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SF10-ES Republic of the Philippines

Department of Education

Learner Permanent Record for Elementary School (SF


(Formerly Form 137)

LEARNER'S PERSONAL INFORMATION

LAST NAME: FIRST NAME: NAME EXTN. (Jr,I,II)

Learner Reference Number (LRN): ______________ Birthdate (mm/dd/yyyy):


ELIGIBILITY FOR ELEMENTARY SCHOOL ENROLMENT
Credential Presented for Grade 1: Kinder Progress Report ECCD Checklist
Name of School: School ID: Address of School:
Other Credential Presented
PEPT Passer Rating: _________ Date of Examination/Assessment (mm/dd/yyyy): ____________
Name and Address of Testing Center:____________________________________________________ Remark:
SCHOLASTIC RECORD

School: ____________________________________ School ID: School: _______________________


District: ______________________ Division: _______________ Region: District: ______________________ D
Classified as Grade: ______ Section: __________ School Year: Classified as Grade: ______ Section
Name of Adviser/Teacher: ______________________Signature: Name of Adviser/Teacher: ________
Quarterly Rating Final
LEARNING AREAS Remarks Learning Areas
1 2 3 4 Rating

Mother Tongue Mother Tongue

Filipino Filipino
English English
Mathematics Mathematics

Science Science
Araling Panlipunan Araling Panlipunan

EPP / TLE EPP / TLE


MAPEH MAPEH
Music Music

Arts Arts
Physical Education Physical Education

Health Health
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao
*Arabic Language *Arabic Language

*Islamic Values Education *Islamic Values Education


General Average General Average
Remedial Classes Conducted from: to Remedial Classes
Remedial Class Recomputed
Learning Areas Final Rating Remarks Learning Areas
Mark Final Grade

School: ____________________________________ School ID: School: _______________________


District: ______________________ Division: _______________ Region: District: ______________________ D
Classified as Grade: ______ Section: __________ School Year: Classified as Grade: ______ Section
Name of Adviser/Teacher: ______________________Signature: Name of Adviser/Teacher: ________

Quarterly Rating Final


Learning Areas Remarks Learning Areas
1 2 3 4 Rating

Mother Tongue Mother Tongue


Filipino Filipino

English English
Mathematics Mathematics
Science Science

Araling Panlipunan Araling Panlipunan


EPP / TLE EPP / TLE

MAPEH MAPEH
Music Music
Arts Arts

Physical Education Physical Education


Health Health

Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao


*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Education
General Average General Average
Remedial Classes Date Conducted: to Remedial Classes
Remedial Class Recomputed
Learning Areas Final Rating Remarks Learning Areas
Mark Final Grade
ool (SF10-ES)

MIDDLE NAME:

Sex:
MENT
Kindergarten Certificate of Completion

Others (Pls. Specify): _________________________


Remark:____________________________________

_______________ School ID:


________ Division: ________ Region:
___ Section: ____ School Year:
______________ Signature:
Quarterly Rating Final
as Remarks
1 2 3 4 Rating

ion
Conducted from: to
Remedial Recomputed
Final Rating Remarks
Class Mark Final Grade

_______________ School ID:


________ Division: ________ Region:
___ Section: ____ School Year:
______________ Signature:

Quarterly Rating Final


as Remarks
1 2 3 4 Rating

ion

Date Conducted: to
Remedial Recomputed
Final Rating Remarks
Class Mark Final Grade

SFRT 2017
SF10-ES
SCHOLASTIC RECORD
School: _____________________________________ School ID: School: _______________
District: ______________________ Division: ________________Region: District: _______________
Classified as Grade: ______ Section: __________ School Year: Classified as Grade: _____
Name of Adviser/Teacher: ______________________Signature: Name of Adviser/Teacher:

Quarterly Rating Final


LEARNING AREAS Remarks Learning Area
1 2 3 4 Rating

Mother Tongue Mother Tongue


Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan Araling Panlipunan
EPP / TLE EPP / TLE
MAPEH MAPEH
Music Music
Arts Arts
Physical Education Physical Education
Health Health
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Educati
General Average General Average
Remedial Classes Date Conducted: to Remedial Classes
Remedial Class Recomputed
Learning Areas Final Rating Remarks Learning Areas
Mark Final Grade

School: _____________________________________ School ID: School: _______________


District: ______________________ Division: ________________Region: District: _______________
Classified as Grade: ______ Section: __________ School Year: Classified as Grade: _____
Name of Adviser/Teacher: ______________________Signature: Name of Adviser/Teacher:

Quarterly Rating Final


Learning Areas Remarks Learning Area
1 2 3 4 Rating

Mother Tongue Mother Tongue


Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan Araling Panlipunan
EPP / TLE EPP / TLE
MAPEH MAPEH
Music Music
Arts Arts
Physical Education Physical Education
Health Health
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Educati
General Average General Average
Remedial Classes Date Conducted: to Remedial Classes
Remedial Class Recomputed
Learning Areas Final Rating Remarks Learning Areas
Mark Final Grade

For Transfer Out /Elementary School Completer Only


CERTIFICATION
I CERTIFY that this is a true record of ___________________________________ with LRN ___________________ and tha
School Name: __________________________________ School ID ________________ Division: ___________ Last Schoo

____________________________________
Date Name of Principal/School Head over Printed Name

CERTIFICATION
I CERTIFY that this is a true record of ___________________________________ with LRN ___________________ and tha
School Name: __________________________________ School ID ________________ Division: ___________ Last Schoo

____________________________________
Date Name of Principal/School Head over Printed Name

CERTIFICATION
I CERTIFY that this is a true record of ___________________________________ with LRN ___________________ and tha
School Name: __________________________________ School ID ________________ Division: ___________ Last Schoo

____________________________________
Date Name of Principal/School Head over Printed Name
May add Certification Box if needed
Page 2 of ________

________________________ School ID:


_________________ Division: ________ Region:
Grade: ______ Section: ____ School Year:
er/Teacher: ______________ Signature:

Quarterly Rating Final


arning Areas Remarks
1 2 3 4 Rating

punan

ucation

papakatao
guage
ues Education
age
ses Date Conducted: to
Remedial Recomputed
g Areas Final Rating Remarks
Class Mark Final Grade

________________________ School ID:


_________________ Division: ________ Region:
Grade: ______ Section: ____ School Year:
er/Teacher: ______________ Signature:

Quarterly Rating Final


arning Areas Remarks
1 2 3 4 Rating

e
punan

ucation

papakatao
guage
ues Education
age
ses Date Conducted: to
Remedial Recomputed
g Areas Final Rating Remarks
Class Mark Final Grade

____ and that he/she is eligible for admission to Grade ________.


_ Last School Year Attended: _________________________

(Affix School Seal here)

____ and that he/she is eligible for admission to Grade ________.


_ Last School Year Attended: _________________________

(Affix School Seal here)

____ and that he/she is eligible for admission to Grade ________.


_ Last School Year Attended: _________________________
(Affix School Seal here)
SFRT Revised 2017

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