DepEd FORM 137-E

Republika ng Pilipinas (Republic of the Philippines) Kagawaran ng Edukasyon (Department of Education)

KAWANIHAN NG EDUKASYONG ELEMENTARYA (BUREAU OF ELEMENTARY EDUCATION)

Rehiyon V (Region V)

PALAGIANG TALAAN SA MABABANG PAARALAN

(Elementary School Permanent Record)

Pangalan (Name)

Apelyido

Unang Ngalan

M.I.

Sangay (Division)

Paaralan (School)

Kasarian (Sex)

Petsa ng Kapanganakan (Date of Birth)

Pook (Place)

Bayan/Lalawigan/Lungsod (Town/Province/City)

Petsa ng Pagpasok (Date of Entrance)

Magulang/Tagapag-alaga (Parent/Guardian)

Pangalan (Name)

Tirahan (Address)

Hanapbuhay (Occupation)

PAG-UNLAD SA MABABANG PAARALAN

(Elementary School Progress) Eligible for admission to Grade Grade I School School Year Learning Areas Filipino English Mathematics MAKABAYAN (Sibika at Kultura, MSEP) (Average rating of Sibika at Kultura, MSEP)
1 Periodical Rating 2 3 4

Eligible for admission to Grade Grade II School School Year FINAL RATING Learning Areas Filipino English Mathematics MAKABAYAN (Sibika at Kultura, MSEP) (Average rating of Sibika at Kultura, MSEP)
1 Periodical Rating 2 3 4

FINAL RATING

GENERAL AVERAGE TEACHERS SIGNATURE

GENERAL AVERAGE TEACHERS SIGNATURE

Eligible for admission to Grade Grade III School

Periodical Rating 2 3

Eligible for admission to Grade Grade IV FINAL RATING School

Periodical Rating 2 3

School Year Learning Areas Filipino English Mathematics MAKABAYAN (Sibika at Kultura, MSEP) (Average rating of Sibika at Kultura, MSEP)
1 4

School Year Learning Areas Filipino English Mathematics MAKABAYAN (Sibika at Kultura, MSEP) (Average rating of Sibika at Kultura, MSEP)
1 4

FINAL RATING

GENERAL AVERAGE TEACHERS SIGNATURE

GENERAL AVERAGE TEACHERS SIGNATURE

Eligible for admission to Grade Grade V School School Year Learning Areas Filipino English Mathematics MAKABAYAN (Sibika at Kultura, MSEP) (Average rating of Sibika at Kultura, MSEP)
1 Periodical Rating 2 3 4

Eligible for admission to Grade Grade VI FINAL RATING School

Periodical Rating 2 3

School Year Learning Areas Filipino English Mathematics MAKABAYAN (Sibika at Kultura, MSEP) (Average rating of Sibika at Kultura, MSEP)
1 4

FINAL RATING

GENERAL AVERAGE TEACHERS SIGNATURE

GENERAL AVERAGE TEACHERS SIGNATURE

Eligible for admission to Grade

Eligible for admission to Grade

III. CHARACTER BUILDING

Grade __________ Sch. Yr. ___________ Grade __________ Sch. Yr. ___________ Grade __________ Sch. Yr. ___________

F.R.

F.R.

F.R.

1. 2. 3.

Honesty Courtesy Helpfulness & Cooperation 4. Obedience 5. Consideration for Others 6. Sportsmanship 7. Love of Country 8. Self-Reliance 9. Industry 10. Cleanliness & Orderliness
Grade __________ Sch. Yr. ___________ Grade __________ Sch. Yr. ___________ Grade __________ Sch. Yr. ___________

F.R.

F.R.

F.R.

1. 2. 3.

Honesty Courtesy Helpfulness & Cooperation 4. Obedience 5. Consideration for Others 6. Sportsmanship 7. Love of Country 8. Self-Reliance 9. Industry 10. Cleanliness & Orderliness A Outstanding B Very Satisfactory C Satisfactory D Needs Improvement

IV. ATTENDANCE RECORD

Grade No. of School Days No. of School Days Absent Cause No. of Times Tardy Cause No. of School Days Present

C E R T I F I C A T E TO WHOM IT MAY CONCERN:

O F

T R A N S F E R

This is to certify that this is a true record of the Elementary School Permanent Record of ________________________________________________ He/She is eligible for transfer and admission to Grade / Year
(Signature) (Date) (Designation)