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School:
Date:
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VI- Western Visayas
Division of Capiz
DUMALAG CENTRAL NATIONAL HIGH SCHOOL
Poblacion, Dumalag, Capiz
LRN:
ID no:
Name: Date of Birth:
Family Name First Name M.I. Year Month Day
Place of Birth:
Street/Brgy. Town/City Province
Parent/Guardian: Address:
Elementary Grades Completed(School): School Year: Gen. Ave.
Total Number of Years to Complete Elementary Course: Sex:
School: School Year:
Year & Section: Adviser:
Periodical Ratings
Subject Final Rating Action Taken
1 2 3 4
English ( ) Has Advanced Units in:
Mathematics ( )
Filipino ( )
Science ( ) Lacks Units in:
Araling Panlipunan ( )
ICT ( )
MAPEH ( ) To be classified as:
Music ( )
Arts ( ) Total number in School
Physical Education ( ) to date _____________________________
Health ( )
Eduk. sa Pagpapakatao ( ) General Average:
Enviro/ Astronomy ( ) Rank:
Months: June July Aug Sept. Oct. Nov. Dec. Jan. Feb. March April Total Extra Cur. Activities
Days of School:
Days Present
Name:
GELYN B. FACTO
Principal I
Months: June July Aug Sept. Oct. Nov. Dec. Jan. Feb. March April Total Extra Cur. Activities
Days of School:
Days Present
Name:
GELYN B. FACTO
Principal I