Section

AGE as of
1st Friday
of June
(nos. of
years as
per last
birthday)
House # /
Street/Sitio/
Purok
Barangay Municipality/ City Province Name Relationship
12/24/77 36
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
School Form 1 (SF 1) School Register
(This replaced Form 1, Master List & STS Form 2-Family Background and Profile)
LRN
Sex
(M/F)
BIRTH
DATE (mm/
dd/yy)
BIRTH
PLACE
(Province)
MOTHER
TONGUE
IP
(Specify
Ethnic Group)
NAME
(Last Name, First Name, Middle Name)
School Name
School ID
Region Division District
School Year
RELIGION
ADDRESS NAME OF PARENTS
Grade Level
Father (1st name only if
family name identical to
learner)
Mother (Maiden: 1st Name,
Middle & Last Name)
GUARDIAN (If not Parent)
Contact Number
(Parent
/Guardian)

AGE as of
1st Friday
of June
(nos. of
years as
per last
birthday)
House # /
Street/Sitio/
Purok
Barangay Municipality/ City Province Name Relationship
LRN
Sex
(M/F)
BIRTH
DATE (mm/
dd/yy)
BIRTH
PLACE
(Province)
MOTHER
TONGUE
IP
(Specify
Ethnic Group)
NAME
(Last Name, First Name, Middle Name)
RELIGION
ADDRESS NAME OF PARENTS
Father (1st name only if
family name identical to
learner)
Mother (Maiden: 1st Name,
Middle & Last Name)
GUARDIAN (If not Parent)
Contact Number
(Parent
/Guardian)
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
114
Indicator Code Required Information Indicator Code Required Information BoSY EoSY
List and code of Indicators under REMARK column
Prepared by: Certified Correct:
AGE as of
1st Friday
of June
(nos. of
years as
per last
birthday)
House # /
Street/Sitio/
Purok
Barangay Municipality/ City Province Name Relationship
LRN
Sex
(M/F)
BIRTH
DATE (mm/
dd/yy)
BIRTH
PLACE
(Province)
MOTHER
TONGUE
IP
(Specify
Ethnic Group)
NAME
(Last Name, First Name, Middle Name)
RELIGION
ADDRESS NAME OF PARENTS
Father (1st name only if
family name identical to
learner)
Mother (Maiden: 1st Name,
Middle & Last Name)
GUARDIAN (If not Parent)
Contact Number
(Parent
/Guardian)
Transferred Out T/O Name of Public (P) Private (PR) School & Effectivity Date CCT Recipient CCT MALE
Transferred IN T/I Name of Public (P) Private (PR) School & Effectivity Date Balik-Aral B/A Name of school last attended & Year FEMALE
Dropped DRP Reason and Effectivity Date Learner With Dissability LWD Specify
Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) Accelarated ACL Specify Level & Effectivity Data BoSY Date: EoSYDate: BoSY Date: EoSYDate:
TOTAL
CCT Control/reference number & Effectivity Date
(Signature of Adviser over Printed Name) (Signature of School Head over Printed Name)
REMARK/S
(Please refer to the
legend on last page)
School Form 1 (SF 1) School Register
(This replaced Form 1, Master List & STS Form 2-Family Background and Profile)

REMARK/S
(Please refer to the
legend on last page)
Certified Correct:
REMARK/S
(Please refer to the
legend on last page)
BoSY Date: EoSYDate:
(Signature of School Head over Printed Name)