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School Form 1 School Register for Senior High School (SF1-SHS)

BUHAYNASAPA NATIONAL HIGHSCHOOL


School Name School ID 301090 District SAN JUAN Division BATANGAS
Semester School Year 2017-2018 Grade Level TWELVE (12) Track and Strand ACAD
Section EMERALD Course (For TVL Only)

COMPLETE ADDRESS PARENTS GUARDIAN


(if learner is not Living with Parent)

Sex (M/F)
NAME BIRTHDATE AGE Religious
LRN (Last Name, First Name, Name Mother's Maiden Name Name
Extension, Middle Name)
(mm/dd/yyyy) Affiliation House No./ Street/ Municipality/ Father's Name (Last Name, First Name, (Last Name, First Name,
Sitio/ Purok Barangay Province (Last Name, First Name, Name Relationship
City Extension, Middle Name) Name Extension, Middle Name Extension, Middle
Name) Name)
107636050005 Conchas, Mark John Jolo M 11/10/1999
109273050016 Endaya, John Paul Umali M
107621050032 Faigmani, Arvin Indicio M
107605050054 Gero, Christian Rey Eudin M
136905050116 Gojo, Romnick Cueto M
107608050058 Larangjo, Allan Umali M
107637050028 Piol. John Lester Bautista M
107605050111 Samadan, Jaypee Geron M
107637050034 Samonte, Louie Gusi M
136538050680 Valencia, John Leo Delos Reyes M
10 <=== TOTAL MALE
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F
F

<=== TOTAL FEMALE


<=== COMBINED
Legend: List and Code of Indicators under REMARKS column
Beginning of the Prepared By:
Indicator Code Required Information Indicator Code Required Information REGISTERED End of the Semester
Semester
Transferred Out T/O CCT Recipient CCT CCT Control/reference
number & Effectivity Date MALE
Transferred In Name of school last attended
Balik Aral B/A
& Year
T/I
Name of School, Date of 1st Learner With LWE
Specify Exceptionality of the Signature of Adviser over Printed Name
Attendance and Date of Last Exceptionality Learner FEMALE
Specify Level & Effectivity
Attendance if Transferred Out Accelerated ACL Date
Beginning of the Semester Date:
TOTAL

SFRT 2017
S Region IV- A
ACADEMIC- ABM

Contact Number REMARKS


of Parent/ (Please refer to the legend)
Guardian

of Adviser over Printed Name

End of the Semester Date:

SFRT 2017
School Form 2 Daily Attendance Report of Learners for Senior High School (SF2-SHS)
School Name School ID District Division

Semester School Year Grade Level Track and Strand

Section Course/s (only for TVL) Month of


DATE
NAME Total for the Month
No. (Last Name, First Name, Name Extension, Middle
Name) M T W TH F S M T W TH F S M T W TH F S M T W TH F S M T W TH F S ABSENT TARDY

10

11

12

13

14

15

16

17

<=== MALE | TOTAL Per Day ===>

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25
HS)
Region

REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If TRANSFERRED
IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).
DATE
NAME Total for the Month
No. (Last Name, First Name, Name Extension, Middle
Name) M T W TH F S M T W TH F S M T W TH F S M T W TH F S M T W TH F S ABSENT TARDY

26

27

<=== FEMALE | TOTAL Per Day ===>

Combined TOTAL Per Day

No. of Days of Classes:


GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance (blank) - Present; (x) - Absent; Tardy (half shaded = Upper for
2. To compute the following: Late Comer, Lower for Cutting Classes)
* Enrolment (as of 1st Friday of the semester)

2. REASONS/CAUSES FOR NO LONGER IN SCHOOL Late Enrolment during the month (beyond cut-off)

a. Percentage of Enrolment = x 100 (NLS)


Registered Learners as of end of the month Registered Learners as of end of the month

