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: DELA CRUZ FIRST NAME: MACKIE NAME EXTN. (Jr,I,II) MIDDLE NAME: ABALOS

Learner Reference Number (LRN): 101396180007 Birthdate (mm/dd/yyyy): 03/22/2013 Sex: M

ELIGIBILITY FOR ELEMENTARY SCHOOL ENROLMENT
Credential Presented for Grade 1: Kinder Progress Report ECCD Checklist Kindergarten Certificate of Completion
Name of School: Salomague Norte Elementary School School ID: 101396 Address of School: Salomague Norte, Bugallon, Pangasinan
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: Salomague Norte Elementary School____ School ID: 101396 School: _Salomague Norte Elementary School_ School ID: 101396
District: Bugallon II___________ Division: Pangasinan I____ Region: I District: __Bugallon II___ Division: Pangasinan I_ Region: I
Classified as Grade: _One__ Section: _One____ School Year: 2019-2020
2018-2019 Classified as Grade: _Two_ Section: _One_ School Year: 2020-2021
Name of Adviser/Teacher: Ophelia V. Alipio______ Signature: Name of Adviser/Teacher: _Renafhel A. Jimenez_ 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 80 82 83 85 83 PASSED Mother Tongue

Filipino 82 82 85 83 PASSED Filipino
English 82 84 83 PASSED English
Mathematics 82 83 84 86 84 PASSED Mathematics
Science Science
Araling Panlipunan 82 83 84 86 84 PASSED Araling Panlipunan
EPP / TLE EPP / TLE
MAPEH 81 82 85 86 84 PASSED MAPEH
Music 81 82 85 85 83 PASSED Music
Arts 80 82 85 86 83 PASSED Arts
Physical Education 80 82 84 86 83 PASSED Physical Education
Health 81 83 85 86 84 PASSED Health
Eduk. sa Pagpapakatao 83 84 85 87 85 PASSED Eduk. sa Pagpapakatao
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Education
General Average 82 83 84 86 84 PROMOTED 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 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