SF10-ES

Republic of the Philippines

Department of Education

Learner Permanent Record for Elementary School (SF10-ES)

(Formerly Form 137)

LEARNER'S PERSONAL INFORMATION

LAST NAME: FIRST NAME: NAME EXTN. (Jr,I,II) MIDDLE NAME:

Learner Reference Number (LRN): Birthdate (mm/dd/yyyy): Sex:

ELIGIBILITY FOR ELEMENTARY SCHOOL ENROLMENT
Credential Presented for Grade 1: Kinder Progress Report ECCD Checklist Kindergarten Certificate of Completion
Name of School: School ID: Address of School:
Other Credential Presented
PEPT Passer Rating: _________ Date of Examination/Assessment (mm/dd/yyyy): ____________ Others (Pls. Specify): _________________________
Name and Address of Testing Center:____________________________________________________ Remark:____________________________________
SCHOLASTIC RECORD

School: School ID: School: ______________________________ School ID:

District: Division: Region: District: ______________________ Division: __________ Region:
Classified as Grade: Section: School Year: Classified as Grade: ______ Section: ______ School Year:
Name of Adviser/Teacher: Signature: Name of Adviser/Teacher: _______________ Signature:
Quarterly Rating Final Quarterly Rating Final
LEARNING AREAS Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating

Mother Tongue Mother Tongue

Filipino Filipino

English English

Mathematics Mathematics

Araling Panlipunan Araling Panlipunan

MAPEH MAPEH

Music Music

Arts Arts

Physical Education Physical Education

Health Health
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao

General Average General Average

Remedial Classes Conducted from: to Remedial Classes Conducted from: to
Remedial Class Recomputed Final Remedial Recomputed
Learning Areas Final Rating Remarks Learning Areas Final Rating Remarks
Mark Grade Class Mark Final Grade

School: ______________________________________ School ID: School: ______________________________ School ID:

District: ______________________ Division: ________________ Region: District: ______________________ Division: __________ Region:
Classified as Grade: ______ Section: __________ School Year: Classified as Grade: ______ Section: ______ School Year:
Name of Adviser/Teacher: ______________________ Signature: Name of Adviser/Teacher: _______________ Signature:

Quarterly Rating Final Quarterly Rating Final

Learning Areas Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating

Mother Tongue Mother Tongue

Filipino Filipino

English English

Mathematics Mathematics

Science Science

Araling Panlipunan Araling Panlipunan

EPP / TLE EPP / TLE

MAPEH MAPEH

Music Music

Arts Arts

Physical Education Physical Education

Health Health

Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao

*Arabic Language *Arabic Language

*Islamic Values Education *Islamic Values Education
General Average General Average
Remedial Classes Date Conducted: to Remedial Classes Date Conducted: to
Remedial Class Recomputed Final Remedial Recomputed
Learning Areas Final Rating Remarks Learning Areas Final Rating Remarks
Mark Grade Class Mark Final Grade

SFRT 2017
SF10-ES Page 2 of ________
SCHOLASTIC RECORD
School: ______________________________________ School ID: School: _____________________________ School ID:
District: ______________________ Division: ________________ Region: District: ______________________ Division: _________ Region:
Classified as Grade: ______ Section: __________ School Year: Classified as Grade: ______ Section: _____ School Year:
Name of Adviser/Teacher: ______________________ Signature: Name of Adviser/Teacher: _______________Signature:

Quarterly Rating Final Quarterly Rating Final

LEARNING AREAS Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating

Mother Tongue Mother Tongue

Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan Araling Panlipunan
EPP / TLE EPP / TLE
MAPEH MAPEH
Music Music
Arts Arts
Physical Education Physical Education
Health Health
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Education
General Average General Average
Remedial Classes Date Conducted: to Remedial Classes Date Conducted: to
Remedial Class Recomputed Remedial Recomputed
Learning Areas Final Rating Mark Final Grade Remarks Learning Areas Final Rating Class Mark Final Grade Remarks

School: ______________________________________ School ID: School: _____________________________ School ID:

District: ______________________ Division: ________________ Region: District: ______________________ Division: _________ Region:
Classified as Grade: ______ Section: __________ School Year: Classified as Grade: ______ Section: _____ School Year:
Name of Adviser/Teacher: ______________________ Signature: Name of Adviser/Teacher: _______________Signature:

Quarterly Rating Final Quarterly Rating Final

Learning Areas Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating

Mother Tongue Mother Tongue

Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan Araling Panlipunan
EPP / TLE EPP / TLE
MAPEH MAPEH
Music Music
Arts Arts
Physical Education Physical Education
Health Health
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Education
General Average General Average
Remedial Classes Date Conducted: to Remedial Classes Date Conducted: to
Remedial Class Recomputed Remedial Recomputed
Learning Areas Final Rating Remarks Learning Areas Final Rating Remarks
Mark Final Grade Class Mark Final Grade

For Transfer Out /Elementary School Completer Only

CERTIFICATION
I CERTIFY that this is a true record of ___________________________________ with LRN ___________________ and that he/she is eligible for admission to Grade ________.
School Name: __________________________________ School ID ________________ Division: ___________ Last School Year Attended: _________________________

____________________________________
Date Name of Principal/School Head over Printed Name (Affix School Seal here)

CERTIFICATION
I CERTIFY that this is a true record of ___________________________________ with LRN ___________________ and that he/she is eligible for admission to Grade ________.
School Name: __________________________________ School ID ________________ Division: ___________ Last School Year Attended: _________________________

____________________________________
Date Name of Principal/School Head over Printed Name (Affix School Seal here)

CERTIFICATION
I CERTIFY that this is a true record of ___________________________________ with LRN ___________________ and that he/she is eligible for admission to Grade ________.
School Name: __________________________________ School ID ________________ Division: ___________ Last School Year Attended: _________________________

____________________________________
Date Name of Principal/School Head over Printed Name (Affix School Seal here)
May add Certification Box if needed SFRT Revised 2017