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  • Republic Ofthephilippines Region Iv-A Calabarzon

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    sweetheart barrion
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    This document appears to be a form collecting demographic and educational information for students in Agoncillo National High School in the Philippines. It includes fields for collecting a student's name, age, gender, birthdate, address, disability status if any, educational attainment, current enrollment status, and future enrollment plans. Interviewers are asked to note the type of any disabilities and obtain details from residents on whether their living arrangements are permanent or if they plan to move.

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    child-mapping-format.xlsx

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    This document appears to be a form collecting demographic and educational information for students in Agoncillo National High School in the Philippines. It includes fields for collecting a student's name, age, gender, birthdate, address, disability status if any, educational attainment, current enrollment status, and future enrollment plans. Interviewers are asked to note the type of any disabilities and obtain details from residents on whether their living arrangements are permanent or if they plan to move.

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    Download as XLSX, PDF, TXT or read online from Scribd
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    18 views2 pages

    Republic Ofthephilippines Region Iv-A Calabarzon

    Uploaded by

    sweetheart barrion
    This document appears to be a form collecting demographic and educational information for students in Agoncillo National High School in the Philippines. It includes fields for collecting a student's name, age, gender, birthdate, address, disability status if any, educational attainment, current enrollment status, and future enrollment plans. Interviewers are asked to note the type of any disabilities and obtain details from residents on whether their living arrangements are permanent or if they plan to move.

    Copyright:

    © All Rights Reserved
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    of 2

    REPUBLIC OFTHEPHILIPPINES

    REGION IV-A CALABARZON


    DIVISION OF BATANGAS
    DISTRICT OF AGONCILLO
    AGONCILLO NATIONAL HIGH SCHOOL

    Barangay:____________________________________ Division:____________________________
    Municipality:_________________________________ Region:_____________________________

    NAME DEMOGRAPHIC INFORMATION RESIDENCE DISABILITY

    Date of Present Number of Is residence Has disability?


    Last First Middle Gender Age Years in Present Permanent?
    Birth Address Address? (YES/NO) (YES/NO)
    With Birth
    Certificate?
    (YES/NO)

    ASK:"Is the child a permanent resident? (YES/NO), If yes, follow up, do the residents plan on moving moving out"

    Types of Disabilities: EDUCATIONAL ATTAINMENT


    1. Visula Impairment 6. Serious Emotional Disturbances C7- Completed Grade 7
    2. Hearing Impairment 7. Autism C8- Completed Grade 8
    3. Intellectual Disability 8. Orthopedic Imapairment C9- Completed Grade 9
    4. Learning Disability 9. Special Health Problem C10- Completed Grade 10
    5. Speech/Language Impairment 10. Multiple Disabilities
    PHILIPPINES
    ALABARZON
    ATANGAS
    GONCILLO
    L HIGH SCHOOL

    DISABILITY EDUCATIONAL STATUS FUTURE ENROLLMENT


    If no, state
    If studying Planning to If yes, Specify
    If yes, Specify Currently If yes, Specify If no, State reason for not
    Educational through ADM, study next the name of
    type of Studying? the Name of reason for not Specify planning to
    Attainment (YES/NO) type of School year? Prospective
    Disability the School studying study next
    ADM (YES/NO) School school year

    INTERVIEWER NAME AND SIGNATURE

    DATE OF INTERVIEWS

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