RICARDO M.

TEJERAS EPS, DepED RO-V-BICOL

ANABEL P UNCAD EPSA-DEPED DAVAO DEL SUR -RO-XI
RANDOLPH ELIZER G. SIMON DALSC-DIVISION OF CAGAYAN RO-2
MARIA DAPHHNIE T. DANO EPS-II-ALS
KRISTINE LEE S. LUMANOG EPSA-NCR-CALOOCAN
JOSEPHINE C. INTINO SEPS-DEPED CO- PASIG CITY
MARICEL S. LANGAHID EPS-RO-XI
ELENAR B. OPENA PSDS, QUEZON PROVINCE
ELEONOR D. MAGPANTAY EPS- SDO, SAN JOSE CITY, NE-REGION 3
REUBEN C. HERRERA EPS-II-ALS, SDO PALAWAN
HELEN A. ARANCON EPS-ALS-DAVAO DEL SUR-ROXI
ELSON C. JAMERO ITO, DEPED CAMIGUIN-ROX
 Republic of the Philippines
Department of Education AF-1
ALTERNATIVE LEARNING SYSTEM
AF-1 (MASTER LIST OF MAPPED LEARNERS)
Region: VII CEBU CITY Calendar
School Division: District: NORTH DISTRICT Year :
2024

Docu COMPLETE ADDRESS PARENTS REMARKS

ment
Sex (M/F)

BIRTH Contact
NAME DATE Refer IP Last Grade Date Mapped
(Last Name, First Name, Age ence Mother (Yes or Religion Mother's Maiden
Number of Level
Middle Name, Ext) (mm/ (Birth Tongue No) Street/ Father's Name (Last Learner Completed (mmddyyyy) Interested Enrolled in
dd/yyyy) Certifi Sitio/ Barangay Municipality/ Province Name, First Name, Name (Last Name, (if available) in ALS? Yes
Purok City Middle Name) First Name, Middle or No ALS
cate) Name)

2
3
4
5
6
7
8
9
10

11
12
13
14

Prepared by:
MAPPED LEARNERS ENROLLED LEARNERS
RYAN B.GODES
(Signature of ALS Teacher/Facilitator over Printed Name)
MALE MALE

FEMALE FEMALE

TOTAL TOTAL Certified Correct: (Signature ofEPSA/ PSDS over Printed Name)
put code for mapped prospective learners

2 alpha and 8 numeric

Region I ba00000001
2nd alpha region
 Republic of the Philippines AF-2
Department of Education
ALTERNATIVE LEARNING SYSTEM
ALS ENROLLMENT FORM
Region : Municipal :
City/Province : Barangay :
Date : LRN (if available) :

1) : Personal information (Part I)

Last name First name Middle Name Ext. Name

• Address :
House #/Street/Sitio Barangay Municipality/City Province
• Birth date (mm/dd/yyyy): _____/_____/________ Place of Birth (Municipality/City) _________________

• Sex:  Male  Female • Civil status:  Single  Married  Widow/er  Separated  Solo Parent  Common Law

• Religion: ____________• IP (Specify ethnic group) : ______________ • Mother Tongue : _______________ PWD: Yes No

• Name of Father/Legal Guardian

Last name First name Middle Name Occupation

• Mother's Maiden Name

Last name First name Middle Name Occupation

2) : Educational information (Part II)

• Last grade level completed
Elementary : K  G-I  G-II  G-III  G-IV  G-V  G-VI 
Secondary : G-7  G-8  G-9  G-10 
• Why did you drop out of school? (For OSY only)
No school in Barangay  School too far from home  Needed to help family 
Unable to pay for miscellaneous and other expenses  Others :

• Have you attended ALS learning sessions before? YES  NO 

If YES, name of the Program: Level of literacy: : Basic  Elem.  Sec.  InfEd 

If YES, have you completed the program? YES  NO  If NO, state the reason:

3) : Learning Center information (Part III)

• How far is it from your home to your Learning Center? km hours and mins.
• How do you get from your home to your Learning Center? Walking  Motorcycle  Bicycle  Others (Pls Specify)  _________
• When can you attend your Learning session?
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
What specific
time can you be
at your
Learning
Centre?

RYAN B.GODES _____________________________

Facilitator: Signature and Date Learner: Signature and Date
 Republic of the Philippines
AF-3
Department of Education
ALTERNATIVE LEARNING SYSTEM
AF-3 (MASTER LIST OF ENROLLED AND STATUS OF LEARNERS)
City/Municipality Name of Facilitator
Barangay Position

NAME NONFORMAL EDUCATION

PROGRAM ENROLLED
Assesment for Basic
Literacy (ABL) Functional Literacy Assesment

Sex (M/F)

PIS Score
Birthdate Age First Date of Status InfEd 4Ps beneficiary
LRN Age (Completer/No (Specify
Last First Middle mmddyyyy Group Attendance (YES/NO)

Basic Literate
n-Completer course)

Post Literate
Neo Literate
Name Name Name Ext
Learning Mode of
Learning Strand 1
Strand 1
Learning Learning Learning Learning Learning Overall Type of Program
English
Filipino
Strand 2 Strand 3 Strand 4 Strand 5 Strand 6 Score Program
Delivery

