REPUBLIC OF THE PHILIPPINES

SAMPLE FOR JHS

DEPARTMENT OF EDUCATION
REGION III
SCHOOLS DIVISION OFFICE OF CITY OF
MALOLOS
DepEd FORM137-A City of Malolos,
Bulacan
Tel./Fax NO. (044) 305-
1523/1521

Identification _____________ on
Copy of this record sent to principal of
______________________________ SECONDARY STUDENT'S
______________________________
______________________________
School on ______________________
Principal PERMANENT RECORD
Principal

Name: Date of Birth:

Year Month Day
Learners' Reference Number (LRN:)
Place of Birth: Province Town
Brgy.
Parent or Guardian:
Occupation:
Address of Parent or Guardian:
Intermediate course completed (School)
Year General Average:
Total number of years in school to compelte elementary course

CLASSIFIED AS Total Number of

years in school to date:
Grade School
School Year: 20 ____

Grading
Periods
Grade Level Subject
Final Grade Action Taken
1 2
3 4
FILIPINO
ENGLISH
MATHEMATICS
SCIENCE
ARALING PANLIPUNAN (AP)
TECHNOLOGY AND LIVELIHOOD EDUCATION
(TLE)
MAPEH
MUSIC
ARTS
PE
HEALTH
EDUKASYON SA PAGPAPAKATAO (ESP)
Promoted to Retained in
Gen. Average:
Lacks unit in Has advanced unit
in

June July Aug. Sept. Oct.

Nov. Dec. Jan. Feb. Mar Apr TOTAL
Number of school days
Number of school days present
Number of school days absent

CLASSIFIED AS Total Number of

years in school to date:
Grade School
School Year: 20 ____

Grading
Periods
Grade Level Subject
Final Grade Action Taken
1 2
3 4
FILIPINO
ENGLISH
MATHEMATICS
SCIENCE
ARALING PANLIPUNAN (AP)
TECHNOLOGY AND LIVELIHOOD EDUCATION
(TLE)
 MAPEH
MUSIC
ARTS
PE
HEALTH
EDUKASYON SA PAGPAPAKATAO (ESP)

Promoted to Retained in
Gen. Average:
Lacks unit in Has advanced unit in

June July Aug. Sept. Oct. Nov.

Dec. Jan. Feb. Mar Apr TOTAL
Number of school days
Number of school days present
Number of school days absent
ADVISER'S SIGNATURE ADVISER'S SIGNATURE
LRN:
Student's Name in full

CLASSIFIED AS Total Number of

years in school to date:
Grade School
School Year: 20 _____

Grading Periods
Grade Level Subject
Final Grade Action Taken
1 2
3 4
FILIPINO
ENGLISH
MATHEMATICS
SCIENCE
ARALING PANLIPUNAN (AP)
TECHNOLOGY AND LIVELIHOOD
EDUCATION (TLE)
MAPEH
MUSIC
ARTS
PE
HEALTH
EDUKASYON SA PAGPAPAKATAO (ESP)

Promoted to Retained in
Gen. Average:
Lacks unit in Has advanced unit in

June July Aug. Sept. Oct.

Nov. Dec. Jan. Feb. Mar Apr TOTAL
Number of school days
Number of school days present
Number of school days absent

CLASSIFIED AS Total Number of

years in school to date:
Grade School
School Year: 20 _____

Grading Periods
Grade Level Subject
Final Grade Action Taken
1 2
3 4
FILIPINO
ENGLISH
MATHEMATICS
SCIENCE
ARALING PANLIPUNAN (AP)
TECHNOLOGY AND LIVELIHOOD
EDUCATION (TLE)
MAPEH
 MUSIC
ARTS
PE
HEALTH
EDUKASYON SA PAGPAPAKATAO (ESP)

Promoted to Retained in
Gen. Average:
Lacks unit in Has advanced unit in

June July Aug. Sept. Oct.

Nov. Dec. Jan. Feb. Mar Apr TOTAL
Number of school days
Number of school days present
Number of school days absent

SUMMARY OF CREDITS ACHIEVED TOWARD

GRADUATION
Grade 7 Grade 8
Grade 9 Grade 10
GRADE GRADE
GRADE GRADE
CREDIT CREDIT
CREDIT CREDIT
SUBJECT COMPLETE SUBJECT COMPLETE
SUBJECT COMPLETE SUBJECT COMPLETE
EARNED EARNED
EARNED EARNED
D D
D D
Total Number of Unit Earned:

CERTIFICATE OF
TRANSFER
I certify that this is a true record of
this student, on this
day of _____________________________ . He/She is eligible for admission to grade
as (a regular, an irregular)
student, and has no property responsibility in this school.

Principal
ADVISER'S SIGNATURE ADVISER'S SIGNATURE