FORM 137-E

Republika ng Pilipinas
(Republic of the Philippines)
Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYON ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)
Rehiyon III
(Region III)
PALAGIANG TALAAN SA MABABANG PAARALAN
(Elementary School Permanent Record) LRN:_______________________

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/Lunsod (Date of Entrance)
(Town/Province/City)
Magulang/Tagapag-alaga____________________________________________________________________________________________________________________
(Parent/Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

PAG-UNLAD SA MABABANG PAARALAN

(Elementary School Progress)

Grade I-School_________________________________________________________________ Grade II-School________________________________________________________________

School Year__________________________________________________________________ School Year__________________________________________________________________
Periodic Rating Periodic Rating
LEARNING AREAS F.R. Remarks LEARNING AREAS F.R. Remarks
1 2 3 4 1 2 3 4
Mother Tongue Mother Tongue
Filipino Filipino
English English
Mathematics Mathematics
Araling Panlipunan (AP) Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP) Edukasyon sa Pagpapakatao (EsP)
MAPEH MAPEH
*Music *Music
*Arts *Arts
*PE *PE
*Health *Health
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 Periodic Rating
LEARNING AREAS F.R. Remarks LEARNING AREAS F.R. Remarks
1 2 3 4 1 2 3 4
Mother Tongue Filipino
Filipino English
English Mathematics
Mathematics Science
Science Araling Panlipunan (AP)
Araling Panlipunan (AP) Edukasyon sa Pagpapakatao (EsP)
Edukasyon sa Pagpapakatao (EsP) EPP
MAPEH MAPEH
*Music *Music
*Arts *Arts
*PE *PE
*Health *Health
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 Periodic Rating
LEARNING AREAS F.R. Remarks LEARNING AREAS F.R. Remarks
1 2 3 4 1 2 3 4
Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan (AP) Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP) Edukasyon sa Pagpapakatao (EsP)
EPP EPP
MAPEH MAPEH
*Music *Music
*Arts *Arts
*PE *PE
*Health *Health
General Average General Average
Signature of Adviser ______________________________________________ Signature of Adviser ______________________________________________
Eligible for Admission to Grade_____________________________________________ Eligible for Admission to Grade______________________________________________
III. REPORT ON LEARNER’S OBSERVED VALUES
Gr. 1 S.Y. ________________ Gr. 2 S.Y. ________________ Gr. 3 S.Y. ________________
Core Values Quarter Quarter Quarter
Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one’s spiritual beliefs
1. Maka- while respecting the spiritual
Diyos beliefs of others
Shows adherence to ethical
principles by upholding truth
Is sensitive to individual, social
2. Makatao and cultural differences
Demonstrates contributions
toward solidarity
Cares for the environment and
3. Maka- utilizes resources wisely,
kalikasan judiciously, and economically

Demonstrates pride in being a

Filipino; exercises the rights and
responsibilities of a Filipino
4.Makabansa citizen.

Demonstrates appropriate
behavior in carrying out activities
in the school, community, and
country

Gr. 4 S.Y. _______________ Gr. 5 S.Y. ________________ Gr. 6 S.Y. ________________

Core Values Quarter Quarter Quarter
Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one’s spiritual beliefs
1. Maka- while respecting the spiritual
Diyos beliefs of others
Shows adherence to ethical
principles by upholding truth
Is sensitive to individual, social
2. Makatao and cultural differences
Demonstrates contributions
toward solidarity
Cares for the environment and
3. Maka- utilizes resources wisely,
kalikasan judiciously, and economically

Demonstrates pride in being a

Filipino; exercises the rights and
responsibi-lities of a Filipino
4.Makabansa citizen.

Demonstrates appropriate
behavior in carrying out activities
in the school, community, and
country

AO – Always Observed SO – Sometimes Observed RO – Rarely Observed NO – Not Observed

IV. ATTENDANCE RECORD

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

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 of Grade/Year_____________________.

_____________________________________________
Signature

___________________________________________ ____________________________________________
Date Designation