DepEd Form .

02*E

Republika ng Pilipinas (Republic of the Philippines) Kagawaran ng Edukasyon (Department of Education) KAWANIHAN NG EDUKASY NG E!E"EN#ARYA
(BUREAU OF ELEME !AR" EDU#A!$O )

Re$iyon I (Re%ion $) D$&$'$O OF $LO#O' 'UR PA!AGIANG #A!AAN SA "A%A%ANG PAARA!AN

(ELEME !AR" '#(OOL PERMA E ! RE#ORD)

I&

Pangalan
( ame) Apelyido Unang Pangalan M.I.

Sangay

$LO#O' 'UR Paaralan M$RAMAR ELEME !AR" '#(OOL

(Division) (School) Pe'sa ng Pagpasok

Kasarian (Sex)

Pe'sa ng Kapanganakan (Date of Birth)

Pook (Place) Bayan/ ala!igan/ "ngsod

Ma%ulan%)!a%apa%*ala%a (Parent / #"ardian) Pan%alan ($a%e) !irahan (Address) (anapbuha+ (&cc"pation)

PA!AGIANG #A!AAN SA "A%A%ANG PAARA!AN (ELEME !AR" '#(OOL PRO,RE'')

Grade I ( S)$ool S)$ool Year Learnin% Areas
Periodic Ratin% Final Ratin% Remar-s

Grade II ( S)$ool S)$ool Year Learnin% Areas

Periodic Ratin% Final Ratin% Remar-s

Filipino English Mathematics Makabayan

' Si(i)a at *"lt"ra ' MS+P ' ,haracter +d"cation Eligible *or Ad+ission 'o Grade Grade III ( S)$ool S)$ool Year Learnin% Areas
Periodic Ratin% Final Ratin% Remar-s

Filipino English Mathematics Makabayan

' Si(i)a at *"lt"ra ' MS+P ' ,haracter +d"cation Eligible *or Ad+ission 'o Grade Grade I, ( S)$ool S)$ool Year Learnin% Areas
Periodic Ratin% Final Ratin% Remar-s

English Mathematics Science and Health Filipino Makabayan

' Si(i)a at *"lt"ra ' MS+P ' ,haracter +d"cation Eligible *or Ad+ission 'o Grade Grade , ( S)$ool S)$ool Year Learnin% Areas
Periodic Ratin% Final Ratin% Remar-s

English Mathematics Science and Health Filipino Makabayan

' -*S ' +PP ' MS+P ' ,haracter +d"cation Eligible *or Ad+ission 'o Grade Grade ,I ( S)$ool S)$ool Year Learnin% Areas
Periodic Ratin% Final Ratin% Remar-s

English Mathematics Science and Health Filipino Makabayan

' -*S ' +PP ' MS+P ' ,haracter +d"cation Eligible *or Ad+ission 'o Grade

English Mathematics Science and Health Filipino Makabayan

' -*S ' +PP ' MS+P ' ,haracter +d"cation Eligible *or Ad+ission 'o Grade

III& -HARA-#ER %UI!DING Gr& . . Hones'y / -our'esy 0 1 3 Help*ulness and -oopera'ion bedien)e -onsidera'ion *or '$ers S)$& Yr& / 0 1 2&R& Gr& . S)$& Yr& / 0 1 2&R& Gr& . S)$& Yr& / 0 1 2&R&

4 Spor's+ans$ip 5 Resour)e*ulness and -rea'i9eness

6 Sel*(Relian)e 7 Indus'ry .8 5 6 7 .8 -leanliness and rderliness Resour)e*ulness and -rea'i9eness Sel*(Relian)e Indus'ry -leanliness and rderliness

2&R&

2&R&

2&R&

. Hones'y / -our'esy 0 1 3 Help*ulness and -oopera'ion bedien)e -onsidera'ion *or '$ers

4 Spor's+ans$ip 5 Resour)e*ulness and -rea'i9eness

6 Sel*(Relian)e 7 Indus'ry .8 -leanliness and rderliness A ( u's'anding % ( ,ery Sa'is*a)'ory I,& A##ENDAN-E RE- RD
Grade No& o* S)$ool Days No& o* S)$ool Days Absen' -ause No& o* #i+es #ardy -ause No& o* S)$ool Days Presen'

- ( Sa'is*a)'ory D ( Needs I+pro9e+en'

-ER#I2I-A#E #

2 #RANS2ER

WH " I# "AY - N-ERN: !his is to certif+ that this is a true record of the Elementar+ 'chool Permanent record of 3 (e)'he is eli%ible for transfer and admission to ,rade)"ear 3 'i%nature

Date

Desi%nation