School Form 1 (SF 1)
School Form 1 (SF 1)
School Form 1 (SF 1)
School Name Rajah Cabungsuan Integrated Secondary School School ID 500327 District Lingig II
Division Surigao
Semester Second Semester School Year 2021 - 2022 Grade Level Grade 11 Track and Strand
Sex (M/F)
NAME BIRTH DATE as of
LRN Religious Affilication Mother's Maid
(Last Name, First Name, Name Extension, Middle Name) (mm/dd/yyyy) Octob Father's Name (Last
er 31st Name (Last Na
House #/ Street/ Sitio/ Purok Barangay Municipality/ City Province Name, First Name, Middle
First Name, Mi
Name)
Name)
RAJAH
SURIGAO DEL ARTIZA, VICTOR OTOM,MERLI
132808090004 ARTIZA,MARVIN OTOM M 12/25/2001 19 Christianity CABUNGSO- LINGIG
SUR CURAS BILLONES,
AN
RAJAH
SURIGAO DEL COBOY, ANTONIO LATIBAN,ALB
132808090009 COBOY,JAMES LATIBAN M 07/26/2004 17 Christianity CABUNGSO- LINGIG
SUR IMLAY COBOY G,ARTIZA,
AN
RAJAH
SURIGAO DEL DAGA-ANG, RAMIREZ,ANA
132808100018 DAGA-ANG,JOHN LLOYD RAMIREZ M 01/30/2005 16 Christianity CABUNGSO- LINGIG
SUR ANTONIO ESIO N,ASIS,
AN
RAJAH
SURIGAO DEL NOCOS, DOMINGO ARTIZA,MARI
132808070046 NOCOS,DINDO ARTIZA M 01/26/2000 21 Christianity CABUNGSO- LINGIG
SUR TOLIDO TA,LATIBAN,
AN
RAJAH
SURIGAO DEL ROZ, ARMANDO ESIO,ADELAID
132808100047 ROZ,ARMANDO JR ESIO M 09/01/2004 17 Christianity CABUNGSO- LINGIG
SUR QUILAY SR CORRAS,
AN
CITY OF RUAREZ,MAR
MAGUGPO DAVAO DEL
214518060001 ARTIZA,MARYFLOR DOMINADOR F 04/21/1999 22 Christianity TAGUM ANN,DOMINA
NORTH NORTE
(Capital) R
RAJAH
SURIGAO DEL BELTRAN, MARCOS NANANG,CAR
132808100008 BELTRAN,MECAILA NANANG F 05/28/2004 17 Christianity CABUNGSO- LINGIG
SUR PURALAN NCITA,CORTE
AN
RAJAH GAY-
SURIGAO DEL CORTEZ, JOEL
132808130040 CORTEZ,JASRIL GAY-OD F 12/06/2004 16 Christianity CABUNGSO- LINGIG OD,REGINA,P
SUR COTIC
AN DONG,
TRECE
LAPIDARIO DE GUZMAN, JOSE LONJAMON,M
132575090024 DE GUZMAN,JOCELYN LONJAWON F 01/06/2002 19 Christianity MARTIRES CAVITE
(BAYOG) MENDEZ JR TINEZ,AMALI
CITY (Capital)
F1-SHS)
GUARDIAN
TS REMARKS
(if learner is not Living with Parent)
Contact
Number of Learning
Mother's Maiden Parent or Modality
Name
Name (Last Name, Guardian (Please refer to the
(Last Name, First Name, Relationship
First Name, Middle legend on last page)
Name Extension, Middle
Name)
OTOM,MERLINA,
PARENT Modular (print)
BILLONES,
LATIBAN,ALBIN
PARENT Modular (print)
G,ARTIZA,
RAMIREZ,ANALY
PARENT Modular (print)
N,ASIS,
ARTIZA,MARIQUI
PARENT Modular (print)
TA,LATIBAN,
ESIO,ADELAIDA,
PARENT Modular (print)
CORRAS,
MALBAS,MARICE
PARENT Modular (print)
L,JADOL,
RUAREZ,MARRY,
ANN,DOMINADO PARENT Blended
R
COLAS,GEGIE,LA
PARENT Modular (print)
TIBAN,
NANANG,CARME
PARENT Modular (print)
NCITA,CORTEZ,
GAY-
OD,REGINA,PUN PARENT Modular (print)
DONG,
LONJAMON,MAR
PARENT Modular (print)
TINEZ,AMALIA,
CITY OF
DAVAO DEL ERMAC, LOPE ABADAL,MEL
214518100006 ERMAC,CYRIL JOY ABADAL F 09/17/2003 18 Christianity APOKON TAGUM
NORTE ABRAHAM MARAVILLA,
(Capital)
RAJAH
SURIGAO DEL CORAS,LUTG
132808090016 ESIO,JENABIE CURAS F 06/18/2002 19 Christianity CABUNGSO- LINGIG ESIO, ROSIL -
SUR A,LATIBAN,
AN
RAJAH
SURIGAO DEL GAY-OD, RECARDO DOMINADOR
132808120067 GAY-OD,RECAMAE DOMINADOR F 01/03/2004 17 Christianity CABUNGSO- LINGIG
SUR LINGAY RILYN,RUALE
AN
RAJAH GAY-
SURIGAO DEL LASUTA, SANNY
132808120069 LASUTA,STEPHANIE GAY-OD F 08/27/2004 17 Christianity CABUNGSO- LINGIG OD,LENNY,LI
SUR NAMOCO
AN AY,
RAJAH
SURIGAO DEL SARNO, JOVELITO TOMAS,LELIA
132808100049 SARNO,ELIZABETH TOMAS F 10/31/2004 17 Christianity CABUNGSO- LINGIG
SUR ORCULLO RTEZ,
AN
20 <=== COMBINED
Transfered Out T/O CCT Receipient CCT CCT Control/reference number &
Effectivity Date MALE 5
Name of School, Date of 1st Attendance and Balik Aral B/A Name of school last attended & Year
Date of Last Attendance if Transferred Out
Transfered In T/I Learner With LWE Specify Exceptionality of the Learner
FEMALE 15
Exceptionality Beginning of the Semeste
Accelerated ACL Specify Level & Effectivity Date
TOTAL 20
2/7/22 12:00 AM
CORAS,LUTGARD
PARENT Modular (print)
A,LATIBAN,
DOMINADOR,ME
PARENT Modular (print)
RILYN,RUALES,
GAY-
OD,LENNY,LING PARENT Modular (print)
AY,
CORTEZ,ENILDA,
RELATIVE Modular (print)
LATIBAN,
DIANSAY,MARIT
Modular (print)
ES,BLANCO,
CABARILLAS,MA
PARENT Modular (print)
RIA,-,
TOMAS,LELIA,CO
PARENT Modular (print)
RTEZ,
VIRTUDAZO,CRIS
PARENT Modular (print)
PULA,GULDE,
d by;