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Republic of the Republic

Department of Education
Region XI
Division of Davao Occidental

ALBERTO OLARTE SR. NATIONAL HIGH SCHOOL


Mabila, Sarangani, Davao Occidental

JUNIOR HIGH SCHOOL REGISTRATION FORM

Name:______________________________________ ___________ Grade:___________LRN:____________________


Last First Middle
Birthdate:________________ Age:_________ Sex:____________ Ethnicity:_____________________
Address:______________________________________________________ Cellphone No.:_________________
Last School Attended:______________________________________________________________________________
Father’s Name: _______________________________Mother’s Maiden Name:________________________________
Occupation:_________________________________Occupation:____________________________________________
Contact Number:____________________________Religion:________________________________________________

Student’s Profile Reading Status


___ Regular ___ Parental Support ___Independent
___ Repeater ___4Ps ___Instructional
___Balik Aral ___Self Supporting ___Frustration
___Transferee ___ Non-reader

Credential Submitted: Nutritional Status


___Form 138 Weight: ______kg ___Severely Wasted
___Birth Certificate Height:_______cm ___Wasted
___Good moral BMI:___________ ___Normal
___Overweight
___Obese

CELERINA L. LARAÑO HEDDY N. ARENDAIN


Librarian School Nurse Designate

RODRIGO S. YANGA NELIDA R. HERMINA


Prefect of Discipline Guidance Counselor

DENEIMEL B. PADILLON
Teacher In-charge

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