ALS Learners Basic Profile Per CLC

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Alternative Learning System

Address
NO. LRN no. Last Name First Name Middle Name Name Extension House Barangay
(if Available) no./Street/Sitio

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Personal Information (Part I)

Address
Municipality Province Birthdate Place of Birth Sex Civil Status (single, Religion IP (Specify Mother
M/F married, widow, ethnic group)
separated, solo parent ) Tongue
Name of Father/ Legal Guardian Name of Mother
PWD Last Name First Name Middle Name Occupation Last Name First Name Middle Name
Yes/No
Mother Why did you drop out of scho
Last Grade Level Completed
Occupation Elementary Secondary No school in Unable to pay for
(K, G-1, G-2, G-3, G-4, (G-7, G-8, G-9, G-10) Barangay? Yes/No Miscellaneous and other
G-5, G-6) expenses ( Yes/No)
Educational Information (Part II)
ALS Session
Have you attended
did you drop out of school? (For OSY only) ALS session If Attended ALS Session
before? Yes/No
School too far from Needed to help Others
home (Yes/No) family (Yes/No) (please Name of the Year
Specify) Program Attended
Accessibility a
ALS Session

How far is it from your home


If Attended ALS Session
to your Learning Center?

Level of Literacy Have you Completed


If Not Completed in hours and
(Basic, Elem., the Program? in kms
State the Reason mins.
Sec., InfEd) (Yes/No)
Accessibility and Availability (Part III)
When can you attend your Learning Center

What specific time can be at your Learning Center?


How do you get from your home
to your Learning Center? (Walking,
Motorcycle, Bicycle, Others pls. Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Specify)
Passed the
Academic and
Equivalency
Test? (Yes/No)
Alternative Learning System

Address
NO. LRN no. Last Name First Name Middle Name Name Extension House Barangay
(if Available) no./Street/Sitio

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Personal Information (Part I)

Address
Municipality Province Birthdate Place of Birth Sex Civil Status (single, Religion IP (Specify Mother
M/F married, widow, ethnic group)
separated, solo parent ) Tongue
Name of Father/ Legal Guardian Name of Mother
PWD Last Name First Name Middle Name Occupation Last Name First Name Middle Name
Yes/No
Mother Why did you drop out of scho
Last Grade Level Completed
Occupation Elementary Secondary No school in Unable to pay for
(K, G-1, G-2, G-3, G-4, (G-7, G-8, G-9, G-10) Barangay? Yes/No Miscellaneous and other
G-5, G-6) expenses ( Yes/No)
Educational Information (Part II)
ALS Session
Have you attended
did you drop out of school? (For OSY only) ALS session If Attended ALS Session
before? Yes/No
School too far from Needed to help Others
home (Yes/No) family (Yes/No) (please Name of the Year
Specify) Program Attended
Accessibility a
ALS Session

How far is it from your home


If Attended ALS Session
to your Learning Center?

Level of Literacy Have you Completed


If Not Completed in hours and
(Basic, Elem., the Program? in kms
State the Reason mins.
Sec., InfEd) (Yes/No)
Accessibility and Availability (Part III)
When can you attend your Learning Center

What specific time can be at your Learning Center?


How do you get from your home
to your Learning Center? (Walking,
Motorcycle, Bicycle, Others pls. Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Specify)
Passed the
Academic and
Equivalency
Test? (Yes/No)
Alternative Learning System

Address
NO. LRN no. Last Name First Name Middle Name Name Extension House Barangay
(if Available) no./Street/Sitio

1
2
3
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100
101
102
103
104
105
106
107
108
Personal Information (Part I)

Address
Municipality Province Birthdate Place of Birth Sex Civil Status (single, Religion IP (Specify Mother
M/F married, widow, ethnic group)
separated, solo parent ) Tongue
Name of Father/ Legal Guardian Name of Mother
PWD Last Name First Name Middle Name Occupation Last Name First Name Middle Name
Yes/No
Mother Why did you drop out of scho
Last Grade Level Completed
Occupation Elementary Secondary No school in Unable to pay for
(K, G-1, G-2, G-3, G-4, (G-7, G-8, G-9, G-10) Barangay? Yes/No Miscellaneous and other
G-5, G-6) expenses ( Yes/No)
Educational Information (Part II)
ALS Session
Have you attended
did you drop out of school? (For OSY only) ALS session If Attended ALS Session
before? Yes/No
School too far from Needed to help Others
home (Yes/No) family (Yes/No) (please Name of the Year
Specify) Program Attended
Accessibility a
ALS Session

How far is it from your home


If Attended ALS Session
to your Learning Center?

Level of Literacy Have you Completed


If Not Completed in hours and
(Basic, Elem., the Program? in kms
State the Reason mins.
Sec., InfEd) (Yes/No)
Accessibility and Availability (Part III)
When can you attend your Learning Center

What specific time can be at your Learning Center?


How do you get from your home
to your Learning Center? (Walking,
Motorcycle, Bicycle, Others pls. Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Specify)
Passed the
Academic and
Equivalency
Test? (Yes/No)

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