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Request Form-Unenrollment of Learner

This document is a template for requesting the unenrollment of a learner from the Learner Information System. It contains fields for entering the learner's personal details like name, date of birth, gender, region, and division. It also contains fields for the school the learner is currently enrolled in including the school ID, grade, section, and school year. There is a section to provide the reason for unenrollment and spaces for the request to be endorsed by the school head including their signature. The template provides notes for correctly filling out the form and attaching required documents before submitting the request to the Division Planning Officer.

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CHESKA BEBE
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122 views3 pages

Request Form-Unenrollment of Learner

This document is a template for requesting the unenrollment of a learner from the Learner Information System. It contains fields for entering the learner's personal details like name, date of birth, gender, region, and division. It also contains fields for the school the learner is currently enrolled in including the school ID, grade, section, and school year. There is a section to provide the reason for unenrollment and spaces for the request to be endorsed by the school head including their signature. The template provides notes for correctly filling out the form and attaching required documents before submitting the request to the Division Planning Officer.

Uploaded by

CHESKA BEBE
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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ICT

Learner Information System (L

Template for Une

Service Request Type : Unenrolment of Learner


Submit to : Division Planning Officer, Schools Governance and Operations Division
Note : Endorsement of School Head is required (signed and scanned). Please us

Present and Correct Enrolment Learn


Region Division School School ID Grade Section Date of First LRN
Attendance
(MM/DD/YYYY)
QUEZON
MIMAROPA PALAWAN NHS 301726 10 ROXAS 10/18/2020 111120080085

Requested Teacher/ICT Coordinator Name of School School ID


by QUEZON NATIONAL HIGH SCHOOL 301726
LAARNI GRACE E. SOBERANO

Note for school:


1. Fill-up the form correctly and completely
2. Attach this form as Excel file.
3. Attach a scanned copy of the form with School Head signature
4. Attach the following copies:
a. Birth Certificate
b. Form 137 and/or Form 138

Note for Division Planning Officer:


1. Consolidate requests by school by issue
2. Submit to Regional Planning Officer for encoding in the online form
ICTS - User Support Division
rner Information System (LIS) and Basic Education Information System (BEIS)
National Helpdesk
Template for Unenrollment of Learner (Request Form 15)

nd Operations Division
d and scanned). Please use worksheet/excel format for the matrix.

Learner's Personal Information Unenroled


First Name Middle Name Last Name Ext Name Date of Birth Gender Region Division
(MM/DD/
YYYY)

ANTHONY IPONG CASTILLOTE 9/5/2002 MALE MIMAROPA PALAWAN

School ID Division Region Date Endorsed by


301726 PALAWAN MIMAROPA DECEMBER 7, 2020 School Head
Unenroled From Reason for
School School ID Grade Section School Year Unenrolment

QUEZON
NHS 301726 10 ROXAS 2020-2021 PEPT PASSER

Endorsed by Signature
School Head Name HAYDEE L. MADRIÑAN

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