Departm
ALTERNATIVE
MASTERLIST OF MAPPED AND PO
District
COMPLETE HOME ADD
NAME Sex (M/F) IP
Date of Birth House
(Last Name, First Name, Name Extension, Age Mother Tongue (Yes or Religion
(mm/dd/yyyy) No./Street/ Barangay
Middle Name) No)
Sitio/ Purok
Department of Education
ALTERNATIVE LEARNING SYSTEM
ST OF MAPPED AND POTENTIAL LEARNERS (AF1)
COMPLETE HOME ADDRESS PARENTS
Contact Last Grade
Father's Name (Last Mother's Maiden Name Number of Level Date Mapped
Barangay Municipality/ City Province Name, First Name, Middle (Last Name, First Name, Learner Completed in (mm/dd/yyyy)
Name) Middle Name) (if available) Formal School
REMARKS
If already enrolled in
Interested in If Yes,
ALS, provide date
ALS? Preferred
of first attendance
Yes or No Program
(DOFA) and LRN
MASTERLI
District
Sex (M/F)
NAME
Date of Birth Mother IP House
(Last Name, First Name, Name Extension, Age Religion
(mm/dd/yyyy) Tongue (Yes or No) No./Street/
Middle Name)
Sitio/ Purok
Learner Enrollment and Survey Information Summary (ALS)
SY 2020-2021 af1
Father's Information
INCOMING LEARNERS SY 2020-2021
C3. Employment Status
DISTRICT Unempl
C.1 Father Self-
oyed
Male Female Total Full TimePart TimeEmploye
due to
d
ECQ
MASTERLIST OF MAPPED AND POTENTIAL LEARNERS (AF1)
COMPLETE HOME ADDRESS PARENTS
Father's Name (Last Name, First Name,
Barangay Municipality/ City Province
Middle Name)
PARENT/GUARDIAN INFORMATION
nformation Mother's Information
Status C4. Working from home due to ECQ C9. Employment Status
Unempl
C.7 Mother Self-
oyed
Not Working YES No Full TimePart TimeEmploye Not Working
due to
d
ECQ
PARENTS REMARKS
Last Grade If already
Level enrolled in
Mother's Maiden Name Contact Number of Learner Date Mapped Interested in If Yes, ALS, provide
Completed in
(Last Name, First Name, (if available) (mm/dd/yyyy) ALS? Preferred date of first
Formal
Middle Name) School Yes or No Program attendance
(DOFA) and
LRN
T/GUARDIAN INFORMATION
n Other than the Father or Mother
C10. Working from home due to ECQ C15. Employment Status C16. Working from home due to ECQ
C.13
Other Unempl
than the Self-
oyed
YES NO Father or Full TimePart TimeEmploye due toNot Working YES
Mother d
ECQ
C18. a beneficiary of 4Ps D1. HOW DOES YOUR CHILD GO TO SCHOOL?
orking from home due to ECQ
Public
Commut Family-
School
NO YES NO Walking e owned
Service
(Land/W vehicle
ater)
D2. How many of your household members (including the enrollee) are studying in School
Kinder Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9
e) are studying in School D3. Who among the household members can provide instructional support to the child’
Extended Others
Parents/
Elded Grandpar Members (Tutor,
Grade 10 Grade 11 Grade 12 Others Guardia Siblings ents of the House
ns Family helper)
D. HOUSEHOLD CAPACITY AND ACCESS TO DISTANCE LEARNING
D4. What devices are available at home that the learner can use for learn
uctional support to the child’s distance learning?
With Television With Cellphone
With
Able to Internet With
do With
Connectio Smartpho Tablet/
None independ Cable Non-Cable Basic Radio
n at ne Ipad
ent Home
learning
STANCE LEARNING
t the learner can use for learning? D5. Do you have a D6. How do you connect to the in
way to connect to
the internet
Own
Broadban
Own d Internet
Dekstop Others:__
Laptop None Mobile (DSL,
Computer _ YES NO Data Wireless
Fiber,
Satellite)
How do you connect to the internet? D7. What distance learning modality/ies do you prefer for your child
Other
Combina
Places
Outside tion of
Face to
Computer the Home
None Online Television Radio Modular Face with Other
Shop with
Internet other
Modalitie
Connectio
s
n
D8. What are the challenges that may affect your child’s process through distance education?
Distracti
Conflict ons (i.e.,
Lack of Unstabl
Insuffici Difficult with No or lack social
availabl e Existing
ent load/ y in other of media,
e mobile/ health
data indepen activitie available noise Others
gadgets/ internet conditio space for from
allowan dent s (i.e.,
equipme connecti n/s studying commun
ce learning house
nt on
chores) ity/neigh
bor)
FOR SPED
Number of Learners
moved in
Available Assisted Device at Home
from private & public schools
sucs & to ALS
Element Learner
ary With
With Without (Kinderg
Junior High
Senior
School
High School
Disabiiti Total
arten to es (Non-
Grade 6) Graded)
