Beruflich Dokumente
Kultur Dokumente
(This replaced Form 1, Master List & STS Form 2-Family Background and Profile)
School Name
LRN
NAME
(Last Name, First Name, Middle Name)
Division
Region V-Bicol
School ID 112245
Camarines Norte
BIRTH
Sex
DATE (mm/
(M/F)
dd/yy)
AGE as of
1st Friday
of June
(nos. of
years as
per last
birthday)
School Year
District
2013-2014
Grade Level
ADDRESS
BIRTH
PLACE
(Province)
MOTHER
TONGUE
IP
(Specify
Ethnic Group)
Paracale District
IV
NAME OF PARENTS
RELIGION
House # /
Street/Sitio/
Purok
Barangay
Municipality/ City
Province
11/21/02
10
Camarines
Norte
Tagalog
Catholic
Pinagbirayan
Munti
Paracale
Camarines
Norte
Sonny
112245090002
11/21/03
Camarines
Norte
Tagalog
Catholic
Dagang
Paracale
Camarines
Norte
Wilfredo
112245090004
9/6/03
Camarines
Norte
Tagalog
Catholic
Talusan
Paracale
Camarines
Norte
Nicolas
112245090008
12/16/03
Metro Manila
Tagalog
Catholic
Pinagbirayan
Munti
Paracale
Camarines
Norte
Marvin
112245090011
2/16/01
12
Camarines
Norte
Tagalog
Catholic
Talusan
Paracale
Camarines
Norte
Richard Sr.
112245090017
10/10/02
10
Camarines
Norte
Tagalog
Catholic
Talusan
Paracale
Camarines
Norte
Lorenzo
112245090018
7/10/02
10
Camarines
Norte
Tagalog
Catholic
Purok 3
Dagang
Paracale
Camarines
Norte
Roel
112245090019
2/14/02
11
Camarines
Norte
Tagalog
Catholic
Purok 3
Talusan
Paracale
Camarines
Norte
Renato
112242090015
9/12/02
10
Camarines
Norte
Tagalog
Catholic
Purok 1
Pinagbirayan
Munti
Paracale
Camarines
Norte
Toriano
112245090022
10/25/02
10
Camarines
Norte
Tagalog
Catholic
Purok 2
Talusan
Paracale
Camarines
Norte
Archie
112234090001
Section
Purok 1
Name
Relationship
LRN
NAME
(Last Name, First Name, Middle Name)
BIRTH
Sex
DATE (mm/
(M/F)
dd/yy)
AGE as of
1st Friday
of June
(nos. of
years as
per last
birthday)
ADDRESS
BIRTH
PLACE
(Province)
MOTHER
TONGUE
IP
(Specify
Ethnic Group)
NAME OF PARENTS
House # /
Street/Sitio/
Purok
Barangay
Municipality/ City
Province
112245090005
8/1/04
Camarines
Norte
Tagalog
Catholic
Purok 1
Talusan
Paracale
Camarines
Norte
Nicanor
112245090006
8/31/02
10
Camarines
Norte
Tagalog
Catholic
Purok 2
Talusan
Paracale
Camarines
Norte
Hilario
8/30/01
12
Camarines
Norte
Tagalog
Catholic
Purok 3
Talusan
Paracale
Camarines
Norte
112245090013
10/9/02
10
Camarines
Norte
Tagalog
Catholic
Purok 1
Dagang
Paracale
Camarines
Norte
Ramon
112245090015
3/20/00
13
Camarines
Norte
Tagalog
Catholic
Purok 1
Talusan
Paracale
Camarines
Norte
Felicito
112245090016
8/5/03
Camarines
Norte
Tagalog
Catholic
Purok 1
Talusan
Paracale
Camarines
Norte
112245090021
8/5/03
Camarines
Norte
Tagalog
Catholic
Purok 1
Pinagbirayan
Munti
Paracale
Camarines
Norte
Juancho
112245090024
10/5/02
10
Camarines
Norte
Tagalog
Catholic
Pinagbirayan
Munti
Paracale
Camarines
Norte
Sonny
8/9/01
12
Camarines
Norte
Tagalog
Iglesia ni Crist0
Dagang
Paracale
Camarines
Norte
1/23/03
10
Camarines
Norte
Tagalog
Catholic
Pinagbirayan
Munti
Paracale
Camarines
Norte
112245090027
Contact Number
(Parent
/Guardian)
RELIGION
Renato
Name
Relationship
Angelyn Andaya
Sister
Rosalie Adecer
Code
Required Information
Indicator
Code
CCT
Required Information
CCT Control/reference number & Effectivity Date
BoSY
MALE
EoSY
Prepared by:
Certified Correct:
10
JOAN V. ASAS
(Signature of Adviser over Printed Name)
Transferred IN
Dropped
T/I
DRP
Late Enrollment LE
B/A
LWD
Specify
ACL
FEMALE
10
TOTAL
20
BoSY Date:
EoSYDate:3/31/14
MANUEL A. OATE
(Signature of School Head over Printed
BoSY Date:
EoSYDate:3/31/14
REMARK/S
REMARK/S
T/I Libmanan
Elem.School
T/I Batobalani
Elem.School
Certified Correct:
MANUEL A. OATE
(Signature of School Head over Printed Name)
BoSY Date:
EoSYDate:3/31/14
School ID
School Year
Name of School
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Section
Total for the
Month
ABSENT TARDY
LEARNER'S NAME
(Last Name, First Name, Middle Name)
ABSENT TARDY
x 100
x 100
Month:
2. REASONS/CAUSES OF DROP-OUTS
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
4. Every End of the month, the class adviser will submit this form to the office of the principal for recording of
summary table into the School Form 4. Once signed by the principal, this form should be returned to the adviser.
