Sex (M/F)

NAME BIRTHDATE
LRN (Last Name, First Name, Name Extension, Middle AGE
(mm/dd/yyyy)
Name)

104863090015 Alonzo, John Kenneth, L. M

104782090004 Arcilla, Kevin B. M 10/5/2003 18

240002120026 Bongcawil, Jimboy T. M 10/16/2003 18

104893080008 Bulaong, Ian Romar V. M 8/11/2002 19

104873090038 Colcol, Joseph V. M 12/17/2003 18

104822080023 Cruz, George R. M

104782090033 Daulo, Ron Benedict D. M 7/19/2003 18

104873090060 Esguerra, John Lenard V. M 10/6/2002 19

104887080014 Gagal, Kean M 6/19/2003 18

418520150141 Gimpaya, Alberto Louis I. M 8/4/2003 18

104868090042 Leonardo, Boris M. M 12/6/2002 19

10486509007 Macapanas, Alberto T. M 11/16/2003 17

104847090071 Manalo, John Edrei S. M 17

223502140677 Nagai, Pierre Gabrielle A. M 9/1/2004 17

104854090076 Oliva, Christian Joy L. M 12/10/2003 18

104867080070 Pangilinan, Jerico DJ. M 12/4/2001 20

136687070435 Reyes, Richard P. M 7/11/2000 21

104868090077 Sanchez, Mark Joseph I. M 1/10/2004 17

104868090079 Santos, Gareth B. M 11/9/2002 19

104874090060 Talon, John Kenneth M. M 9/19/2002 19

104879090236 Yumol Prince B. M

<=== TOTAL MALE = 20

101648080001 Aldaya, Janine M. F 7/23/2002 19
104863090044 Baun, Marella Isabel D.C. F 3/26/2003 18

104847090015 Belen, Karla Shane Y. F 3/19/2004 17

104825090045 Buenaflor, Arrianne Jade Q. F 5/10/2004 17

104867090024 Caspillan, Angela M. F 5/16/2004 17

104863090083 Castillo, Kayla Cassandra I. F

104867090025 Clemente, Althea S. F 7/27/2004 17

104993090033 Cruz, Sofia Gabriele S. F 4/1/2004 17

104873090056 Dequilla, Destiny Villamor V. F 10/13/2003 18

104868090031 Drizza, Gemmaross E. F 4/8/2002 19

104863090140 Eramis, Irene D. F 7/15/2004 17

104867090046 Faustino, Rencel Rose V. F 7/24/2003 18

136736080238 Isidro, Jonalyn T. F 3/5/2003 18

104863090176 Herrera, Ricamae B. F

418520190013 Kitajama, Yuka F

104773090026 Lanon, Princess Baby Pearl M. F 10/18/2003 18

104863090233 Martinez, Jaymie Lynl P. F 10/31/2003 18

104867090083 Nolasco, Bea Marie A. F 12/1/2002 19

104867090092 Pilarca, Mariel A. F 9/26/2002 19

104863090259 Pagsanjan, Gwyneth Laine G. F

104869090064 Polintan, Angeli B. F 3/16/2004 17

104998090046 Rocabo, Clarissa M. F 9/9/2003 18

104868090074 Roque, Angel D.C. F 3/3/2003 18

104864090047 Roque, Shierlyn J. F 5/1/2004 17

104862090040 Sacdalan, Yasmin A. F 1/19/2004 17

104993090048 Santiago, Kristelyn M. F 11/6/2002 19

104867090105 Santiago, Jasmine M. F 11/6/2004 17

104830090108 Serilla, Cristal Joy S. F 9/7/2002 19

104988080092 Tero, Ma. Jessa S. F 10/13/2001 20

104868090083 Velasco, Mariel Novela N. F 10/26/2004 17

<=== TOTAL FEMALE =

<=== COMBINED =
Legend: List and Code of Indicators under REMARKS column
Indicator Code Required Information Indicator
Transferred Out T/O CCT Recipient
Transferred In T/I Name of School, Date of 1st Attendance Balik Aral
and Date of Last Attendance if Transferred Learner With Exceptionality
Out Accelerated
 COMPLETE ADDRESS
Religious
AGE
Affiliation
House No./ Street/ Sitio/
Purok Barangay Municipality/ City

