REPUBLIC OF THE PHILIPPINES SAMPLE FOR JHS

DEPARTMENT OF EDUCATION
REGION III
SCHOOLS DIVISION OFFICE OF CITY OF MALOLOS
DepEd FORM137-A City of Malolos, Bulacan
Tel./Fax NO. (044) 305-1523/1521

Identification _____________ on Copy of this record sent to principal of

______________________________ SECONDARY STUDENT'S ______________________________
______________________________ School on ______________________
Principal PERMANENT RECORD Principal

Name: Date of Birth: Year Month Day

Learners' Reference Number (LRN:)
Place of Birth: Province Town Brgy.
Parent or Guardian: Occupation:
Address of Parent or Guardian:
Intermediate course completed (School) Year General Average:
Total number of years in school to compelte elementary course

CLASSIFIED AS Total Number of years in school to date:

Grade School School Year: 20 ____

Grading Periods
Grade Level Subject Final Grade Action Taken
1 2 3 4
FILIPINO
ENGLISH
MATHEMATICS
SCIENCE
ARALING PANLIPUNAN (AP)
TECHNOLOGY AND LIVELIHOOD EDUCATION
(TLE)
MAPEH
MUSIC
ARTS
PE
HEALTH
EDUKASYON SA PAGPAPAKATAO (ESP)

Promoted to Retained in Gen. Average:

Lacks unit in Has advanced unit in

June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar Apr TOTAL
Number of school days
Number of school days present
Number of school days absent

CLASSIFIED AS Total Number of years in school to date:

Grade School School Year: 20 ____

Grading Periods
Grade Level Subject Final Grade Action Taken
1 2 3 4
FILIPINO
ENGLISH
MATHEMATICS
SCIENCE
ARALING PANLIPUNAN (AP)
TECHNOLOGY AND LIVELIHOOD EDUCATION
(TLE)
 MAPEH
MUSIC
ARTS
PE
HEALTH
EDUKASYON SA PAGPAPAKATAO (ESP)

Promoted to Retained in Gen. Average:

Lacks unit in Has advanced unit in

June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar Apr TOTAL
Number of school days
Number of school days present
Number of school days absent
ADVISER'S SIGNATURE ADVISER'S SIGNATURE
 LRN:
Student's Name in full

CLASSIFIED AS Total Number of years in school to date:

Grade School School Year: 20 _____

Grading Periods
Grade Level Subject Final Grade Action Taken
1 2 3 4
FILIPINO
ENGLISH
MATHEMATICS
SCIENCE
ARALING PANLIPUNAN (AP)
TECHNOLOGY AND LIVELIHOOD
EDUCATION (TLE)
MAPEH
MUSIC
ARTS
PE
HEALTH
EDUKASYON SA PAGPAPAKATAO (ESP)

Promoted to Retained in Gen. Average:

Lacks unit in Has advanced unit in

June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar Apr TOTAL
Number of school days
Number of school days present
Number of school days absent

CLASSIFIED AS Total Number of years in school to date:

Grade School School Year: 20 _____

Grading Periods
Grade Level Subject Final Grade Action Taken
1 2 3 4
FILIPINO
ENGLISH
MATHEMATICS
SCIENCE
ARALING PANLIPUNAN (AP)
TECHNOLOGY AND LIVELIHOOD
EDUCATION (TLE)
MAPEH
MUSIC
ARTS
PE
HEALTH
EDUKASYON SA PAGPAPAKATAO (ESP)

Promoted to Retained in Gen. Average:

Lacks unit in Has advanced unit in

June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. Mar Apr TOTAL
Number of school days
Number of school days present
Number of school days absent

SUMMARY OF CREDITS ACHIEVED TOWARD GRADUATION

Grade 7 Grade 8 Grade 9 Grade 10
GRADE GRADE GRADE GRADE
CREDIT CREDIT CREDIT CREDIT
SUBJECT COMPLETE SUBJECT COMPLETE SUBJECT COMPLETE SUBJECT COMPLETE
EARNED EARNED EARNED EARNED
D D D D
 Total Number of Unit Earned:

CERTIFICATE OF TRANSFER
I certify that this is a true record of this student, on this
day of _____________________________ . He/She is eligible for admission to grade as (a regular, an irregular)
student, and has no property responsibility in this school.

Principal
ADVISER'S SIGNATURE ADVISER'S SIGNATURE