Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF ZAMBOANGA DEL NORTE
UBAY NATIONAL HIGH SCHOOL

Name of Adviser : Burdago, Juliet D. Age: 35 Sex : Female

Year Level/Section: Grade 11 HUMMS 2
No. of Male Students: 15
No. of Female Students: 14
Total: 29
Child with Disability: Name: NONE Age:____ Sex: _____ Disability: ________________
Age Bracket:
Age 13 ____ Age 14____ Age 15 1 Age 16__8__ Age 17__6__
Age 18__6__ Age 19__3__ Age 20____ Age 21____ Age 22 -25__1__

SCHOOL WATCHING CHECKLIST ( DO 23 S 2015)

Broken windows
Slippery pathways
Blocked corridors
Heavy objects mounted on cabinets/shelves
Flooded area
Busted plugs/light bulbs/electrical facilities
Exposed electrical wires
Protruding nails from chairs and tables
Broken door knobs
Warning signs for slippery pathways/corridors
Plants mounted on building railings
Flooding
Exposed chemicals and liquids
Lack/absence of storage for equipment
Unlabeled chemicals
Dripping ceilings
Open pit
Stagnant water
Unpruned trees/bushes/shrubs
Open/Clogged canals
No ramps for elevated school buildings or other facilities
Swing-in doors
Broken/dilapidated ceiling
Open/incomplete perimeter fence
Presence of stray animals inside the school campus
Presence of electrical post/transformer near or within the school perimeter
No system of learner release to parents during emergencies
No posted emergency hotlines around the school
Garbage Area (Segregation of Biodegradable and Non-Biodegradable)
Detached or peeled off GI sheet
Broken toilet bowl and/or sinks
Broken chairs/desks/tables
Blocked/no emergency exits
Unmounted cabinets/shelves
Medical kits in every classroom
Bells/alarms
Condemnable building (i.e. very old structure, collapsing building and/or prominent cracks on classroom walls)
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF ZAMBOANGA DEL NORTE
UBAY NATIONAL HIGH SCHOOL
YEAR/SECTION: GRADE 11 HUMMS 2
NAME ADDRESS DATE OF BIRTH PARENTS
1. Babor, Wingston La Union, Lab. Z.N 08/ 19/01 Roselyn Babor
2. Ban, John Lester Upper La Union Lab. Z.N 03/16/01 Lynne Ban
3. Datoy, Efren Bobongan Lab. Z.N. 01/09/99 Jaime Datoy
4. Digamon, John Dave Ubay Lab. Z.N 12/19/00 Ronilla Digamon
5. Esolana, Shane Patrick Lower La Union Lab. Z.N 05/22/01 Ronnie Esolana
6. Galon, Mark Anthony Gil Sanchez Lab. Z.N 11/23/01 Remilyn Galon
7. Gumoba, Arprech Lapatan Lab. Z.N 06/03/02 Aida Gumoba
8. Ligoro, Franklin III Lapatan, Lab Z.N 07/22/01 Franklin Ligoro jr.
9. Lozada, Fernando Antonino Lab. Z.N 11/23/00 Lito Lozada
10. Mamenta, Christian La Union, Lab. Z.N 12/25/00 Merry Anne Mamenta
11. Patrocenio, Isobel Emilda, Lab. Z.N 05/31/00 Ronnie Patrocenio
12. Sumicad, Axl Greg Antonino, Lab. Z.N 12/23/01 Airene Sumicad
13. Villafuerte, Elcid Ubay, Lab. Z.N 10/13/01 Esidra Awa
14. Villarojo, Alvin Lopoc, Lab. Z.N 03/07/00 Alejandro Villarojo
15. Bentazar, Kurt Ubay, Lab.Z.N 08/04/02 Riel Bentazar
16. Aguilar, Angelie Antonino, Lab. Z.N 10/14/00 Ariel Aguilar
17. Ba-ay, Sharen Key Lopoc, Lab. Z.N 07/24/01 Richard Ba-ay Jr.
18. Anog, Mary Francine Lopoc, Lab.Z.N 03/ 11 /01 Maribet Anog
Kate
19. Bagundol, Gia Lapatan, Lab. Z.N 08/ 09/ 01 Alejandro Bagundol
20. Balaki, Mariel Fatima, Kalawit Z.N
21. Cabasag, Jezzriel Dawn Lapatan, Lab. Z.N 07/ 19/ 97 Evelyn Cabasag
22. Quizon, Jody Mae Lopoc, Lab. Z.N 12/ 17/ 01 Melody Quizon
23. Dinoy, Chriselle Lopoc, Lab. Z.N 10/ 14/ 99 Liberato Dinoy
24. Dologan, Jessabelle Lapatan, Lab. Z.N 08/ 01/ 99 Vilma Dologan
25. Egason, Jayan San Isidro, Lab. Z.N 12/ 10/ 01 Norma Egason
26. Garan, Lorena La Union, Lab. Z.N 08/ 16/ 00 Merly Garan
27. Grapia, Margelyn Antonino, Lab. Z.N 05/15/00 Jenelyn Grapia
28. Omongos, Ivy Osukan, Lab. Z.N 12/ 07/ 01 Emelda Omongos
29. Raya, Merry Anne Lapatan, Lab. Z.N 01/ 23/ 00 Merlyn Raya
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