Republika ng Pilipinas

DEP. ED FORM 137-E (Republic of the Philippines)

Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYONG ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)
Pambansang Punong Rehiyon
(National Capital Region)
Sangay ng mga Paaralang Lungsod
Lungsod ng Marikina

PALAGIANG TALAAN SA MABABANG PAARALAN

(ELEMENTARY SCHOOL PERMANENT RECORD)

I. Pangalan_____________________________________________Sangay___________________ Paaralang Elementarya ng FORTUNE

(Name) ApelyidoUnang Pangalan (M.I.) (Division) (School)

Kasarian ______________ Petsa ng Kapanganakan ___________________Pook ________________Petsa ng Pagpasok ___________

(Sex) (Date of Birth) (Place) (Date of Entrance)

Magulang/Tagapag-alaga ________________________________ _____________________________________ ______________

(Name) (Address) (Occupation)
PAG-UNLAD SA MABABANG PAARALAN
(ELEMENTARY SCHOOL PROGRESS)
Grade I - School___________________ Grade II - School__________________
School Year__________________ School Year__________________

Periodic Rating Periodic Rating

Learning Areas Remarks Learning Areas Remarks
1 2 3 4 1 2 3 4
ENGLISH ENGLISH
MATHEMATICS MATHEMATICS
FILIPINO FILIPINO
MAKABAYAN MAKABAYAN
(Sibika at Kultura; MSEP) (Sibika at Kultura; MSEP)

CHARACTER EDUCATION CHARACTER EDUCATION

Eligible for Admission to Grade_______________________ Eligible for Admission to Grade_______________________

Grade III - School__________________ Grade IV - School__________________

School Year__________________ School Year__________________
Periodic Rating Periodic Rating
Learning Areas Remarks Learning Areas Remarks
1 2 3 4 1 2 3 4
ENGLISH ENGLISH
MATHEMATICS MATHEMATICS
SCIENCE AND HEALTH SCIENCE AND HEALTH
FILIPINO FILIPINO
MAKABAYAN MAKABAYAN
(Sibika
(Sibikaat
atKultura;
Kultura;MSEP)
MSEP) (Sibika at Kultura; MSEP)
HEOGRAPIYA/KASAYSAYAN/
SIBIKA(HKS)
Edukasyong Pantahanan at
Pangkabuhayan (EPP)
Musika,Sining at Edukasyon
Pagpapalakas ng Katawan(MSEP)

CHARACTER EDUCATION

Eligible for Admission to Grade_______________________ Eligible for Admission to Grade_______________________

Grade V - School___________________ Grade VI - School__________________

School Year__________________ School Year__________________

Periodic Rating Periodic Rating

Learning Areas Remarks Learning Areas Remarks
1 2 3 4 1 2 3 4
ENGLISH ENGLISH
MATHEMATICS MATHEMATICS
SCIENCE AND HEALTH SCIENCE AND HEALTH
FILIPINO FILIPINO
MAKABAYAN MAKABAYAN
(Sibika at Kultura; MSEP)
HEOGRAPIYA/KASAYSAYAN/ (Sibika at Kultura; MSEP)
HEOGRAPIYA/KASAYSAYAN/
SIBIKA(HKS) SIBIKA(HKS)
Edukasyong Pantahanan at Edukasyong Pantahanan at
Pangkabuhayan (EPP) Pangkabuhayan (EPP)
Musika,Sining at Edukasyon Musika,Sining at Edukasyon
Pagpapalakas ng Katawan(MSEP) Pagpapalakas ng Katawan(MSEP)

CHARACTER EDUCATION CHARACTER EDUCATION

Eligible for Admission to Grade_______________________ Eligible for Admission to Grade_______________________
III. CHARACTER BUILDING
Gr. _________ Sch. Yr.________ Gr. _________ Sch. Yr.________ Gr. _________ Sch. Yr.________
1 2 3 4 F.R. 1 2 3 4 F.R. 1 2 3 4 F.R.
1. Honesty

2. Courtesy

3. Helpfulness and Cooperation

4. Resourcefulness and Creativeness

5. Consideration for Others

6. Sportsmanship

7. Obedience
8. Self-Reliance

9. Industry

10. Cleanliness and Orderliness

Gr. _________ Sch. Yr.________ Gr. _________ Sch. Yr.________ Gr. _________ Sch. Yr.________
1 2 3 4 F.R. 1 2 3 4 F.R. 1 2 3 4 F.R.
1. Honesty

2. Courtesy

3. Helpfulness and Cooperation

4. Resourcefulness and Creativeness

5. Consideration for Others

6. Sportsmanship

7. Obedience
8. Self-Reliance

9. Industry

10. Cleanliness and Orderliness

A - Very Good B - Good C - Fair D - Poor

IV. ATTENDANCE RECORD
No. of School No. of Times No. of School
Grade Days
No. of School
Days Absent Cause Tardy Cause Days Present

C E R T I F I C A T E O F T R A N S F E R
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 ______________________________________.
____________________________
Signature
____________________________
_____________________________________________ Designation
Date