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