DepEd Form 137-E Republika ng Pilipinas

(Republic of the Philippines)

Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYONG ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)

Rehiyon XI
(Region XI)
DIVISION OF DAVAO CITY

PALAGIANG TALAAN SA MABABANG PAARALAN

(ELEMENTARY SCHOOL PERMANENT RECORD)

I. Pangalan Sangay Paaralan

(Name) Apelyido Unang Pangalan M.I. (Division) (School)

Kasarian Petsa ng Kapanganakan Pook Petsa ng Pagpasok

(Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod

Magulang/Tagapag-alaga
(Parent / Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

PALAGIANG TALAAN SA MABABANG PAARALAN

(ELEMENTARY SCHOOL PROGRESS)
Grade I - School Grade II - School
School Year School Year

Periodic Rating Final Periodic Rating Final

Learning Areas Rating
Remarks Learning Areas Rating
Remarks
1 2 3 4 1 2 3 4
English English
Mathematics Mathematics
Filipino Filipino
Makabayan Makabayan
* Sibika at Kultura * Sibika at Kultura
* MSEP * MSEP
* Character Education * Character Education

Eligible for Admission to Grade Eligible for Admission to Grade

Grade III - School Grade IV - School

School Year School Year

Periodic Rating Final Periodic Rating Final

Learning Areas Rating
Remarks Learning Areas Rating
Remarks
1 2 3 4 1 2 3 4
English English
Mathematics Mathematics
Science and Health Science and Health
Filipino Filipino
Makabayan Makabayan
* Sibika at Kultura * HKS
* MSEP * EPP
* Character Education * MSEP
* Character Education
Eligible for Admission to Grade Eligible for Admission to Grade

Grade V - School Grade VI - School

School Year School Year

Periodic Rating Final Periodic Rating Final

Learning Areas Rating
Remarks Learning Areas Rating
Remarks
1 2 3 4 1 2 3 4
English English
Mathematics Mathematics
Science and Health Science and Health
Filipino Filipino
Makabayan Makabayan
* HKS * HKS
* EPP * EPP
* MSEP * MSEP
* Character Education * Character Education
Eligible for Admission to Grade Eligible for Admission to Grade
III. CHARACTER BUILDING

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
Helpfulness and
3
Cooperation
4 Obedience
Consideration for
5
Others
6 Sportsmanship
Resourcefulness and
7
Creativeness
8 Self-Reliance

9 Industry
Cleanliness and
10
Orderliness

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
Helpfulness and
3
Cooperation
4 Obedience
Consideration for
5
Others
6 Sportsmanship
Resourcefulness and
7
Creativeness
8 Self-Reliance

9 Industry
Cleanliness and
10
Orderliness
A - Outstanding C - Satisfactory
B - Very Satisfactory D - Needs Improvement
IV. ATTENDANCE RECORD

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

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