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Form 02 1

This document is a request form to reactivate or enroll a learner into the Learner Information System (LIS) and Basic Education Information System (BEIS) due to data issues. It contains fields for the learner's present and correct personal information, including name, date of birth, gender, mother's maiden name, and learner registration number (LRN). One example is provided for a learner from Dologon National High School-San Roque Annex with a pending enrollment and a gap. The request requires endorsement from the school head.

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Joannie Amparo
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36 views

Form 02 1

This document is a request form to reactivate or enroll a learner into the Learner Information System (LIS) and Basic Education Information System (BEIS) due to data issues. It contains fields for the learner's present and correct personal information, including name, date of birth, gender, mother's maiden name, and learner registration number (LRN). One example is provided for a learner from Dologon National High School-San Roque Annex with a pending enrollment and a gap. The request requires endorsement from the school head.

Uploaded by

Joannie Amparo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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ICTS - User Support Division

Learner Information System (LIS) and Basic Education Information System (BEIS)
National Helpdesk
Template for LRN Reactivation / Enrollment with Data Issues (Request Form 02)
Service Request Type : LRN Reactivation / Enrolment with Data Issues
Submit to : Division Planning Officer, Schools Governance and Operations Division
Note : Endorsement of School Head is required (signed and scanned). Please use worksheet/excel format for the matrix.

Present Enrolment Correct Learner Personal Information Code: Reason for


(as appeared in Birth Certificate) 1. No enrolment found
Reactivation
2. Update Failed
Region Division School School ID Grade Section Date of First LRN First Name Middle Name Last Name Ext Name Date of Birth Gender Mother's Maiden Name 3. Enrolment Failed
Attendance (Currently Used) (MM/DD/YYYY) 4. Previously Disapproved
(MM/DD/YYYY)

DNHS-SAN ROQUE JENNEVIL BAYLOSIS PENDING ENROLMENT WITH A


X BUKIDNON ANNEX HS 314928 8 WISDOM 9/13/2021 126668120040 JANPOL LAMPASO BATUTAY N/A 12/12/2005 M LAMPASO GAP

Requested Teacher/ICT Coordinator Name of School School ID Division Region Date Signature
by DOLOGON NATIONAL HIGH SCHOOL-SAN ROQUE Endorsed by
MADEL L. CAYASAN ANNEX
314928 BUKIDNON X MAY16,2022 School Head Name JOCELYN G. BATOY

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