Enrolment as of 1st Friday of the school year


a. Domestic-Related Factors Percentage of Enrolment as of end of the month
a.1. Had to take care of siblings Average Daily Attendance
Total Daily Attendance a.2. Early marriage/pregnancy
b. Average Daily Attendance =
Number of School Days in reporting month a.3. Parents' attitude toward schooling Percentage of Attendance for the month
a.4. Family problems
Number of students absent for 5 consecutive days
Average daily attendance
c. Percentage of Attendance for the month = x 100
Registered Learners as of end of the month
b. Individual-Related Factors
3. Every end of the month, the Class Adviser will submit this form to the Office of the Principal for recording of summary table into School Form 4. Once b.1. Illness
No Longer in School (NLS)
signed by the School Head, this form should be returned to the Class Adviser. b.2. Overage
4. The Class Adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days b.4. Drug Abuse
b.5. Poor Academic Performance
Transferred Out
and/or those at risk of dropping out. b.6. Lack of Interest/Distractions
5. Attendance performance of learners will be reflected in the SF9-SHS of every grading period. b.7. Hunger/Malnutrition Transferred In

Shifting Out

c. School-Related Factors Shifting In


c.1. Teacher Factor
c.2. Physical Condition of Classroom
c.3. Peer Influence
I certify that this report is true and correct:
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. tribal wars & clan feuds)
d.3. Calamities/Disasters Signature of Class Ad

e. Financial-Related
e.1. Child labor, work Attested By:

f. Others (Specify) Signature of School H


a. Death
b. Transferred to School Abroad
c. Transferred to International School
d. Transferred to ALS
REMARKS
1. If No Longer in School (NLS), state reason, please refer to legend number. 2. If TRANSFERRED
IN/OUT, write the name of School. 3. If SHIFTING IN/OUT, write the name of
Track/Strand/Program).

No. of Days of Classes:


Summary

M F TOTAL
the semester)

h (beyond cut-off)

of the month

end of the month

e month

consecutive days

ol (NLS)

port is true and correct:

Signature of Class Adviser over Printed Name

Signature of School Head over Printed Name


School Form 3 Books Issued and Returned for Senior High School (SF3-SHS)
School Name School ID District Division

Semester School Year Grade Level Track and Strand

Section Course/s (only for TVL)

Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

NAME
No. (Last Name, First Name, Name Extension,
Middle Name) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
TOTAL MALE ===>
1
2
3
4
5
6
7
8
9
10
11
12
13
SHS)
Region

/ ModuleTitle Book / ModuleTitle

REMARKS/ACTION TAKEN
(Please refer to the codes below)
(mm/dd/yy) Date (mm/dd/yy)
Returned Issued Returned
Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

NAME
No. (Last Name, First Name, Name Extension,
Middle Name) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
TOTAL FEMALE ===>
COMBINED ===>

GUIDELINES: In case of lost/unreturned books, please provide information with the following code:
Prepared By:
1. Title of Books Issued to each learner must be recorded by the Class Adviser. A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
2. The Date of Issuance and the Date of Return shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code
3. The Total Number of Copies issued shall be reflected in the form. FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian (for code
4. The Total Number of Copies of Books Returned shall be reflected in the form. TDO), PTL=Paid by the Learner (for code NEG). References: DO No.23, s.2001, DO No.25, s.2003, DO No.14, s.2012.
5. All textbooks being used must be included. Additional copies of this form may be used if needed.
Signature of Class A
/ ModuleTitle Book / ModuleTitle

REMARKS/ACTION TAKEN
(Please refer to the codes below)
(mm/dd/yy) Date (mm/dd/yy)
Returned Issued Returned

ature of Class Adviser over Printed Name


School Form 4 Monthly Learners' Movement and Attendance for Senior High School (SF4-SH

School Name District Division Region

School ID Semester School Year

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN SHIFTED O

REGISTERED
LEARNERS (A) (A+B) (A) (A+B) (A) (A+B) (A)
(As of End Cumulative Cumulative Cumulative Cumulative Cumulative Cumulative Cumulative
TRACK STRAND Daily % for the
Number as
(B) Total for
Number as of Number as
(B) Total for
Number as Number as
(B) Total for
Number as of Number as
(B) Total fo
of the Month) Average Month the Month the Month the Month the Month
of Previous End of the of Previous of End of the of Previous End of the of Previous
Month Month Month Month Month Month Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M

TOTAL FOR GRADE 11

TOTAL FOR GRADE 12


GRAND TOTAL

Prepared and Submitted By:

Signature of School Head over Printed Name


SF4-SHS)

Region

For the Month of

SHIFTED OUT SHIFTED IN

(A+B) (A) (A+B)


