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: CRISOSTOMO FIRST NAME: VINCENT NAME EXTN. (Jr,I,II) MIDDLE NAME: GONZALES

Learner Reference Number (LRN): 101396170003 Birthdate (mm/dd/yyyy): 05/11/2011 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 73 72 72 72 72 FAILED Mother Tongue

Filipino 72 72 72 72 FAILED Filipino
English 72 72 72 FAILED English
Mathematics 73 72 72 72 72 FAILED Mathematics
Science Science
Araling Panlipunan 73 72 72 72 72 FAILED Araling Panlipunan
EPP / TLE EPP / TLE
MAPEH 73 72 72 72 72 FAILED MAPEH
Music 73 72 72 72 72 FAILED Music
Arts 73 72 72 72 72 FAILED Arts
Physical Education 73 72 72 72 72 FAILED Physical Education
Health 73 72 72 72 72 FAILED Health
Eduk. sa Pagpapakatao 73 72 72 72 72 FAILED Eduk. sa Pagpapakatao
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Education
General Average 73 72 72 72 72 RETAINED 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