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Annex 2 Enrolment Form PDF

This document is a basic education enrollment form that collects student information including name, date of birth, gender, address, parents' names, contact details, previous school details, and signature of parent or guardian. The form notes that it is not for sale and provides instructions to print information clearly and submit the completed form to the person in charge. It collects details needed to create or update the student's learner profile in the Learner Information System in accordance with the Data Privacy Act of 2012.

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Myra Cabading
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307 views

Annex 2 Enrolment Form PDF

This document is a basic education enrollment form that collects student information including name, date of birth, gender, address, parents' names, contact details, previous school details, and signature of parent or guardian. The form notes that it is not for sale and provides instructions to print information clearly and submit the completed form to the person in charge. It collects details needed to create or update the student's learner profile in the Learner Information System in accordance with the Data Privacy Act of 2012.

Uploaded by

Myra Cabading
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ANNEX 2

BASIC EDUCATION ENROLLMENT FORM


THIS FORM IS NOT FOR SALE.
Check the appropriate box only:

School Year: - No LRN With LRN Returning (Balik-Aral)

INSTRUCTIONS: Print legibly all information required in CAPITAL letters. Submit accomplished form to the
Person-in-Charge/Registrar/Class Adviser. Use black or blue pen only.
STUDENT INFORMATION
PSA Birth Certificate No.

Learner Reference No. (LRN)

LAST NAME

FIRST NAME

MIDDLE NAME
EXTENSION NAME e.g. Jr., III (if applicable)
DATE OF
BIRTH / / SEX MALE FEMALE AGE
(Month/Day/Year)

Belonging to any Indigenous Peoples (IP)


No Yes If Yes, please specify:
Community/Indigenous Cultural Community?

Mother Tongue

ADDRESS
House Number and Street

Barangay

City/Municipality/Province/Country
Zip Code

PARENT’S/GUARDIAN’S INFORMATION
Father’s Name (Last Name, First Name, Middle Name) Mother’s Maiden Name (Last Name, First Name, Middle Name)

Guardian’s Name (Last Name, First Name, Middle Name)

Telephone Cellphone No.


No.
For Returning Learners (Balik-Aral) and Those Who Shall Transfer/Move In

Last Grade Level Completed Last School Year Completed

School Name School ID

School Address
For Learners in Senior High School
Semester 1st Sem 2ndSem
Track Strand (if any)
I hereby certify that the above information given are true and correct to the best of my knowledge
and I allow the Department of Education to use my child’s details to create and/or update his/her learner
profile in the Learner Information System. The information herein shall be treated as confidential in
compliance with the Data Privacy Act of 2012.

Signature Over Printed Name of Parent/Guardian Date


For use of DepEd Personnel Only. To be filled up by the Class Adviser.
DATE OF FIRST ATTENDANCE / /
(Month/Day/Year)

Grade
Track (for SHS)
Level

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