Department of Education

ALTERNATIVE LEARNING SYSTEM

MASTERLIST OF MAPPED AND POTENTIAL LEARNERS (AF1)

District 4-C Jaro (RGHMNS) Division: Iloilo City Region VI Calendar Year 2020

COMPLETE HOME ADDRESS PARENTS REMARKS

Last Grade

Sex (M/F)
IP Contact Number
NAME Date of Birth Mother Level Date Mapped
Age (Yes or Religion of Learner If already enrolled in
(Last Name, First Name, Name Extension, Middle Name) (mm/dd/yyyy) Tongue House Completed in (mm/dd/yyyy) Interested in If Yes,
No) Father's Name (Last Name, Mother's Maiden Name (Last Name, (if available) ALS, provide date of
No./Street/ Barangay Municipality/ City Province Formal School ALS? Preferred
First Name, Middle Name) First Name, Middle Name) first attendance
Sitio/ Purok Yes or No Program
(DOFA) and LRN

JEHOVAHS
ALERA, JOSHUA NATHANIEL M 5/1/2003 QUINTIN SALAS ILOILO CITY ILOILO ALERA, SOFRONIO JIMERA MARIJO 9503987839 YES
WITNESS

TOLENTINO, FRIEZEL JUN M 5/2/2003 CATHOLIC QUINTIN SALAS ILOILO CITY ILOILO TOLENTINO, CLAY ABELAR, JENNIFER YES

LUCINE, CLARENCE JOHN M 04/20/2001 CATHOLIC TACAS, JARO ILOILO CITY ILOILO LUCINE, ROMEL NOBLEZA, SUSAN 9504887121 YES

MORENO,
ORTEGA, JADE M 4/6/1999 CATHOLIC QUINTIN SALAS ILOILO CITY ILOILO ORTEGA, ROLAND YES
LENIE

SAMILLANO, MARY JOY F 05/28/1997 CATHOLIC QUINTIN SALAS ILOILO MIRANDA, DALYN 9093680912 YES
ILOILO CITY SAMILLANO, EDWIN

BARREDO, JOSHTJINE MAI F 3/8/1997 CATHOLIC CALAHUNAN, MANDURRIAO ILOILO CITY BARREDO, JONATHAN BONSARAN, MONICA 9096899809 YES
ILOILO

PANIZA, SAM M 09/28/2002 CATHOLIC QUINTIN SALAS ILOILO CITY PANIZA, JOSELITO ASIS, SHIELA 9460824208 YES
ILOILO
IGLESIA NI
PIO, JAYSON M 4/29/2002 ILOILO CITY ILOILO PIO, ALADIN LEUTERIO, VIBILYN 9097500088 YES
CRISTO QUINTIN SALAS

TACORDA, SHANNA MARIE F 2/3/2003 CATHOLIC TAP-OC, MOLO ILOILO CITY ILOILO TACORDA, MA. CONCEPTION 9129566271 YES

JAMOLO, MARK, LAWRENCE LEE M 1/31/2001 CATHOLIC CALAHUNAN, MANDURRIAO ILOILO CITY ILOILO JAMOLO, RONELFO ATIJON, LORENA 9285827795 YES

GRAJO, JUVY ANN F 9/22/2000 CATHOLIC BALABAGO, JARO ILOILO CITY ILOILO GRAJO, JOSE GENE ROJO, NILDA YES

ALERA, ROLAND SHEM M 12/27/2004 CATHOLIC QUINTIN SALAS ILOILO CITY ILOILO ALERA, SOFRONIO JIMERA, MARIE JO 9078322726 YES

BEUP, NOEL M 02/16/2001 CATHOLIC BUHANG, JARO ILOILO CITY ILOILO BEUP. NOLI AGSAMOSAM, LILIBETH YES

VERGARA, JOHN MARK M 6/6/2003 ISLAM ILOILO CITY ILOILO VERGARA, REY ALOMIA, MARELYN YES
MV HECHANOVA

RAPISTA, WENNIE ROSE F 8/27/1999 CATHOLIC QUINTIN SALAS ILOILO CITY ILOILO RAPISTA, WILFREDO CANTARA, RUFINA 9084056064 YES

