ALS FORMS

1-5

DR. CIELITO FE C. ANGELES

 A list of potential ALS learners identified during mapping activities

ALS FORM 1
(AF-1)

List of
Mapped
Learners Name and Code:  List of Mapped Learners (AF1)
Person Responsible:  Facilitator
Schedule:  December of each Calendar Year
Instruction/s:  This shall be prepared by ALS Implementer
 A basic information sheet of
individuals who signified
interest to enroll in ALS
program

ALS FORM 2 • Name and Code: ALS

(AF-2) Enrolment Form (AF-2)
• Person
Enrolment Responsible: Facilitator
• Instructions: This will be
Form accomplished as soon as the
learner decides to participate
in the ALS Program. The
ALS facilitator shall
guide/assist the potential
learner in accomplishing this
form
 A record of learners who are officially enrolled in ALS classes and their individual
assessment status at the end of the program for the calendar year.

ALS FORM 3
(AF-3)
Masterlist of
Enrolled
Learners with
End of Name and Code:  ALS Form 3 Masterlist of Enrolled Learners with End of
Program Program Status (AF-3)
Person Responsible:  Test Registration Officer – DASLC
Status Schedule: 
Instructions: 
Quarterly
The facilitator shall include all learners who actually started
 A list of
candidates
qualified to take
the A&E
accreditation and
equivalency exam

• Name and Code: ALS

ALS FORM 4 Form 4 Masterlist of
A&E Registrants (AF-4)
(AF-4) • Person
Responsible: Test
Registration Officer –
DASLC
Masterlist of • Instructions: Submit to
Division ALS In-
A&E Charge/Division Testing
Coordinator
Registrants
 Learner’s Permanent
Record (AF-5)

A record of learner’s
basic personal profile
and learning
ALS FORM 5 performance
LEARNERS
PERMANENT • The Learner Permanent
RECORD Record for ALS is to be
accomplished as soon as
(AF-5) the Facilitator has
conducted “End of
Program”
assessment/evaluation of
the learner’s
performance.
 Learner’s Permanent Record (AF-5)
A record of learner’s basic personal profile and learning performance.

Data Element Description

Name of the Regional Office as created by DepEd, headed by a Regional Director who
Region oversees the operation of the Schools Division Office where the CLC is situated

Name of the Schools Division Office where the CLC is situated as created by DepEd, supervised by a
Division Schools Division Superintendent

ALS FORM 5
Name of the Public Schools District where the CLC is located as created by DepEd, supervised by a
District Public Schools District Supervisor

LEARNERS Learner Reference

Unique twelve-digit identification number assigned to a learner to keep track of his/her progress through
the basic education cycle, regardless of transfer to another school or learning center in the public or

PERMANENT Number (LRN) private sector and promotion/moving up from the elementary to the secondary level (DO No. 22, s.
2012)

RECORD Last Name

Learner’s last name as reflected in the birth certificate issued by the NSO/PSA or any equivalent
document

(AF-5) First Name

Learner’s first name as reflected in the birth certificate issued by the NSO/PSA or any equivalent
document

Learner’s middle name as reflected in the birth certificate issued by the NSO/PSA or any equivalent
Middle Name document

Learner’s extension name (if any) as reflected in the birth certificate issued by the NSO/PSA or any
Name Extension equivalent document. Normally placed along with First Name.

Learner’s biological category based on reproductive function, either Male or Female, as reflected in the
Sex NSO/PSA-issued birth certificate or any relevant document
 Learner’s Permanent Record (AF-5)
A record of learner’s basic personal profile and learning performance.

Data Element Description

Calendar Year Twelve-month period starting with January 1 and ending with December 31

Similar to class organization in a formal school, the community learning center (CLC) is referring
to a facility/venue that the learning session is being conducted.

Types of CLC:

ALS FORM 5 Type 1: Simple, temporary (makeshift) meeting place with tables and chairs, chalkboard (shared
use with community chapel or any multipurpose facility owned/managed by barangay authority
LEARNERS or any private facility temporarily loaned for learning purposes

PERMANENT Type 2: Semi-concrete structure mostly made of light materials such as nipa and softwood,
dedicated to ALS learning sessions and related activities, equipped with basic furniture and

RECORD Type of CLC learning equipment

Type 3: Typical barangay learning center or facility made of concrete building materials
(AF-5) dedicated to ALS learning sessions and related activities. The facility is equipped with basic
furniture and learning equipment such as but not limited to chairs, tables, chalkboard or library
corner.

Type 4: Two-storey or higher building fully equipped with basic furniture and advanced ICT
equipment for learning dedicated to ALS learning sessions and related activities

Type 5: The learning materials are being transported from one place to another or from house to
house of individual interested to learn through ALS programs
 Learner’s Permanent Record (AF-5)
A record of learner’s basic personal profile and learning performance.
Description
Data Element

Learner attended learning session in any of the following:

Basic Literacy Program (BLP)
Program Enrolled
Accreditation and Equivalency Program (A&E) – Elementary
Accreditation and Equivalency Program (A&E) – Secondary

ALS FORM 5 Delivery Mode Mode of Delivery/intervention given to a learner

LEARNERS Learner’s Address

Refers to the location where the learner currently holds residence with specific
details in the order indicated: House No./Street/Sitio/Purok, Barangay,
PERMANENT Municipality/City, and Province

RECORD Name of Facilitator

The person in the CLC assigned to guide & direct a specific class and actual
teaching to his/her assigned class and other classes, if there is any.
(AF-5) Score in the Personal Information Sheet that determines the level of literacy
PIS Score
rate of a learner.
Non Literate

Neo Literate A score of a learner based on the ABL

 Learner’s Permanent Record (AF-5)
A record of learner’s basic personal profile and learning performance.
Data Element Description
Post Literate

FLT Score in Reading A score of a Learner based on the FLT- Reading

FLT Score in Numeracy A score of a Learner based on the FLT- Numeracy

FLT Score in Writing A score of a Learner based on the FLT -Writing

FLT Score in Listening & Speaking A score of a Learner based on the FLT-Listening and Speaking

ALS FORM 5 Overall Score Total score of Functional Literacy Test

LEARNERS Remarks Note if NC or COC was received by the learner

PERMANENT Test Taken

Date of Examination
Level of A&E Exam taken by a learner

Actual date of A&E Exam

RECORD Testing Center Name of the Testing Center where the A&E Exam took place

(AF-5) Location of Testing Center Location of the Testing Center

A&E Test Result Result of the Accreditation and Equivalency Test / Certificate of Rating

Eligible for admission to Learner may be admitted to formal school or other learning institution

EPS-ALS Name and signature of the ALS Supervisor attesting to correctness of the data

Facilitator Name and signature of the teacher who prepared the form

Certificate of Transfer Eligibility of learner to transfer or continue study in a certain level