School Form 3 (SF3) Books Issued and Returned(This replaces Form 1 & Inventory of Textbooks)

School ID 104951 School Year 2015 - 2016

School Name NORTH HILLS VILLAGE ELEMENTARY SACHOOL Grade Level Grade 5 Section LAUREL

No.ENGLISH LANGUAGE ENGLISH READING MATHEMATICS SCIENCE AND HEALTH HIYAS SA PAGBASA HIYAS SA WIKA MAKABAYAN KASAYSAYAN

Date Date Date Date Date Date Date Date Date DateIssued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1 Abunda, Julius A. 6/1/2015 6/1/2015 6/1/2015

2 Avila, Van Christopher A. 6/1/2015 6/1/2015 6/1/2015

3 Balderama John Mico O. 6/1/2015 6/1/2015 6/1/2015

4 Dela Pea, Harold P. 6/1/2015 6/1/2015 6/1/2015

5 Duarte, Dharyll D. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

6 Escarcha, Cedrick 6/1/2015 6/1/2015 6/1/2015

7 Escorpion, James Eliot A. 6/1/2015 6/1/2015 6/1/2015

8 Flores, Rudenil F. 6/1/2015 6/1/2015 6/1/2015

9 Fuertes, Mark Rainer A. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

10 Galutera, Eduardo C. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

11 Gonzales, Matt C. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

12 Guangco, Daniel M. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

13 Lim Ron Jeffrey S. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

14 Mainit, Joven I. 6/1/2015 6/1/2015 6/1/2015 6/1/2015 6/1/2015

15 Manatad, John Vincent A. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

16 Morallos, Marc Angelo D. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

17 Narciso, James M. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

18 Repol, Mark Rey 6/1/2015 6/1/2015 6/1/2015 6/1/2015

19 Solero, Christian B. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

20 Tolledo, John Casper 6/1/2015 6/1/2015 6/1/2015 6/1/2015

21 Villegas, Rommel B. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

NAME(Last Name, First Name, Middle

Name)

REMARKS/ACTION TAKEN (Please refer to the legend on last

page)

21 1 5 16 14 21 10 11

1 Alarde, Shemae Ann R. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

2 Ambor, Rasmia C. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

3 Atienza, Angelica H. 6/1/2015 6/1/2015 6/1/2015

4 Bacangoy, Kyra Camille J. 6/1/2015 6/1/2015 6/1/2015 6/1/2015 6/1/2015 6/1/2015

5 Bolanio, Dharl R. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

6 Calimlim, Samantha Jane T. 6/1/2015 6/1/2015 6/1/2015

7 Concepcion, Mary Asjdhel L. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

8 De Guzman, Jamie Ysabelle F. 6/1/2015 6/1/2015 6/1/2015

9 Evangelista, Samantha P. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

10 Kapangyatihan, Trixcel F. 6/1/2015 6/1/2015 6/1/2015

11 Laping, Eunice R. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

12 Mabini, Geodette N. 6/1/2015 6/1/2015 6/1/2015

13 Magan, Catherine I. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

14 Paite, Georgina M. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

15 Postrano, LJ Zhusane D. 6/1/2015 6/1/2015 6/1/2015

16 Quintana, Christine Ann 6/1/2015 6/1/2015 6/1/2015 6/1/2015

17 Tobias, Eloisa Mae C. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

18 Valencia, Jenica C. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

19 Villaruel, Karylle D. 6/1/2015 6/1/2015 6/1/2015 6/1/2015

20

21

22

19 10 4 16 6 19 9 8

41 11 9 32 20 41 19 19

GUIDELINES: In case of lost/unreturned books, please provide information with the following code: Prepared By:

SHERYL CRUZ ESPIRITU

1. Title of Books Issued to each learner must be recorded by the class adviser.2. The Date of Issuance and the Date of Return shall be reflected in the form.3. The Total Number of Copies issued at BoSY shall be reflected in the form.4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form.5. All textbooks being used must be included. Additional copies of

A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=NegligenceB. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14, 2.2012.

(Signature of Adviser over Printed Name)

1. Title of Books Issued to each learner must be recorded by the class adviser.2. The Date of Issuance and the Date of Return shall be reflected in the form.3. The Total Number of Copies issued at BoSY shall be reflected in the form.4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form.5. All textbooks being used must be included. Additional copies of

A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=NegligenceB. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14, 2.2012.

Date of BoSY: 06/01/2015 Date of EoSY:

school_form_3_ver2014.2.1.1