FORM 137-8
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REPUBLIC OF THE PHILIPPINES
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Principal Diision of Surigao del Sur
PANIKIAN NATIONAL HIGH SCHOOL
Reena Pekan, Gora, Suto alu
SECONDARY STUDENT'S PERMANENT RECORD
Nave Aecvedo y Arnold Dae ofits Your 2002 Moh Tusly_Dy_ A
Pace of Bh Province Ti Bee eatig e
Purcat or Guardian: LT
Address of Parent of Guardian: fe {aa Carrascad Surigao Sow
Intermediate course competed School): PariLi wa Elenearaty ate ‘Year S0N— Sie Goneral Average 1 OO
TASES Tei a
FATT one lil = aaa eres atin Scho | sero Year 2015 20 ly
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School Year BO Ne = 2013
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REMARKS
‘Remarks on the heath, character and habits ofthe student
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Teal nanber of years th school al
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‘tioenttcandr aeons PassosREQUEST FOR LEARNER INFORMATION SYSTEM (LIS) DATA CORRECTION
Distt CARRASCAL |
‘School Name: PANIKIAN NATIONAL HIGH SCHOOL ___School 1D: 204900
Name of School Head:__ALMA D. PLAZA. Position TEACHER tt!
‘AL Please check the type of data correction(s) needed:
_——Comretion of Leamer Profle, Merging of LRN
_—Comtection of Grace Level —— Request for Une
Correction of 1 Date of Attendance fr Transfer-in Deactivation of LRN
LRN Approval ——Eriment of neipitie
_—J__ Enrolment of w/ Gap
B. Leamer Details:
‘LastName: __ARREZA URN: __132657080004
‘First Name: __ROSALITO ‘Grade Level: GRADE 8_
(Middle Name:_CABADONGA __ ‘Secton: AMETHSYT __
C. Please state the nature of request.
10, Attached supporting documents:
Scanned Copy of Birh Certificate ECD Assessment Resut
‘Scanned Copy of School Form 05, ‘Coxttication
—J___ Scanned Gapy of School Form 10 (F137) Others (specify)
____Stanned Copy of School Form 09 (F136)