5. The adviser will extend neccessary intervention including but not limited to home visitation to learner/s that committed 5 consecutive
days of absences or those with potentials of dropping out
6. Attendance performance of learner is expected to reflect in Form 137 and Form 138 every grading period
* Beginning of School Year cut-off report is every 1st Friday of School Calendar Days
No. of Days of
Classes:
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
TOTAL
LEARNER'S NAME
(Last Name, First Name, Middle Name)
School Form 2: Page 2 of ________
e. Financial-Related
e.1. Child labor, work
f. Others
Attested by:
School ID
School Year
School Name
Subject Area & Title
NO.
Section
Grade Level
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
REMARK/ACTION TAKEN
(Please refer to the legend on last
page)
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
REMARK/ACTION TAKEN
(Please refer to the legend on last
page)
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
Date
Issued
Returned
REMARK/ACTION TAKEN
(Please refer to the legend on last
page)
Date
Issued
Returned
Prepared By:
Region
Division
District
School ID
School Name
NAME OF ADVISER
School Year
GRADE/
YEAR
LEVEL
SECTION
REGISTERED
LEARNER
(As of End of the
Month)
M
ATTENDANCE
DROPPED OUT
Daily Average
TRANSFERRED OUT
TRANSFERRED IN
(A+B) Cumulative
(A+B) Cumulative
(A+B)
(A) Cumulative as
(A) Cumulative as
as of End of the
(B) For the Month as of End of the
(B) For the Month Cumulative as of
of Previous Month
of Previous Month
Month
Month
End of the Month
M
ELEMENTARY/SECONDARY:
KINDER
GRADE 1/GRADE 7
GRADE 2/GRADE 8
GRADE 3/GRADE 9
GRADE 4/GRADE 10
GRADE 5/GRADE 11
GRADE 6/GRADE 12
TOTAL FOR NON-GRADED
TOTAL
GUIDELINES:
1. This forms shall be accomplished every end of the month using the summary box of SF2 submitted by the teachers/advisers to update figures for the month.
2. Furnish copy to Division Office: a week after June 30, October 30 & March 31
3. Only teachers who are handling advisory class shall be reported. May use additional copy/ies of this form if needed.
4. Small school that has one section per grade/year level is not required to fill the columns "Name of Adviser, Grade/Year Level & Section". Instead, they will only accomplish the
summary column per grade/year level.