Cumulative Cumulative Cumulative
(B) Total for (B) Total for
Number as of Number as Number as of
the Month the Month
End of the of Previous End of the
Month Month Month

F T M F T M F T M F T M F T
School Form 5A End of Semester and School Year Status of Learners for Senior High School (SF5A-SHS)

School Name School ID District

Semester School Year Grade Level

Track and Strand Course/s (only for TVL)

BACK SUBJECT/S END OF


LEARNER'S NAME END OF SCHOOL
No. LRN List down subjects where learner obtained a rating SEMESTER
(Last Name, First Name, Name Extension, Middle Name) YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)

MALE

FEMALE

Prepared By:

Certified Correct By:


BACK SUBJECT/S END OF
LEARNER'S NAME END OF SCHOOL
No. LRN List down subjects where learner obtained a rating SEMESTER
(Last Name, First Name, Name Extension, Middle Name) YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)

Reviewed By:

GUIDELINES:

This form shall be accomplished after each semester in a school year, leaving the End of School Year Status Column and Summary Table for End of School Year Status blank/unfilled at the end of the 1st Semeste
data elements shall be filled up only after the 2nd semester or at the end of the School Year.

INDICATORS:
End of Semester Status
Complete - number of learners who completed/satisfied the requirements in all subject areas (with grade of at least 75%)
Incomplete - number of learners who did not meet expectations in one or more subject areas, regardless of number of subjects failed (with grade less than 75%)
Note: Do not include learners who are No Longer in School (NLS)

End of School Year Status


Regular - number of learners who completed/satisfied requirements in all subject areas both in the 1st and 2nd semester
Irregular - number of learners who were not able to satisfy/complete requirements in one or both semesters
ool (SF5A-SHS)

Division Region

Section

SUMMARY TABLE 1ST SEM

STATUS MALE FEMALE TOTAL


COMPLETE

INCOMPLETE

TOTAL

SUMMARY TABLE 2ND SEM

STATUS MALE FEMALE TOTAL

COMPLETE

INCOMPLETE

TOTAL

SUMMARY TABLE (End of the School Year Only)

STATUS MALE FEMALE TOTAL

REGULAR

IRREGULAR

TOTAL

repared By:

Signature of Class Adviser over Printed Name

Certified Correct By:

Signature of School Head over Printed Name


Reviewed By:

Signature of Division Representative over Printed Name

e end of the 1st Semester. These


School Form 5B List of Learners with Complete SHS Requirements (SF5B-SHS)
School Name School ID District Division Region
Semester School Year Section
Track and Strand Course/s (only for TVL)

Completed SHS in
2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification Level
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)

MALE

SUMMARY TABLE A
STATUS MALE FEMALE TOTAL

Learners who
completed SHS
Program within 2
SYs or 4
semesters

Learners who
completed SHS
Program in more
than 2 SYs or 4
semesters
TOTAL

SUMMARY TABLE B
STATUS MALE FEMALE TOTAL
NC III
NC II
NC I
TOTAL

Note: NCs are recorded here for documentation but is not a requirement for
graduation.
Completed SHS in
2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification Level
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)
Note: NCs are recorded here for documentation but is not a requirement for
graduation.

GUIDELINES:
1. This form should be accomplished by the Class Adviser at End of School
Year.
2. It should be compiled and checked by the School Head and
passed to the Division Office before graduation.

FEMALE
Reviewed By:

Signature of Class Adviser over Printed Name

Certified Correct & Submitted By:

Signature of School Head over Printed Name

Reviewed By:

Signature of Division Representative over Printed Name


Completed SHS in
2 SYs? (Y/N)
National
LEARNER'S FULL NAME Certification Level
No. LRN
(Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)
School Form 6 Summarized Report of Learner Status as of End of Semester and School Year for Senior High School (SF6-SHS)

School Name School ID District Division

Semester School Year

END OF SCHOOL YEAR


END OF SEMESTER STATUS
(Fill up only at the end of the second se

GRADE LEVEL
COMPLETE INCOMPLETE TOTAL REGULAR IRREGULAR

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE

GRADE 11
TRACK/STRAND/COURSE

SUB TOTAL
GRADE 12
TRACK/STRAND/COURSE

SUB TOTAL
TOTAL

Prepared and Submitted By: Reviewed & Validated By: Noted By:
Signature of School Head over Printed Name Signature of Division Representative over Printed Name Signature of Divisio
GUIDELINES:
1. After receiving and validating the report on Status of Learners submitted by the Class Adviser, the School Head shall compute the grade level total per track/strand/course and school t
2. This report shall be forwarded to the Division Office by the end of the semester.
3. Column for End of School Year shall be accomplished at the end of SY or every after the 2nd semester
4. Protocols of validation & submission are under the discretion of the Schools Division Superintendent.
6-SHS)

Region

OOL YEAR
the second semester.)

