21/08/2023
How To Make Online Deped Enrollment Form Using Google Form - A Complete Guide
If you want a copy of this Online Enrollment Form, Kindly send me your email address at
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GOOGLE FORM LINK: https://docs.google.com/forms
INSTRUCTION ON HOW TO FILL OUT GOOGLE FORM
Deped Enrollment Form
INSTRUCTION: (First Section)
Type all information in CAPITAL letters.
School Year (Multiple Choice, required)
Grade level to Enroll: (Drop-down, required)
With LRN? (Drop-down, required)
Yes
No
2.Returning (Balik-Aral)? (Dropdown, required)
Yes
No
LEARNER INFORMATION (Add Section)
PSA Birth Certificate No. (if available upon registration) (Short Answer)
Learner Reference No.(Short Answer)
Last Name (Short Answer, Required)
First Name (Short Answer, Required)
Middle Name (Short Answer, Required)
Extension Name e.g. Jr., III (if applicable) (Short Answer)
Birthdate (mm/dd/yyyy) (Date, Required)
Place of Birth (Municipality/City) (Short Answer, Required)
S*x (Checkbox, Required)
Male
Female
Age (Short Answer,Required)
Mother Tongue (Short Answer,Required)
Belonging to any Indigenous Peoples (IP) Community/Indigenous Cultural Community? (Checkbox,Required)
Yes
No
If Yes, please specify (Short Answer)
Is your family a beneficiary of 4Ps? (Checkboxes,Required)
Yes
No
If Yes, write the 4Ps Household ID Number below (Short Answer)
Is the child a Learner with Disability? (Checkboxes,Required)
Yes
No
If Yes, specify the type of disability: (dropdown)
Visual Impairment
a. blind
b. low vision
Hearing Impairment
Autism Spectrum Disorder
Speech/Language Disorder
Learning Disability
Emotional- Behavioral Disorder
Cerebral Palsy
Intellectual Disability
Orthopedic/Physical Handicap
Special Health Problem/ Chronic Disease
Multiple Disorder
a. Cancer
Current Address (Short Answer,Required)
House No.
Sitio/Street Name
Barangay
Municipality/City
Province
Country
Zip Code
Permanent Address (Short Answer,Required)
Same with your Current Address? □ Yes □ No
if no, fill out below
House No.
Sitio/Street Name
Barangay
Municipality/City
Province
Country
Zip Code
PARENT'S/GUARDIAN'S INFORMATION (Add Section)
Father’s Name (Short Answer,Required)
Last Name
First Name
Middle Name
Contact Number
Mother’s Maiden Name (Short Answer,Required)
Last Name
First Name
Middle Name
Contact Number
Legal Guardian’s Name (Short Answer,Required)
Last Name
First Name
Middle Name
Contact Number
For Returning Learner (Balik-Aral) and Those Who will Transfer/Move In (Add Section)
Last Grade Level Completed (Short Answer)
Last School Year Completed (Short Answer)
Last School Attended (Short Answer)
School ID (Short Answer)
For Learners in Senior High School
Semester (Checkboxes)
1st
2nd
Track (Short Answer)
Strand (Short Answer)
If school will implement other distance learning modalities aside from face-to-face instruction, what would you prefer for your child? (Checkboxes)
Choose all that apply:
Modular (Print)
Modular (Digital)
Online
Radio-Based Instruction
Blended
Educational Television
Homeschooling
I hereby certify that the above information given are true and correct o the best of my knowledge and I allow the
Department of Education to use my child’s details to create and/or update his/her learner profile in the Learner Information System.
The information herein shall be treated as confidential in compliance with the Data Privacy Act of 2012.
Write your Name and date below to certify the above information (Short Answer)
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If you want a copy of this Online Enrollment Form, Kindly send me your email address atTECHY TEACH FB pagehttps://www.facebook.com/techyteachofficialpagePlea...
