UNFI ALS Application Form

Type of application*

New registrantContinuing
Please input the exact data as how it appears in your birth certificate and other legal documents. And kindly, do not CAPITALIZE your inputs. Thank you.

Gamitin ang eksatong datos kung paano ito nababasa sa mga legal na dokumento ninyo. Pakiusap lang na huwag mag-type ng naka-ALL CAPS. Salamat.
Last Name*
Including name extensions
First Name*
Complete first name
Middle Name*
use a single dash (-) if no middle name
Sex*
Date of Birth*

MonthDayYear
Date
Age*
Mother Tongue*
(your first language)
IP (Yes or No)*
Indigenous People (tribal groups)
Religion*
House No./Street/Sitio/Purok*
House No. / Street / Sitio
Barangay*
Municipality / City*
Municipality / City*
Province*
Region*
Father's Name
(Last Name, First Name, Middle Name)
Mother's Maiden Name*
(Last Name, First Name, Middle Name)
Contact Number of Learner
if available
Last Grade Level Completed in Formal School*
Date Mapped*

MonthDayYear
When you inquired about ALS
Interested in ALS?*
If Yes, preferred program
If already enrolled in ALS, provide date of first attendance (DOFA) and/or LRN
N/A if not applicable

Acknowledgement
UPLOAD PSA BIRTH CERTIFICATE*

Browse Files
If none, you may temporarily submit any document that shows your name and birthday. Deadline for PSA copy is December of the registered school year. Cancelof
UPLOAD PHOTO ID*

Browse Files
Plain white background, passport size, with name tag Cancelof
I hereby certify that the above information given are true and correct to the best of my knowledge and I allow the Department of Education to use my/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, as well as UNFI's Data Privacy Policy.
ALS Teacher / Community ALS Implementer / Learning Facilitator: Signature and Date (for official use only)

Clear
Learner: Signature and Date

Clear
Date Filled*

MonthDayYear
Should be Empty: