(Enclosure No. 2 to DepEd order No.2, s. 2014)FORM 1

DEPARTMENT OF EDUCATION

EARLY REGISTRATION FORM

School ID: 116721 Region: VI-Western VisayasSchool Name: Balbino Seron Elementary School Division: Iloilo

School District: San Joaquin - North

GRADE One

SY 2015-2016

NAME SEX AGE BIRTHDATE ADDRESS

CATEGORY OF C/Y WITH DISABILITY**

(For children and youth with disabilities

only)

REMARKS**

1. Aguilar, Gabriel Sicorsicon M 5 8/14/09 Bucaya2. Baylon, Van Dominique Jarme M 5 7/22/09 Bucaya3. Codera, Adrian Ralph Raidin Semilla M 6 12/11/08 Bulho4. Doromal, Lance Luis Equinan M 6 5/10/08 Cadoldolan5. Dulana, Kent Nove M 6 11/4/09 Bulho6. Hervas, Jhon Mark Secaluya M 5 5/11/09 Masagud7. Hervas, Jonel Villas M 5 6/25/09 Cadoldolan8. Macasio, Marko Antonio Zamora M 6 12/21/08 Bucaya9. Mondragon, Dwight Stifler Sasi M 5 9/21/09 Bucaya10. Perez, Ric Angelo Seron M 5 9/17/09 Masagud11. Pitong, Nick Arthur Mota M 6 2/9/09 Bucaya12. Salinas, Stephan Rey Selibio M 6 1/10/09 Sta. Rita13. Sandig, Fritz Dylan Basbas M 6 1/28/09 Cadoldolan14. Sangria, Nelson Santerva M 5 4/7/09 Bulho15. Sano, Kish Saul Santerva M 6 12/28/08 Bulho16. Sao-a, Erwin Roy Semilla M 5 9/28/09 Bucaya17. Sarad, Ranel Jun Ronel M 5 5/27/09 Cadoldolan18. Sayson, Colleviand Klien Garcia M 6 11/8/08 Bucaya19. Servidad, Luigi Servano M 5 10/17/09 Bulho20. Verano, Antonio Jr. Rubie M 6 12/22/08 Masagud21. Zamora, Zandrey Semilla M 5 8/17/09 Bucaya22.23.24.25.26.27.28.29.30.31.32.33.34.35.36.37.38.39.40.

Remarks*:1. For Grade 1 Registrants: Has attended/not attended Kindergarten class2. For ALS: Information whether the child youth prefers to learn through the ADM = Alternative Delivery Mode (MISOSA, e-Impact, DORP) or ALS = Alternative Learning SystemCategory of C/Y with Disability**: Visual Impairment, Intellectual Disability, Learning Disability, Speech/Language Impairment, Serious Emotional Disturbance, Autism, Orthopedic Impairment, Special Health Problem, Multiple Disabilities