PAR Form - For LIS Pending Approval at Division Level Only

SCHOOLS DIVISION OF PALAWAN

LIS PENDING APPROVAL REQUEST FORM
SY 2019-2020
LIS Change CERTIFIED CORRECT:
Request No.: Signature of School Head or
Representative:
School ID: 111202
School Name: STA. CRUZ ELEMENTAR Name of School Head: LUCIA Y. PECORE
District: San Vicente Contact Number: 9105842690
Email Address: lucia.pecore@deped.gov.ph

I. Profile of Learner with Data Issues/Problems

LRN: 111202130009 Sex: Female
First Name: AIZA JOY Birthdate: July 05, 2008
Middle Name: LUMIBAO
Last Name: VELASCO Name of Adviser: LOURENCE JAY Z. EVIO
Grade Level: 5 Username:
Section: A

II. Pending Request Type

Enrolment w/ gap, Enrolment of Ineligible, Correction of Learner Profile, Correction of Grade Level, LRN Approval, Temporary Enrolment

Enrolment w/ gap

III. Additional Details/Narrative/Justification if applicable

If applicable, narrate additional details inside the box.
has stopped for 1 year

IV. Documentary Requirements for Each Pending Request Type

Pending Request Type
Enrolment w/ gap
Enrolment of Ineligible
Correction of Learner Profile
Required Supporting Documents
*PAR Form, *SF9/SF10/Form 137 & 138,ECCD Summary of Rating for Grade 1,
**RFG, **PEPT, **A&E Rating
*PAR Form, *SF9/SF10/Form 137 & 138,ECCD Summary of Rating for Grade 1,
**RFG, **PEPT, **A&E Rating
*PAR Form, *SF9/SF10/Form 137 & 138, ECCD Summary of Rating for Kinder,
*Birth Certificate

Correction of Grade Level *PAR Form, *SF9/SF10/Form 137 & 138, **RFG, **PEPT, **A&E Rating

*PAR Form, *SF9/SF10/Form 137 & 138, ECCD Summary of Rating for Grade 1,
LRN Approval
**RFG, **PEPT, **A&E Rating, *Birth Certificate, or any Proof of ID
*PAR Form, *Affidavit of Undertaking, **Other available documents that may add
Temporary Enrolment
support to the request
*Required, **If Applicable Only.
NOTE: All attached documents must link or reflect learners eligibility to enroll in current grade level of the school year.

V. Instructions:
General instructions in using and submitting this form and attachments.
1. Properly fill out the required and applicable information in this form. One (1) form per request.
2. Print the filled out form to be signed by the school head. Scan the signed form and Supporting documents.
3.Upload the form and supporting documents at tiny.cc/PAL_LIS_PARF. Log in using Official DepEd Email for Public Schools and
any GMail for SUCs, LUCs and Private Schools.
4. Originally signed hard copies of this form shall be filed at the School Head's Office.
5. For inqueries and follow up, contact us at 0917 125 7774 and 0917 110 1321.
planning.palawan@deped.gov.ph Palawan.PRS

updated 9/16/2019 Download form at: tiny.cc/LIS_PAR_FORM