18

18

19 R.C.

18

18

19 R.C.

18 R.C.

18 R.C.

19 R.C. Catmon Malolos

17 Baptist San Francisco Bulakan

17 JEHOVA W.

17

18 R.C.

20 R.C. Caingin Malolos

21 R.C.

17 R.C.

19 R.C.

19 R.C. Sto. Rosario Malolos

19
18

17 R.C. Tampok Hagonoy

17 R.C.

17 R.C. Caingin Malolos

17 R.C. Caingin Malolos

17 R.C . Pinalagdan Paombong

18 R.C .

19 R.C. San Gabriel Malolos

17 R.C . Sumapang Matanda Malolos

18 547 Malolos

18 R.C.

18 R.C.

18 R.C. 9 Mojon Malolos

19 R.C.

19 Caingin Malolos
17 Dakila Ma Malolos

18 Pinalagdan Paombong

18 Catmon Malolos

17 Barihan Malolos

17

19 Pinalagdan Paombong

17

19 Mojon-Bph Malolos

20 Kapitangan Paombong

17 San Agustin Malolos

Code Required Information REGISTERED

CCT CCT Control/reference number & Effectivity Date Name of school last MALE
B/A attended & Year
LWE Specify Exceptionality of the Learner
FEMALE
Specify Level & Effectivity Date
ACL
TOTAL
 PARENTS GUARDIAN
(if learner is not Living with Parent)

Father's Name Mother's Maiden Name Name

unicipality/ City Province (Last Name, First Name, Name Extension, (Last Name, First Name, Name Extension, Middle (Last Name, First Name, Name Extension, Middle
Middle Name) Name) Name)

Arcilla, Brendon Bernales, Aliena

Bongcawil, Jerry Taruc, Melissa

Bulaong, Nathaniel Valataha, Erlinda

Colcol Jr., Manuel Villamor, Josielyn

Grepal, Orville Gagal, Honeylyln

Gimpaya, Alberto Ignacio, Neriza

Bulacan Leonardo, Robert Manansala, Rhodora

Bulacan Durango, Randy Durango, Jenny

Manalo, Jun Sebastian, Ruth

Oliva, Jonathan Lopez, Charito

Bulacan Pangilinan, Crisanto De Jesus, Magdalena

Reyes, Emerito Pantoja, Rowena

Sanchez, Rolando Iran, Maribel

Santos, Rogelio Barcelona, Gloria

Bulacan Talon, Alvin Magat, Noemi

Macaraeg, Haidee

Bulacan Belen, Roel Yusorez, Carlota

Buenaflor, Reynante Quizel, Maricel

Bulacan Caspillan, Erwin Marinas, Ma. Nerissa

Bulacan Clemente, Jr, Marcial Santos, Cristina

Bulacan Cruz, Leoncio Santos, Juana

Dequilla, Dennis Villamor, Teresita

Bulacan Drizza, Jimmy Recarnacion, Gemma

Bulacan Eramis, Fernando Dumo, Jeriza

Bulacan Faustino, Rogelio Vivas, Rosalie

Bestil, Armingol Isidro, Jocelyn

Bulacan Martinez Jr., Lamberto Perez, Meriam Carla

Nolasco, Alfredo Arada, Cornella Nolasco, Alfredo

Malolos BULACAN Pilarca, Mario Acuña, Nerissa Pilarca, Mario
 Bulacan Polintan, Randy Bautista, Elizabeth Polintan, Randy
Bulacan Rocabao, Benjamin Marcelino, Ma.Lourdes Rocabao, Benjamin
Bulacan Roque, Angelito Dela Cruz, Conception Roque, Angelito
Bulacan Roque, Edgar Dela Cruz, Conception Roque, Edgar
Sacdalan, Francis Apostol, Ruby Rosa Sacdalan, Francis
Bulacan Santiago, Candido Magno, Arlene Santiago, Candido
Santiago, Ariel Mendoza,Rosaly Santiago, Ariel
Bulacan Serilla, Rodrigo Sambere, Janet Serilla, Rodrigo
Bulacan Tero, Ruperto Santos, Norma Tero, Ruperto
Bulacan Velasco, Emelito Novela, Marwin Velasco, Emelito

Beginning of the Prepared By:

End of the Semester
Semester

Signature of Adviser ove

Beginning of the Semester Date:

 GUARDIAN Contact
(if learner is not Living with Parent) REMARKS
Number of
Name Parent/ (Please refer to the legend)
t Name, Name Extension, Middle Relationship Guardian
Name)

0909-0550-721

0905-501-1842

0918-658-4503

0975-635-6839

0935-512-4398

0936-475-3158

0906-776-6959

0910-145-2415

0943-812-2047

0975-438-5045

0999-562-6721

Nolasco, Alfredo

Pilarca, Mario
Polintan, Randy

ocabao, Benjamin

Roque, Angelito

Roque, Edgar

Sacdalan, Francis

antiago, Candido

Santiago, Ariel

Serilla, Rodrigo

Tero, Ruperto

Velasco, Emelito

Signature of Adviser over Printed Name

Semester Date: End of the Semester Date: