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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 XI
(Region XI)

PALAGIANG TALAAN SA MABABANG PAARALAN


(ELEMENTARY SCHOOL PERMANENT RECORD)

LRN: _________________
I. Pangalan _____________________________________
(Name)
Kasarian _
(Sex)

Sangay: Davao del Sur

Paaralan Sacub Elementary School

Apelyido
Unang Ngalan
M.I.
(Division)
(School)
(Surname)
(First Name)
Petsa ng Kapanganakan ____________ Pook ___________________________
Petsa ng Pagpasok: _____________
(Date of Birth)
(Place) Bayan / Lalawigan / Lungsod (Date of Entrance)

Magulang/Tagapag-alaga:________________________________________________________________________________________________
Pangalan
Tirahan
Hanapbuhay
(Name)
(Address)
(Occupation)

II.

PAG-UNLAD SA MABABANG PAARALAN


(ELEMENTARY SCHOOL PROGRESS REPORT)
Grade I - School __________________________________________
Name of Teacher _________________________________________
Periodical Rating
Learning Areas

Grade II - School _______________________________________


Name of Teacher _______________________________________
Learning Areas
Periodical Rating

Remarks
1

Remarks

Final

Filipino
English
Mathematics
MAKABAYAN
* Sibika at Kultura

Final

Filipino
English
Mathematics
MAKABAYAN
* Sibika at Kultura
* Eduk. Pagpapakatao

* Character Education

GENERAL AVERAGE

GENERAL AVERAGE

School Year:_______________ E______________L_____________

Eligible for Admission to Grade Two

School Year

: ___________

E____________ L ___________

Eligible for Admission to Grade Three

Grade III - School __________________________________________


Name of Teacher _________________________________________
School Year:_______________ E______________L_____________
Learning Areas
Periodical Rating

Grade IV - School _______________________________________


Name of Teacher ________________________________________
School Year:_______________ E______________L_____________
Learning Areas
Periodical Rating

Remarks

Remarks

Final

Filipino

Filipino

English
Mathematics
Science and Health
Makabayan
* Sibika at Kultura
* MSEP

English
Mathematics
Science and Health
Makabayan
* HEKASI
* EPP
* MSEP
* Eduk. Pagpapakatao

* Eduk. Pagpapakatao

GENERAL AVERAGE

Final

GENERAL AVERAGE

Eligible for Admission to Grade Four

Eligible for Admission to Grade Five

Grade V - School __________________________________________


________________________________________
Name of Teacher _________________________________________
School Year:_______________ E______________L_____________
Learning Areas
Periodical Rating

Grade VI - School
Name of Teacher ________________________________________
School Year:_______________ E______________L_____________
Learning Areas
Periodical Rating

Remarks

Remarks

Filipino
English
Mathematics
Science and Health
Makabayan
* HEKASI
* EPP
* MSEP
* Eduk. Pagpapakatao

GENERAL AVERAGE

Eligible for Admission to Grade Six

Final

Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao
Edukasyong Pantahanan at Pangkabuhayan

MAPEH
* Music
* Art
* Physical Education
* Health
GENERAL AVERAGE

Eligible for Admission to Grade Seven

Final

III.

CHARACTER BUILDING
Gr. One S.Y. __________
1
2
3
4
F.R.

Traits

Gr. Two S.Y. _________


1
2
3
4
F.R.

Gr. Three S.Y. ____________


1
2
3
4
F.R.

1. Physically clean in body , mind and language


2. ready to work/cooperate in class activities
3. Honest in word and thought
4. Concerned about preserving the environment
5. Thrifty in using resources of time and money
6. Peace loving ; avoid conflicts and quarrels
7. Trustworthy ; can be trusted or depended upon
8. Truthful; seldom tells lies
9. Dependable to complete task given to him/her
10. Is able to discipline himself / herself
11. Has faith in God
12. Respect persons in authority
13. Values Filipino culture/arts
14. Behaves in a manner appropriate for his/her age

Gr. Four
S.Y. ________

Traits

Gr. Five
S.Y. ________

Gr. Six S.Y. 2015 - 2016


Core Values

1 2 3 4

F
R

1 2 3 4

Behavior Statement

FR

1. Physically clean in
body , mind and language
2. ready to work/cooperate
in class activities

Express ones spiritual beliefs while


respecting the spiritual beliefs of
others
Shows adherence to ethical
principles by upholding truth
Is sensitive to individual, social, and
cultural differences

1. Maka-Diyos

3. Honest in word and


thought
4. Concerned about
preserving the
environment
5. Thrifty in using
resources of time and
money
6. Peace loving ; avoid
conflicts and quarrels

2. Makatao

Demonstrates contributions toward


solidarity

3. Makakalikasan

7. Trustworthy ; can be
trusted or depended upon
8. Truthful; seldom tells
lies

4. Makabansa

Cares for the environment and


utilizes resources wisely, judiciously,
and economically
Demonstrates pride in being a
Filipino; exercises the rights and
responsibilities of a Filipino citizen
Demonstrates appropriate behavior
in carrying out activities in the
school, community, and country

9. Dependable to
complete task given to
him/her
10. Is able to discipline
himself / herself
11. Has faith in God
12. Respect persons in
authority
13. Values Filipino
culture/arts
14. Behaves in a manner
appropriate for his/her age

LEGEND:

Marking
AO
SO
RO
NO

A Outstanding 95 100% D Fair 77 82%


B Very Good 89 94%
E Poor Below 70 76%
C Good
- 83 88%

IV.

Non-numerical Rating
Always Observed
Sometimes Observed
Rarely Observed
Not Observed

TALAAN NG PAGPASOK
(Record of Attendance)
Baitang
(Grade)

Bilang ng Araw
Na May Pasok
(No. of School
Days)

Bilang ng Araw na
Lumiban sa Klase
(No. of Days Absent)

Pangunahing Dahilan
(Chief Cause)

Bilang na
Nahuli ng
Pagpasok
(No. of Times
Tardy)

Pangunahing
Dahilan
(Chief Cause)

Bilang ng Araw
na Pagpasok
(No. of School
Days Present)

One
Two
Three
Four
Five
Six

CERTIFICATE OF TRANSFER
TO WHOM IT MAY CONCERN:
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 __________
_______________________________

_________________
(Date)

Signature Over Printed Name


______________________________
Designation

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