REPUBLIKA NG PILIPINAS

(Republic of the Philippines)

KAGAWARAN NG EDUKASYON
(Department of Education)
Rehiyon 10
SANGAY NG MGA PAARALANG PANGLUNGSOD
Division of Gingoog

DepEd FORM 137 - E
PALAGIANG TALAAN SA MABABANG PAARALAN LRN:128021120122
(ELEMENTARY SCHOOL PERMANENT RECORD)

I. Pangalan YAMSON JEANLY E. Purok GINGOOG Paaralan STA. RITA ELEM. SCHOOL
(Name) Apelyido Unang ngalan M.I. (Division) (School)

Kasarian F Petsa ng Kapanganakan 09-09-06 Pook SANTIAGO G.C. Petsa ng Pagpasok JUNE 3, 2013
(Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod (Date of Entrance)
(Town/Province/City)
Magulang/Tagapag-alaga MILAGROS YAMSON SANTIAGO GINGOOG CITY
Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

II. PAG-UNLAD SA MABABANG PAARALAN
(ELEMENTARY SCHOOL PROGRESS)

Grade I School STA. RITA ELEMENTARY SCHOOL Grade II School _ ________________________
School Year 2013-2014 School Year ___________
Learning Areas
Periodic Rating
FINAL RATING

Learning Areas
Periodic Rating
FINAL RATING
1 2 3 4 1 2 3 4
Mother Tongue


Mother Tongue

Filipino


Filipino

English


English

Mathematics

Mathematics

Araling Panlipunan

Araling Panlipunan

EPP/TLE

EPP/TLE

MAPEH


MAPEH

Music


Music

Art


Art

Physical Education


Physical Education

Health


Health

Edukasyon sa Pagpapakatao


Edukasyon sa Pagpapakatao


General Average
General Average

Eligible for Admission to Grade ___II__ Eligible for Admission to Grade ___________ __

Grade III School ________________________________ Grade IV School _______________________________
School Year ________________ School Year ________________
Learning Areas
Periodic Rating
FINAL RATING

Learning Areas
Periodic Rating
FINAL RATING
1 2 3 4 1 2 3 4
Mother Tongue
Mother Tongue

Filipino
Filipino

English
English

Mathematics
Mathematics

Araling Panlipunan
Araling Panlipunan

EPP/TLE
EPP/TLE

MAPEH
MAPEH

Music
Music

Art
Art

Physical Education
Physical Education

Health
Health

Edukasyon sa Pagpapakatao

Edukasyon sa Pagpapakatao

General Average General Average



Eligible for Admission to Grade ____________ Eligible for Admission to Grade ____________


Grade V School ________________________________ Grade VI School _______________________________
School Year ________________ School Year ________________
Learning Areas
Periodic Rating
FINAL RATING

Learning Areas
Periodic Rating
FINAL RATING
1 2 3 4 1 2 3 4
Mother Tongue
Mother Tongue

Filipino
Filipino

English
English

Mathematics
Mathematics

Araling Panlipunan
Araling Panlipunan

EPP/TLE
EPP/TLE

MAPEH
MAPEH

Music
Music

Art
Art

Physical Education
Physical Education

Health
Health

Edukasyon sa Pagpapakatao

Edukasyon sa Pagpapakatao

General Average General Average

Eligible for Admission to Grade _____________ Eligible for Admission to Grade _____________

Legend:
Beginning (B) 74% and above Proficient (P) 85-89 %
Developing (D) 75-79% Advance (A) 90 % and above
Approaching Proficiency (AP) 80-84 %



III. CHARACTER BUILDING
Traits Gr. _I_ Sch. Yr. 2013-2014 Gr. __Sch. Yr. ________ Gr. ___ Sch. Yr. _________
1 2 3 4 F.R. 1 2 3 4 F.R. 1 2 3 4 F.R.
1. Honesty

2. Courtesy

3. Helpfulness and
Cooperation


4. Resourcefulness and
Creativity


5. Consideration for Others

6. Sportsmanship

7. Obedience

8. Self-Reliance

9. Industry

10. Cleanliness and
Orderliness




Traits
Gr. ___ Sch. Yr. ______ Gr. ___ Sch. Yr. _____ Gr. ___ Sch. Yr. ______
1 2 3 4 F.R. 1 2 3 4 F.R. 1 2 3 4 F.R.
1. Honesty
2. Courtesy
3. Helpfulness and
Cooperation

4. Resourcefulness and
Creativity

5. Consideration for Others
6. Sportsmanship
7. Obedience
8. Self-Reliance
9. Industry
10. Cleanliness and
Orderliness



Guidelines for Rating
A. Outstanding B. Very Good C .Good D. Fair E. Poor

IV. ATTENDANCE RECORD

Grade
No. of
School
Days
No. of School
Days Absent
Cause
No. of
Times
Tardy
Cause
No. of School Days
Present











CERTIFICATE OF TRANSFER

TO WHOM IT MAY CONCERN:

This is to certify that this is a true record of the Elementary School Permanent Record of
_____________________________________________. He/She is eligible for transfer and admission to
Grade/Year ______________________

___________________________________
Signature

______________________ ____________________________________
Date Designation