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PAR F 023 Learners Information System LIS Data Issues Request Form

This document is a request form for the Learners Information System (LIS) to address data issues. It requires information about the requesting school, contact details, type of request for learner's details, and required documents for different types of requests. The form is then filled out by Planning and Research personnel with details of receipt, documents submitted, status of request, and remarks.

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Maryrose Lucero
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© © All Rights Reserved
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Download as DOCX, PDF, TXT or read online on Scribd
135 views

PAR F 023 Learners Information System LIS Data Issues Request Form

This document is a request form for the Learners Information System (LIS) to address data issues. It requires information about the requesting school, contact details, type of request for learner's details, and required documents for different types of requests. The form is then filled out by Planning and Research personnel with details of receipt, documents submitted, status of request, and remarks.

Uploaded by

Maryrose Lucero
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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PLANNING AND RESEARCH SECTION

REQUEST FORM
Learners Information System (LIS) Data Issues
***To be filled up by the requesting school.

DATE: _________________________
SCHOOL ID: ____________________
NAME OF SCHOOL: _____________________________________________________________
NAME: _________________________________________ SIGNATURE: ________________________
CONTACT NUMBER: ______________________ E-MAIL ADD: ______________________________
TYPE OF REQUEST: LRN APPROVAL
ENROLMENT OF INELIGIBLE
ENROLMENT WITH GAP
CORRECTION OF BASIC PROFILE (ALS)
CORRECTION OF GRADE LEVEL
CORRECTION OF LEARNER PROFILE
LEARNER’S DETAILS
LRN (if applicable): __________________________
NAME: _________________________ _________________________ ______________________
(Last Name) (First Name) (Middle Name)
DATE OF BIRTH: _______________________
GRADE LEVEL: ________________________

***Required Documents
LRN Approval/Enrolment of Ineligible/with Gap
1. Birth Certificate
2. Form 137/Form 138/ ECCD Checklist (if Kinder)
Correction of Basic Profile (ALS) and Learner Profile
1. Birth Certificate
Correction of Grade Level
1. Form 137/Form 138/ ECCD Checklist (if Kinder)
***To be filled up by the Planning and Research personnel.

Received by: __________________________________________ Date: ___________________


Documents Submitted: Complete With System Request: YES
Incomplete NO
Status of Request: For Approval
For Disapproval
Pending
No Action
REMARKS: ______________________________________________

Evaluated by: ___________________________________________ Date: ___________________

Approved by:____________________________________________ Date: ___________________

DEPEDBATS-PAR-F-023/R2/08-09-2019
(043)722-1840/722-1796/722-1437/722-2675/722-1662(043)723-2816[email protected]www.depedbatangas.org
CRN 44 100 18 93 0045

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