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ICTS - User Support Division
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Learner Information System (LIS) and Basic Education Information System (BEIS)
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National Helpdesk
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Unmerging of LRN (Request Form 04)
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Definition:is a process of rectifying data of two different learners
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Submit to:Division Planning Officer, Schools Governance and Operations Division
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Note:Endorsement of School Head is required (signed and scanned). Please use worksheet/excel format for the matrix.
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Present and Correct EnrollmentLearner's Personal Information
(as appeared in Birth Certificate)		Remarks
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Region-DivisionSchool NameSchool IDGradeSectionDate of First Attendance
(MM/DD/YYYY)		LRNFirst NameMiddle NameLast NameExt NameDate of Birth
(MM/DD/YYYY)		SexMother's Maiden Name
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Requested byTeacher/ICT CoordinatorSchool's Email AddressSchool's Contact NumberSchool Head/System Admin UsernameDate RequestedEndorsed by
School Head		Signature
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Name
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Position/Designation
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Note for School:
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1. Fill-up the form correctly and completely
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2. Attach this form as Excel file
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3. Attach a scanned copy of the form with School Head signature
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4. Attach the following copies:
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a. Birth Certificate
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b. Form 137/School Form 10 and/or Form 138/School Form 9
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5. Data of both learners must be encoded
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Note for Division Planning Officer:
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1. Consolidate requests by school by issue
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