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Module Distribution and Retrieval Form

The document is a module distribution and retrieval form from Guinbialan Integrated School in Capiz, Philippines. It lists the names of 9 students in Grade 9 along with the subjects they will receive learning modules for, including English, Mathematics, Filipino, Science, and MAPEH (Music, Arts, Physical Education, and Health). Spaces are provided to record the name and signature of the parent/guardian receiving the modules, the date received, their contact number, and the name and signature of the parent/guardian returning the modules along with the date returned.

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CRISTAN ALONZO
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229 views10 pages

Module Distribution and Retrieval Form

The document is a module distribution and retrieval form from Guinbialan Integrated School in Capiz, Philippines. It lists the names of 9 students in Grade 9 along with the subjects they will receive learning modules for, including English, Mathematics, Filipino, Science, and MAPEH (Music, Arts, Physical Education, and Health). Spaces are provided to record the name and signature of the parent/guardian receiving the modules, the date received, their contact number, and the name and signature of the parent/guardian returning the modules along with the date returned.

Uploaded by

CRISTAN ALONZO
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

MODULE DISTRIBUTION AND RETRIEVAL FORM


MODULE #: ____
Grade Level & Section: _9__
Brgy: Guinbialan
Received by: Returned by: Remarks
Name of Signature of Date Contact No. Name of Signature of Date
No. Name of Learner SUBJECT AREA ()
Parents/Guardian Parents/ Received () Parents/Guardian Parents/ Returned
Guardian Guardian
1 ALICO, JOLEN D. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH
2 AYONGAO, RONNEL D. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH
Republic of the Philippines
Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

Received by: Returned by: Remarks


SUBJECT Name of Signature of Date Contact No. Name of Signature of Date
No. Name of Learner ()
AREA Parents/Guardian Parents/ Received () Parents/Guardian Parents/ Returned
Guardian Guardian
3 BACINSE, DANIEL B. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH:
MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH:
HEALTH
4 DAPECORTAR, JOSHUA B. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH:
MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH:
HEALTH
Republic of the Philippines
Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

Received by: Returned by: Remarks


Name of Signature of Date Contact No. Name of Signature of Date
No. Name of Learner SUBJECT AREA ()
Parents/Guardian Parents/ Received () Parents/Guardian Parents/ Returned
Guardian Guardian
5 DELA CRUZ, DENNIS B. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH
6 DEOCAMPO, ROMIL E. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH

No. Name of Learner SUBJECT AREA () Received by: Returned by: Remarks
Name of Signature of Date Contact No. () Name of Signature of Date
Parents/Guardian Parents/ Received Parents/Guardian Parents/ Returned
Republic of the Philippines
Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

Guardian Guardian
7 DEVELOS ALVIN D. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH
8 ICAYAN, REYNO D. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH

Received by: Returned by: Remarks


Name of Signature of Date Contact No. Name of Signature of Date
No. Name of Learner SUBJECT AREA ()
Parents/Guardian Parents/ Received () Parents/Guardian Parents/ Returned
Guardian Guardian
Republic of the Philippines
Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

9 JOMOLO, RJ D. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH
10 MARCELINO, JOHN D. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH

Received by: Returned by: Remarks


Name of Signature of Date Contact No. Name of Signature of Date
No. Name of Learner SUBJECT AREA ()
Parents/Guardian Parents/ Received () Parents/Guardian Parents/ Returned
Guardian Guardian
11 SAYAT, BRIAN A. English
Republic of the Philippines
Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH
12 TINGSON, ZANDRO C. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH

Received by: Returned by: Remarks


SUBJECT Name of Signature of Date Contact No. Name of Signature of Date
No. Name of Learner ()
AREA Parents/Guardian Parents/ Received () Parents/Guardian Parents/ Returned
Guardian Guardian
1 BUNDA, MARVE V. English
Mathematics
Republic of the Philippines
Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

Filipino
TLE
Science
AP
EsP
MAPEH:
MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH:
HEALTH
2 DICHOSA, MARIEL ANN O. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH:
MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH:
HEALTH

Received by: Returned by: Remarks


Name of Signature of Date Contact No. Name of Signature of Date
No. Name of Learner SUBJECT AREA ()
Parents/Guardian Parents/ Received () Parents/Guardian Parents/ Returned
Guardian Guardian
Republic of the Philippines
Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

3 DICHOSA, RIZALYN D. English


Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH
4 DICHOSA, RUTH D. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH

Received by: Returned by: Remarks


Name of Signature of Date Contact No. Name of Signature of Date
No. Name of Learner SUBJECT AREA ()
Parents/Guardian Parents/ Received () Parents/Guardian Parents/ Returned
Guardian Guardian
5 GEVERO, CHARMIE JOY English
C.
Mathematics
Filipino
Republic of the Philippines
Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH:
HEALTH
6 GIMENO, JENNY D. English
Mathematics
Filipino
TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH:
HEALTH

Received by: Returned by: Remarks


Name of Signature of Date Contact No. Name of Signature of Date
No. Name of Learner SUBJECT AREA ()
Parents/Guardian Parents/ Received () Parents/Guardian Parents/ Returned
Guardian Guardian
7 GINGCO, FLORENCE English
JOY D.
Mathematics
Filipino
Republic of the Philippines
Department of Education
Region VI – Western Visayas
Schools Division of Capiz
GUINBIALAN INTEGRATED SCHOOL
Guinbialan, Maayon, Capiz

TLE
Science
AP
EsP
MAPEH: MUSIC
MAPEH: ARTS
MAPEH: PE
MAPEH: HEALTH

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