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 I
Region I
PALAGIANG TALAAN SA MABABANG PAARALAN
(ELEMENTARY SCHOOL PERMANENT RECORD)

I. Pangalan Sangay: ILOCOS SUR Paaralan: MIRAMAR ELEMENTARY SCHOOL

(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

General Average General Average

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

General Average General Average

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
General Average General Average
Eligible for Admission to Grade Eligible for Admission to Grade
MENTARYA
ION)

PAARALAN
ECORD)

MIRAMAR ELEMENTARY SCHOOL

PAARALAN
ESS)

Remarks

Remarks

Remarks
III. CHARACTER BUILDING ACTIVITIES

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 Obedience

5 Consideration for Others

6 Sportsmanship

7 Resourcefulness and Creativeness

8 Self-Reliance

9 Industry

10 Cleanliness and Orderliness

11 Promptness and Punctuality

12 Sense of Responsibility

13 Love of God

14 Patriotism/Love of Country

AVERAGE

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 Obedience

5 Consideration for Others

6 Sportsmanship

7 Resourcefulness and Creativeness

8 Self-Reliance

9 Industry

10 Cleanliness and Orderliness

11 Promptness and Punctuality

12 Sense of Responsibility

13 Love of God

14 Patriotism/Love of Country

AVERAGE
A - Outstanding C - Good E - Poor
B - Very Good D - Fair

IV. ATTENDANCE RECORD

No. of Times
Grade No. of School Days No. of School Days Absent Cause Cause No. of School Days Present
Tardy
One
Two
Three
Four
Five
Six

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