NAMEGENDERAGELearner Reference Number (LRN)NAMEGENDERAGELearner Reference Number (LRN)

1. 11.

2. 12.

3. 13.

4. 14.

5. 15.

6. 16.

7. 17.

8. 18.

9. 19.

10. 20.

NETRC FORM 1LIST OF ACTUAL EXAMINEES(To be accomplished by the Room Examiner)

REGION: _____________________________________ DIVISION: ________________________________________SCHOOL: _____________________________________ SCHOOL ID:_________________________ADDRESS:____________________________________ Number of Male:_________Number of Female:______Total________GRADE LEVEL: _______________________

IMPORTANT1. Names listed as they appeared in the Seat Plan. __________________________________________________2. Check if the LRN of each examinee listed in Form 1 matches Room Examiner With the shaded LRN in the front side of his/her Scannable Answer Sheet. ___________________________________________________ School