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Request-for-Data-Correction GBES 109487 DELA PAZ

1) The document is a request form from Jesusa A. Santos, the LIS Coordinator of Guitnangbayan Elementary School, to correct data in the learner profile of one student. 2) The student is Hermoine Eissa Dela Paz with Reference Number 109494130448 who is currently in 5th grade. 3) Santos is requesting a correction to the enrollment status of Dela Paz from ineligible to eligible based on the attached birth certificate and school form.

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45 views1 page

Request-for-Data-Correction GBES 109487 DELA PAZ

1) The document is a request form from Jesusa A. Santos, the LIS Coordinator of Guitnangbayan Elementary School, to correct data in the learner profile of one student. 2) The student is Hermoine Eissa Dela Paz with Reference Number 109494130448 who is currently in 5th grade. 3) Santos is requesting a correction to the enrollment status of Dela Paz from ineligible to eligible based on the attached birth certificate and school form.

Uploaded by

Guitnang bayan es 109487
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

DEPARTMENT OF
EDUCATION
Region IV-A CALABARZON PHP QMS 19 930014
DIVISION OF RIZAL
Request for Data Correction Form

SCHOOL PROFILE
Date: MAY 30, 2020 Requesting Person: JESUSA A. SANTOS
School ID: 109487 Position/Designation: LIS COORDINATOR
School Name: GUITNANGBAYAN ELEM. SCHOOL Contact No.: 09338164934

Code: 1 – LRN Approval 3 – Enrolment of Ineligible 5 – Others (Correction of Learner’s


2 – Enrolment with Gap 4 – Correction of Grade Level Profile, etc.)

LEARNER/S PROFILE
Learner
Grad Attached Code
Reference First Middle Exten Date of Gende
e Last Name Document (1,2,3,4,
Number Name Name sio n Birth r
Level /s 5)
(if Applicable) Nam
e
109494130448 5 HERMOINE ALULOD DELA PAZ N/A 02/28/2008 FEMALE BC, SF9 3
EISSA

Note: Attach separate sheet if necessary.

Remarks: _
_ _
_ _

Action Taken by: Conforme:

_
(Division Personnel) (School Personnel)
Name/Signature/Date Name/Signature/Date

DOR-PLN-F-002 Rev. 02 July 1, 2019

Not to be reproduced or photocopied without prior authorization of SDO Rizal.

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