ULAR TOTAL

TOTAL MALE FEMALE TOTAL

ature of Division Superintendent over Printed Name

e and school total.


School Form 7 School Personnel Basic Profile and Assignment for Senior High School (SF7-SHS)
School Name School ID District Division
Semester School Year
(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non-Teaching Items (C ) Other Appointments and Funding S

Appointment:
Title of Designation
Title of Plantilla Position Title of Plantilla Position (Contractual,
Number of Number of (as it appears in the contract/document:
(as it appears in the appointment (as it appears in the appointment Substitute,
Incumbent Incumbent Teacher, Clerk, Security Guard, Driver etc.)
document/PSIPOP) document/PSIPOP) Volunteer, Others
specify)

EDUCATIONAL QUALIFICATION Daily Program (time


Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Class & Other Ancillary (Enumerate DAY
Source Designation Degree/ Specialization/ From
Number Position, Descending) (Regular/ Minor Assignments sections (M/T/W/T
-T.I.N.) Probationary/ Postgraduate Specialized taught) (00:00)
H/F)
Part Time) Training Attended

First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per D
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per D
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per D
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per D
First Semester:
EDUCATIONAL QUALIFICATION Daily Program (time
Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Class & Other Ancillary (Enumerate DAY
Source Designation Degree/ Specialization/ From
Number Position, Descending) (Regular/ Minor Assignments sections (M/T/W/T
-T.I.N.) Probationary/ Postgraduate Specialized taught) (00:00)
H/F)
Part Time) Training Attended

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per D
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per D

GUIDELINES:
1. This form shall be accomplished at the beginning of each semester by the School Head and is submitted to the Division Office. In case of movement of teachers and other
personnel during the semester, an updated SHSF-7 must be submitted to the Division Office at the end of the semester.
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank to the lowest. Si
3. Please reflect subjects being taught including advisory class or ancillary assignment (if any). Other administrative duties must also be reported.
4. Daily Program Column is for teaching personnel only. Updated as of:
SHS)
Region

nd Funding Sources

Number of Incumbent
Fund Source
(SEF, PTA,
NGO's etc.) Teaching Non-Teaching

Remarks:
ogram (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
To Teaching JHS- please indicate the number
(00:00) Minutes per of teaching minutes per week)
Week

e. Minutes per Day

e. Minutes per Day

e. Minutes per Day

e. Minutes per Day


Remarks:
ogram (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
To Teaching JHS- please indicate the number
(00:00) Minutes per of teaching minutes per week)
Week

e. Minutes per Day

e. Minutes per Day

Signature of School Head over Printed Name

ated as of:

School Form 7, Page ___ of ________


SF 8

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report for Senior High School (SF8-SHS)
(For All Grade Levels)

School Name District Division Region

School ID Grade Section Track/Strand (SHS) School Year

Learner's Name Nutritional Status


Birthdate Weight Height Height² Height for
No. LRN (Last Name, First Name, Name Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category Age (HFA)
Extension, Middle Name) (kg/m²)
MALE

FEMALE

SFRT 2017
Learner's Name Nutritional Status
Birthdate Weight Height Height² Height for
No. LRN (Last Name, First Name, Name Age BMI Remarks
(MM/DD/YYYY) (kg) (m) (m²) BMI Category Age (HFA)
Extension, Middle Name) (kg/m²)

SUMMARY TABLE
Nutritional Status Height for Age (HFA)
Summary Table Summary Table
SEX Severely
Severely Wasted Wasted Normal Overweight Obese TOTAL Stunted Normal Tall Total
Stunted
MALE
FEMALE
TOTAL

Date of Assessment: Conducted/Assessed By: Certified Correct By: Reviewed By:

SFRT 2017

SFRT 2017

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