PLANTA, KEYH F 10/18/2002 CATHOLIC QUINTIN SALAS ILOILO CITY ILOILO PLANTA, RAMONITO ALBAY, ANA 9102929935 YES

AREVALO, JOHN REY M 3/20/2002 CATHOLIC DEMOCRACIA ILOILO CITY ILOILO AREVALO, ALREY JACK AQILO, MA. NORY 9462499598 YES

FERRER, JOHN KRITZEL M 2/25/2001 AGLIPAY DEMOCRACIA ILOILO CITY ILOILO FERRER, MOREL GONZAGA, ARLEEN 9306221024 YES

MENDOZA, MARK
MENDOZA, JHON RHEMSTER M 3/7/2006 CATHOLIC TACAS, JARO ILOILO CITY ILOILO TALAMAN, CHRIZALENE YES
ANTHONY

DATO, MA. CHRITINA F 12/26/1999 CATHOLIC CALAHUNAN, MANDURRIAO ILOILO CITY ILOILO ARROYO, NOLI DATO, SALVACION 9090401721 YES

M 3/1/2003 CATHOLIC BUHANG, JARO ABDON, DONNA

ABDON, GERICO ILOILO CITY ILOILO YES

MAPPED LEARNERS as of ENROLLED LEARNERS as of Prepared By:

(MM/DD/YY) (MM/DD/YY) ANA M. ALBERTE
MALE MALE Signature of Facilitator over Printed Name

FEMALE FEMALE

TOTAL TOTAL Certified Correct: Signature of PSDS over Printed Name

SFRT 2017
AF2 Republic of the Philippines
Department of Education
ALTERNATIVE LEARNING SYSTEM
ALS ENROLMENT FORM (AF2)
Learner's Basic Profile

Date : LRN (if available) :

Personal Information (Part I)

Last Name First Name Middle Name Name Extension

• Address:
House No./Street/Sitio Barangay Municipality/City Province
• Birthdate (mm/dd/yyyy): _____/_____/________ Place of Birth (Municipality/City)

• Sex: □Male □Female • Civil Status: □Single □Married □Widow/er □Separated □Solo Parent (Box first)

• Religion: ____________• IP (Specify ethnic group) : ______________ • Mother Tongue : _______________ PWD: □Yes □No
• Name of Father/Legal Guardian

Last Name First Name Middle Name Occupation

• Mother's Maiden Name

Last Name First Name Middle Name Occupation

Educational information (Part II)

• Last grade level completed
Elementary : □K □G-1 □G-2 □G-3 □G-4 □G-5 □G-6
Secondary : □G-7 □G-8 □G-9 □G-10
• Why did you drop out of school? (For OSY only)
□No school in Barangay □School too far from home □Needed to help family
□Unable to pay for miscellaneous and other expenses Others:

• Have you attended ALS learning sessions before? □YES □NO

If Yes:
Name of the Program: _____________________________________________ Level of Literacy: □Basic □Elem. □Sec. □InfEd
Year Attended: ___________ Have you completed the Program? (Yes/No) _______
If NO, state the reason:

Accessibility and Availability (Part III)

• How far is it from your home to your Learning Center? in kms in hours and mins.
• How do you get from your home to your Learning Center? □Walking □Motorcycle □Bicycle □Others (Pls. Specify) ___________
• When can you attend your Learning Session?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday

What specific time

can you be at your
Learning Center?

_______________________________________ _____________________________
Facilitator: Signature and Date Learner: Signature and Date

SFRT 2017
 Republic of the Philippines
AF-3
Department of Education
ALTERNATIVE LEARNING SYSTEM
MASTERLIST OF ENROLLED LEARNERS WITH END OF PROGRAM/CY STATUS (AF-3)
District Division Region Calendar Year

Type of
Name of CLC Barangay City/Municipality
CLC

NON FORMAL EDUCATION

PROGRAM ENROLLED Assessment for Basic Literacy
Functional Literacy Assessment (FLT) Score
(ABL)

PIS Score
Sex (M/F)
NAME End of
Birthdate First Date of
LRN (Last Name, First Name, Middle Name, Name Age Program/ Remarks
(mmddyyyy) Attendance

Basic Literate

Post Literate
Neo Literate
Extension) CY Status
Type of Listening & Overall
Mode of Program Delivery Reading Numeracy Writing
Program Speaking Score

