Department of Education

Region III
Division of Pampanga
Mexico West District
PANDACAQUI RESETTLEMENT ELEMENTARY SCHOOL
Mexico, Pampanga

June 4, 2019

To whom it may concern: (Parents/Guardians)

Please accomplish your child’d personal data below to serve as reference to

different school reports. Also, please ensure the accuracy of the information that you will
provide.

LEARNER’S PERSONAL DATA FORM

Child’s Name:
Birthdate:
Birth Place:
Current Address:
Father’s Name:
Mother’s Name:
Guardian’s Name: (Tagapag-alaga)

CONTACT PERSON IN CASE OF EMERGENCY

Name of Contact Person:
Relationship:
Cellphone Number:

Attached is a copy of your child’s CLASS PROGRAM. This will serve as a reference
of your child’s schedule inside the classroom. Thank you and GOD BLESS!