<=== TOTAL MALE

<=== COMBINED

Learners Enrolled by
Program Male Female Total Learners Enrolled by Program Delivery Male Female Total

BLP Face to Face Prepared by:

A&E Elem. Independent Learning
A&E Sec. Radio-based Instruction
InFED Computer-based Instruction (Signature of Facilitator over Printed Name)

Learners Enrolled in BLP Male Female Total

by level Male Female Total Certified Correct:
Enrolled Learners 10 15 25
Basic Literate Number of 4P's Learners 5 10 15
Neo Literate Percent of Enrolled 4P's Learners 60 (Signature of PSDS over Printed Name)

Post Literate

Status of Learner Male Female Total

Completer
Non-completer
 Republic of the Philippines AF-4
Department of Education
ALTERNATIVE LEARNING SYSTEM
AF-4 (MASTER LIST OF A&E REGISTRANTS)
Region
School Division

CLC ADDRESS

Sex (M/F)

Birthdate
(Last Name, First Name, A&E Test Level Date Registered Date of
LRN Middle Name, Ext) Registered Examination
Barangay Municipal

<=== TOTAL MALE

<=== TOTAL FEMALE

<=== COMBINED

Registered Male Female Total Prepared by:

Elementary (Signature of Facilitator over Printed Name)
Secondary
Taker Male Female Total Certified Correct:
Elementary
Secondary (Signature of PSDS/DC over Printed Name)
 AF-5
Department of Education
ALTERNATIVE LEARNING SYSTEM
LEARNER'S PERMANENT RECORD
LEARNER'S INFORMATION LRN:_______________________
___
LAST NAME: FIRST NAME: __________________ MIDDLE NAME: ____________ EXT NAME: ______

ADDRESS:
HOUSE # / SITIO / ST. BARANGAY MUNICIPALITY/CITY PROVINCE

DATE OF BIRTH (mm/dd/yyyy): MONTH _____/ DATE__________ / YEAR_____________SEX: Male Female

REGION: DIVISION:

LEARNER'S EDUCATIONAL STATUS

Program Enrolled : Program Enrolled :
Delivery Mode : Delivery Mode :
CLC Name : CLC Name :
District : District :
CLC Address : CLC Address :
Name of Facilitator : Name of Facilitator :
Calendar Year : Calendar Year :
Score Score
ASSESSMENT RESULTS Pre Post
ASSESSMENT RESULTS Pre Post
PIS Score PIS Score
Assesment for Basic Literacy (ABL) Pre Post Assesment for Basic Literacy (ABL) Pre Post
Basic Literate Basic Literate
Neo Literate Neo Literate
Post Literate Post Literate
Functional Literacy Assesment Pre Post Functional Literacy Assesment Pre Post
FLT Score in English FLT Score in English
FLT Score in Filipino FLT Score in Filipino
FLT Score in Scientific Literacy and Critical FLT Score in Scientific Literacy and Critical
Thinking Skills Thinking Skills
FLT Score in Mathematical and Problem Solving FLT Score in Mathematical and Problem Solving
Skills Skills
FLT Score in Life and Career Skills FLT Score in Life and Career Skills
FLT Score in Understanding The Self and Society FLT Score in Understanding The Self and Society
FLT Score in Digital Citizenship FLT Score in Digital Citizenship
Overall Score 0 0 Overall Score 0 0
InfEd Remarks InfEd Remarks

A & E STATUS Remarks A & E STATUS Remarks

Program Status Program Status
Test Taker Test Taker
Date of Examination Date of Examination
Testing Center Testing Center
Place of Testing Center Place of Testing Center
Accreditation and Equivalency (A&E) Test Result Accreditation and Equivalency (A&E) Test Result
Total number of years in school/CLC to date : Total number of years in school/CLC to date :

Certificate of Transfer Certificate of Transfer

Eligible for Admission to Eligible for Admission to
: :
Grade Grade
Certificate of Good Moral Character Certificate of Good Moral Character
This is to certify that the aboved-name is a learner of good moral character. This is to certify that the aboved-name is a learner of good moral character.
This certification is issued upon request of the concerned individual for This certification is issued upon request of the concerned individual for
his/her desire to trasfer to another school or for employment. his/her desire to trasfer to another school or for employment.

Prepared by: Certified Correct: Prepared by: Certified Correct:

ALS Teacher EPS II ALS Teacher EPS II

 Republic of the Philippines
Department of Education
ALTERNATIVE LEARNING SYSTEM

CONSOLIDATED LITERACY MAPPING RESULT (for

District of ________________________

No. of Baranga____________________No. of Mapped Barangays: ____________

No. of OSC No. of OSC No. of OSC No. of OSC No. of OSC No. of OSC
(6-15 (6-24 years (6-15 (6-15 (6-15 years (6-15
Barangay years old) old) years old) years old) old) years old)
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total

TOTAL

Prepared by: Noted:

________________________________ ____________________________________
Mobile Teacher/DALSC Public Schools District Supervisor