Begonia, Garry Masinna Bergantinos, Ailen Salay Bernido, Theresa Tabangay Burzon, Rowena Alba Caballero, Vilma Fenis Canilang, Lolita De Guzman

Mother Mother Mother Mother Mother Father Mother Mother Mother Mother Mother

Cardillo, Leah Ecang Cruz, Grace Dapitan Dela Cruz, Iluminada Paza Delos Santos, Rosemarie Rifareal Diampoc, Nelia Jaca Diesma, Felyn Felarca Duran, Mary Ann Mayor Fernandez, Angelina Capangyarihan Fernandez, Marissa Ballesteros Gialogo, Eufemia Dela Cruz Go, Melchona Garcia Icalla, Lucille Agil Lapitan, Lourder Baylon Lazarte, Sheila May Salar Madrigal, Rowena Zoleta Malay, Josefina Ilagan Mallillin, Myrna Lansangan Odo, Regina Salonga Pilos, Melanie Dona Quindao, Gina Espina Besoro, Marrie Gerard Tajora Rentosa, Analeen Bermeo Repancol, Olivia Trinanes Reyes, Merlene Destajo Sanchez, Amelia Botalon Santos, Ofelia Villaflur

Cardillo, Leah Ecang Cruz, Grace Dapitan Dela Cruz, Iluminada Paza Delos Santos, Rosemarie Rifareal Diampoc, Nelia Jaca Diesma, Felyn Felarca Duran, Mary Ann Mayor Fernandez, Angelina Capangyarihan Fernandez, Marissa Ballesteros Alba, Melanie Gialogo Go, Melchona Garcia Icalla, John Sobredo Lapitan, Lourder Baylon Lazarte, Sheila May Salar Madrigal, Rowena Zoleta Malay, Janine Ilagan Mallillin, Myrna Lansangan Odo, Regina Salonga Pilos, Lydia Dela Cruz Quindao, Gina Espina Regidor, Nicolas Bravo Rentosa, Analeen Bermeo Repancol, Olivia Trinanes Reyes, Merlene Destajo Sanchez, Amelia Botalon Santos, Ofelia Villaflur

Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother Mother

Santos, Iluminada Magnaye

Santos, Iluminada Magnaye

Mother

Sarmiento, Lena Vidal

Mother

Sayson, Beatres Gerodias Seras, Rolita Dela Cruz Suizo, Sheryl Fortaleza Tubice, Mary Jean Yarra Ugayan, Aileen Catapang Valencia, Mary Ann Aquino Varon, Glenda Gasga Villafuerte, Aileen Gutierrez

Mother Mother Mother Mother Mother Mother Mother Mother

01/22/00 136285051141

SANTOS, JOYCE ANN M.

F

105065050066

SARMIENTO, NIMOEL ARON V.

M

485542150307 305329120253 136571050359 136763050414 136884050249 136669050566 305332121225 105120050244

SAYSON, PIA SAMANTHA G. SERAS, JOHANNA KELLY DC. SUIZO, ANDREA F. TUBICE, BONIFACIO JR. Y. UGAYAN, AIMEE JOY C. VALENCIA, JERIC A. VARON, ANNE RAE G. VILLAFUERTE, ERICKA G.

F F F M F M F F

08/04/99 11/24/99 09/13/99 07/21/00 07/14/99 06/05/00 12/01/99 04/17/00 09/09/99 12/04/00

3895 Blk.23 20 Old Cabuyao T-1707 Area 17 #7355 Greenwood St. #8 Road 4 7136 Blk.2 Blk 2 Lot 4 Humanity Village

Pinabuhatan Brgy. Sauyo UP Campus Marcelo Green Village North Daanghari Addition Hills Brgy. Bagong Silangan Galas Maasim

Taguig City

Santos Jr., Pedro Luzon San Miguel, Bulacan

Pasig City Quezon City Quezon City Paranaque City Taguig City Mandaluyong City Quezon City San Rafael

Bulacan

Sarmiento, Romel Palomo Sayson, Roger Sundo Seras, Gennie Pepito Suizo, Jose Mari Rosales Tubice, Bonifacio Torcelino Ugayan, Rodolfo Yamba Jr. Valencia, Joel Catolico Varon, Jose Oclos Villafuerte, Roderic Paulino

Sarmiento, Lena Vidal Sayson, Beatres Gerodias Seras, Rolita Dela Cruz Suizo, Sheryl Fortaleza Tubice, Mary Jean Yarra Ugayan, Aileen Catapang Valencia, Mary Ann Aquino Varon, Glenda Gasga Villafuerte, Aileen Gutierrez

LRN

NAME (Last Name, First Name, Middle Name)

Sex (M/F)

136638050431

VILLALUZ, ROIJI P.

M

104919050112

VISAYA, VINA MARIZ T.

F

BIRTH DATE (mm/dd/ yyyy) 03/25/00 11/30/99

AGE as of 1st Friday June 16

MOTHER TONGUE

16

Filipino Filipino

IP (Ethnic Group) Tagalog Tagalog

ADDRESS RELIGION

House #/ Street/ Sitio/ Purok 74 Sikatuna Avenue Ordua Vilage

Catholic Roman Catholic

P. Javier St.

Barangay

Municipality/ City

Brgy. 172

Camarin. Caloocan City

Camalig Meycauyan

Province

Bulacan

PARENTS Father's Name (Last Name, First Name, Mother's Maiden Name (Last Name, First Name, Middle Name) Middle Name) Villaluz, Renato Arellano Villaluz, Rizalina Pagilagan Visaya, Maximiano Betito

Visaya, Virginia Torres

List and Code of Indicators under REMARKS column Indicator

Code Required Information

Transferred Out

T/OName of Public (P) Private (PR) School & Effectivity Date

Transferred IN

T/IN ame of Public (P) Private (PR) School & Effectivity Date

Dropped ate Enrollment

DRP LE

Reason and Effectivity Date Reason (Enrollment beyond 1st Friday of June)

Code Required Information CCT

CCT Control/reference number & Effectivity Date

REGISTERED

BoSY

GUARDIAN (If not Parent) Name

Relationship

Villaluz, Rizalina Pagilagan

Mother

Visaya, Virginia Torres

Mother

Prepared by:

EoSY

MALE (Signature of Adviser over Printed Name)

Name B/Aof school last attended & Year

FEMALE

LWD Specify Specify ACL Level & Effectivity Data

TOTAL

BoSY Date:

EoSYDate:

BoSY Date:

EoS

17 Contact Number of Parent or Guardian 9502924848 9122492876 9258009699 9174921414 9285906098 9399170308 9291874218 9278981364 9291630135 9282660464 9361245785 9108579788 9362760524 9369621045 9178864679 9196896688 9212732468 9216082918 9193448641 9393059550 9093549512 9425678459 9959916948 9166059432 9287833808 9752720467 9284307245 9183328545 9463693255 9212244072 9297024411 9055267532 9398330400 9176503243 9291874218

09058477056

9105064000 9436927554 9420679166 9105722818 9058477056 9099289331 9155110455 9207588638 9335058713 9057312909

REMARKS (Please refer to the legend on last page)

Contact Number of Parent or Guardian

REMARKS (Please refer to the legend on last page)

9994716238 9168289722

Certified Correct:

(Signature of School Head over Printed Name)

BoSY Date:

EoSYDate: