The document contains an examinee's answer sheet for an assessment. It includes personal information like name, birthdate, gender, school, and community type. The answer sheet contains grids for examinees to fill in their responses to test questions using pencil. There are also descriptive questions about programs the examinee or family may participate in.

1. LAST NAME FIRST NAME EXAMINEE NO.
A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A
B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B B
C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C C
D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D D
E E E E E E E E E E E E E E E E E E E E E E E E E E E E E E E E E E E E
F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F
G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G
H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H H
I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I
J J J J J J J J J J J J J J J J J J J J J J J J J J J J J J J J J J J J
K K K K K K K K K K K K K K K K K K K K K K K K K K K K K K K K K K K K
L L L L L L L L L L L L L L L L L L L L L L L L L L L L L L L L L L L L
M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M M
N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N N
O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O
P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P
Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q Q
R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R R
S S S S S S S S S S S S S S S S S S S S S S S S S S S S S S S S S S S S
T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T T
U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U U
V V V V V V V V V V V V V V V V V V V V V V V V V V V V V V V V V V V V
W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W W
X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X
Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z Z
Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Ñ Boy
-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Girl
A 0 0 0 0 0 0 0 0 JAN
B 1 1 1 1 1 1 1 1 FEB
C 2 2 2 2 2 2 2 2 0 0 0 0 0 0 0 0 0 0 0 0 MAR 0 0 0 0 6 0 6 0 0 0
D1 3 3 3 3 3 3 3 1 1 1 1 1 1 1 1 1 1 1 1 APR 1 1 1 1 7 1 7 1 1 1
D2 4 4 4 4 4 4 4 2 2 2 2 2 2 2 2 2 2 2 2 MAY 2 2 2 2 8 2 8 2 2 2
E 5 5 5 5 5 5 5 3 3 3 3 3 3 3 3 3 3 3 3 JUN 3 3 3 3 9 3 9 3 3 3
F 6 6 6 6 6 6 6 4 4 4 4 4 4 4 4 4 4 4 4 JUL 4 4 4 4 4 4 4
G 7 7 7 7 7 7 7 5 5 5 5 5 5 5 5 5 5 5 5 AUG 5 5 5 5 5 5 5
H 8 8 8 8 8 8 8 6 6 6 6 6 6 6 6 6 6 6 6 SEP 6 6 6 6 6 6 6
I 9 9 9 9 9 9 9 7 7 7 7 7 7 7 7 7 7 7 7 OCT 7 7 7 7 7 7 7
J 8 8 8 8 8 8 8 8 8 8 8 8 NOV 8 8 8 8 8 8 8
K 9 9 9 9 9 9 9 9 9 9 9 9 DEC 9 9 9 9 9 9 9
L
M
N
P ● Use No. 1 or No. 2 pencil only.
R YES DONT KNOW U Urban ● Do not use ink, ballpoint or felt tip pens.
NO R Rural ● Make solid marks that fill the response
YES NO 0 0 completely.
1 1 ● Erase cleanly any marks you wish to change.
NUMBER OF SHIFTS PER DAY (G3) 1 2 3 4 2 2 ● Make no stray marks on this form.
3 3
4 4
5 5
6 6 A B C D A B C D
Central / Pilot Elementary School Multi-Grade School 7 7 A B C D
Non-Central Elementary School State College/University ES 8 8 A B C D
Primary School Madaris School 9 9
1. A B C D E F G H I J K L M N O P Q R S T 6. A B C D E F G H
2. A B C D E F G H I J K L M N O P Q R S T 7. A B C D E F G H
3. A B C D E F G H I J K L M N O P Q R S T 8. A B C D E
4. A B C D E F G H I J K L M N O P Q R S T 9. A B C D E
5. A B C D E F G H 10. A B C
11. A B C D E F G
EXAMPLE
ELEMENTARY SCHOOL TYPE
RIGHT WRONG
EXAMINEE'S DESCRIPTIVE QUESTIONNAIRE (EDQ)
ARMM Do you belong to a class/section?
CARAGA section with Special
Science Curriculum?
FOR THOSE IN PUBLIC
SCHOOLS ONLY:
TYPE OF
COMMUNITY
How many are
MARKING INSTRUCTIONS
CAR you in your
7
8
9
10
11
12
NCR
2
3
4A
4B
5
6
1
DAY YEAR English Filipino
GENDER
Is your family a
recipient of Pantawid
Pamilya Pilipino
Program?
NATIONAL EDUCATION TESTING & RESEARCH CENTER
LANGUAGE ASSESSMENT FOR PRIMARY GRADES
Answer Sheet
NAME:
MI
REG DIV SCHOOL ID
LEARNER REFERENCE NUMBER (LRN)
BIRTHDATE LATEST
GRADE AGE
MONTH
DEPARTMENT OF EDUCATIONDEPARTMENT OF EDUCATION
B
A
R
C
O
D
E

2. B
A
R
C
O
D
E