IN
(A+B)
Cumulative as of
End of the Month
T
Region
School ID
V-Bicol
112234090001
112245090002
112245090004
112245090008
112245090011
112245090017
112245090018
112245090019
112242090015
112245090022
School Year
112245
School Name
LRN
Camarines Norte
Division
2013-2014
LEARNER'S NAME
(Last Name, First Name, Middle Name)
GENERAL
AVERAGE
(Numerical Value in 3
decimal places for
honor learner, 2 for
non-honor &
Descriptive Letter)
Promoted
82.40
Promoted
79.40
Promoted
83.40
Promoted
82.20
Promoted
81.80
Promoted
83.40
Promoted
82.40
Promoted
81.20
Promoted
IV
Section
INCOMPLETE SUBJECT/S
(This column is for K to 12 Curriculum and
remaining RBEC in High School. Elementary
grades level that still implementing RBEC
need not to fill up this column)
Completed as of end
of current SY
80.00
84.00
RBEC
Curriculum
Grade Level
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
Paracale
District
as of End of the
current SY
SUMMARY TABLE
Promoted
STATUS
MALE
10
10
20
*IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
BEGINNNING
(B: 74% and below)
TOTAL MALE
TOTAL
PROMOTED
MALE
10
FEMALE
DEVELOPING (D:
75%-79%)
APPROACHING
PROFICIENCY
(AP: 80%-84%)
PROFICIENT
(P: 85% -89%)
FEMALE
TOTAL
LRN
LEARNER'S NAME
(Last Name, First Name, Middle Name)
GENERAL
AVERAGE
(Numerical Value in 3
decimal places for
honor learner, 2 for
non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/S
(This column is for K to 12 Curriculum and
remaining RBEC in High School. Elementary
grades level that still implementing RBEC
need not to fill up this column)
Completed as of end
of current SY
as of End of the
current SY
PROFICIENT
(P: 85% -89%)
ADVANCED
(A:
90% and above)
85.80
Promoted
78.40
Promoted
82.20
Promoted
81.40
Promoted
Class Adviser
82.00
Promoted
112245090016
81.40
Promoted
112245090021
82.40
Promoted
112245090024
81.40
Promoted
82.60
Promoted
MANUEL A. OATE
82.40
Promoted
School Head
112245090005
112245090006
112698090027
112245090013
112245090015
112245090027
PREPARED BY:
JOAN V. ASAS
TOTAL FEMALE
COMBINED
REVIEWED BY:
GUIDELINES:
1. For All Grade/Year Levels
2. To be prepared by the Adviser. Final rating per
subject area should be taken from the record of subject
teacher. The class adviser should make the
3. On the summary table, reflect the total number of
learners promoted, retained and irregular ( *for grade 7
onwards only) and the level of proficiency according to
4. Must tallied with the total enrollment report as of End
of School Year GESP /GSSP (BEIS)
LRN
LEARNER'S NAME
(Last Name, First Name, Middle Name)
GENERAL
AVERAGE
(Numerical Value in 3
decimal places for
honor learner, 2 for
non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/S
(This column is for K to 12 Curriculum and
remaining RBEC in High School. Elementary
grades level that still implementing RBEC
need not to fill up this column)
Completed as of end
of current SY
as of End of the
current SY
4. Must tallied with the total enrollment report as of End
of School Year GESP /GSSP (BEIS)
5. Protocols of validation & submission will remain
under the discretion of the Schools Division
Superintendent
School Form 5: Page 2 of ________
School ID
Region
Division
School Name
District
GRADE 1 /GRADE 7
SUMMARY TABLE
GRADE 2 / GRADE 8
GRADE 3 / GRADE 9
GRADE 4 / GRADE 10
School Year
GRADE 5 / GRADE 11
GRADE 6 / GRADE 12
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
Nos. of BEGINNNING
(B: 74% and below)
Nos. of DEVELOPING
(D: 75%-79%)
Nos. of APPROACHING
PROFICIENCY
(AP: 80%-84%)
Nos. of PROFICIENT
(P: 85% -89%)
Nos. of ADVANCED
(A: 90% and above)
TOTAL
Noted by:
DIVISION REPRESENTATIVE
School Form 7 (SF7) School Personnel Assignment List and Basic Profile
(This replaced Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)
School ID
Division
Region
School Name
District
Number of
Incumbent
School Year
Number of
Incumbent
EDUCATIONAL QUALIFICATION
Employee
No. (or Tax
Identification
Number T.I.N.)
Sex
Fund
Source
Position/
Designation
Nature of
Appointment/
Employment
Status
Degree / Post
Graduate
Major/
Specialization
Minor
Appointment:
(Contractual,
Substitute,
Volunteer, others
specify)
Fund Source
(SEF, PTA, NGO's
etc.)
Number of
Incumbent
Teaching
Remark/s (For
Detailed Items,
Indicate name of
school/office, For
IP's -Ethnicity)
EDUCATIONAL QUALIFICATION
Employee
No. (or Tax
Identification
Number T.I.N.)
Sex
Fund
Source
Position/
Designation
Nature of
Appointment/
Employment
Status
Degree / Post
Graduate
Major/
Specialization
Minor
Remark/s (For
Detailed Items,
Indicate name of
school/office, For
IP's -Ethnicity)
Submitted by:
Number of
Incumbent
NonTeaching
Remark/s (For
Detailed Items,
dicate name of
chool/office, For
P's -Ethnicity)
Remark/s (For
Detailed Items,
dicate name of
chool/office, For
P's -Ethnicity)
Printed Name)
_________
ge 2 of ________