<=== TOTAL MALE

<=== TOTAL FEMALE

<=== COMBINED

Learners Enrolled
Learners Enrolled by Program Male Female Total
by Program Delivery
Male Female Total

BLP Face to Face Prepared By:

A&E Elem. Independent Learning
A&E Sec. Radio-based Instruction
InFED Computer-based Instruction Signature of Facilitator over Printed Name

Learners Enrolled in BLP

by Level
Male Female Total Enrolled Learners Male Female Total
Certified Correct By:
Basic Literate Number of 4P's Learners
Neo Literate Percent of Enrolled 4P's Learners
Signature of PSDS over Printed Name
Post Literate
 Republic of the Philippines AF-4
Department of Education
ALTERNATIVE LEARNING SYSTEM
MASTERLIST OF A&E REGISTRANTS (AF-4)
District Division Region

Place of Registration Center

(Name of School/Center, Barangay, Municipality)
(Testing Center) (Barangay) (Municipality/City)

CLC DETAILS

Sex (M/F)

Birthdate
NAME
A&E Test Level Date of
LRN (Last Name, CLC Registered
Date Registered
Examination
First Name, Middle Name, Ext) CLC Name Barangay Municipal
Type

<=== TOTAL MALE

<=== TOTAL FEMALE

<=== COMBINED

Registered Male Female Total Prepared By:

Elementary Signature of Facilitator over Printed Name
Secondary
Taker Male Female Total Certified Correct By:
Elementary
Secondary Signature of PSDS/DC over Printed Name
 Republic of the Philippines AF-5
Department of Education
ALTERNATIVE LEARNING SYSTEM

LEARNER'S PERMANENT RECORD (AF-5)

DISTRICT: DIVISION: REGION:

LEARNER'S INFORMATION LRN:______________________

____
LAST NAME: FIRST NAME: _____________________ NAME EXTENSION: ______ MIDDLE NAME: _____________________

ADDRESS:
HOUSE NO./ SITIO / ST. BARANGAY MUNICIPALITY/CITY PROVINCE

BIRTHDATE: MONTH _____/ DATE__________ / YEAR______________ SEX: Male Female

LEARNER'S EDUCATIONAL STATUS

Program Enrolled : Program Enrolled :
Delivery Mode : Delivery Mode :
CLC Name : CLC Name :
CLC Address : CLC Address :
Name of Facilitator : Name of Facilitator :
Calendar Year : Calendar Year :

Score Score
ASSESSMENT RESULTS ASSESSMENT RESULTS
Pre Post Pre Post
PIS Score PIS Score
Assesment for Basic Literacy (ABL) Pre Post Assesment for Basic Literacy (ABL) Pre Post
Basic Literate Basic Literate
Neo Literate Neo Literate
Post Literate Post Literate
Functional Literacy Assessment Pre Post Functional Literacy Assessment Pre Post
FLT Score in Reading FLT Score in Reading
FLT Score in Numeracy FLT Score in Numeracy
FLT Score in Writing FLT Score in Writing
FLT Score in Listening & Speaking FLT Score in Listening & Speaking
Overall Score 0 0 Overall Score 0 0
InfEd Remarks InfEd Remarks

A & E STATUS Remarks A & E STATUS Remarks

Program Status Program Status
Test Taken Test Taken
Date of Examination Date of Examination
Testing Center Testing Center
Location of Testing Center Location of Testing Center
Accreditation and Equivalency (A&E) Test Result Accreditation and Equivalency (A&E) Test Result

Certificate of Transfer Certificate of Transfer

Eligible for Admission to : Eligible for Admission to :

Certificate of Good Moral Character Certificate of Good Moral Character

This is to certify that the above-named is a learner of good moral character. This is to certify that the above-named is a learner of good moral character.
This certification is issued upon request of the concerned individual due to This certification is issued upon request of the concerned individual due to
his/her desire to pursue formal schooling/other CLC or for employment. his/her desire to pursue formal schooling/other CLC or for employment.

Prepared By: Certified Correct By: Prepared By: Certified Correct By:

Facilitator PSDS/District Coordinator/EPSA Facilitator PSDS/District Coordinator/EPSA