DECS FORM 137-E

Republic of the Philippines

DEPARTMENT OF EDUCATION, CULTURE AND SPORTS
CARAGA ADMINISTRATIVE REGION
DIVISION OF AGUSAN DEL SUR
Patin-ay, Prosperidad

PALAGIANG TALAAN SA MABABANG PAARALAN

(ELEMENTARY SCHOOL PERMANENT RECORD)

I. Pangalan____________________________________________________ Sangay: Agusan del Sur Paaralan: Duangan Elementary School

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)

Magulang/Tagapag-alaga:________________________________________________________________________________________________
Pangalan Tirahan Hanapbuhay

PAG-UNLAD SA MABABANG PAARALAN

(ELEMENTARY SCHOOL PROGRESS)

Grade I - School:_________________ Grade II - School:_________________

School Year:_____________________ School Year:_____________________
Periodical Rating Periodical Rating
Learning Areas 1 2 3 4 Remarks Learning Areas 1 2 3 4 Remarks

Eligible for Admission to Grade________________ Eligible for Admission to Grade______________

Grade III - School:_________________ Grade IV - School:_________________

School Year:_____________________ School Year:_____________________
Periodical Rating Periodical Rating
Learning Areas 1 2 3 4 Remarks Learning Areas 1 2 3 4 Remarks

Eligible for Admission to Grade________________ Eligible for Admission to Grade______________

Grade V - School:_________________ Grade VI - School:_________________

School Year:_____________________ School Year:_____________________
Periodical Rating Periodical Rating
Learning Areas Remarks Learning Areas Remarks
1 2 3 4 1 2 3 4

Eligible for Admission to Grade________________ Eligible for Admission to Grade______________

II. CHARACTER BUILDING
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. Helpful & Cooperative
4. Obedience
5. Consideration for Others
6. Sportsmanship
7. Love of Country
8. Self-Reliance
9. Industry
10. Cleanliness & Ordeliness

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. Helpful & Cooperative
4. Obedience
5. Consideration for Others
6. Sportsmanship
7. Love of Country
8. Self-Reliance
9. Industry
10. Cleanliness & Ordeliness
A - Outstanding C - Satisfactory
B - Very Satisfactory D - Needs Improvement

Bilang ng Araw na Bilang ng Araw na Bilang na Nahuli

Lumiban sa Klase Pangunahing Dahilan Pangunahing Dahilan Bilang ng Araw na
Baitang (Grade) May Pasok (No. of (No. of School Days (Chief Cause)
sa Pagpasok (No.
(Chief Cause)
Pagpasok (No. of
Days Present)
School Days) Absent) of Times Tardy)

KATIBAYAN NG PAGPASOK
(RECORD OF ATTENDADNCE)

TO WHOMIT MAY CONCERN:

This is to certify that this is a true record of Elementary Schools Permanent Record of _________________________________
________________________________He/She is eligible for transfer and admission to Grade/Year______________________.

_________________________ Signature
Date

Designation