School Form 1 (SF 1) School Register

(This replace Form 1, Master List & STS Form 2-Family Background and Profile)

School ID School Name

Region

Division School Year

District
Grade Level
ADDRESS NAME OF PARENTS

SECTION
GUARDIAN (If not Parent) REMARK/S

AGE as of NAME (Last Name, First Name, Middle Name) Sex (M/F) BIRTH DATE (mm/ dd/yy) (nos. of years as per last birthday) BIRTH PLACE (Province) MOTHER TONGUE IP (Specify Ethnic Group)

LRN

RELIGION

House # / Street/Sitio/ Purok

Barangay

Municipality/ City

Province

Father (1st name only if family name identical to learner)

Mother (Maiden)

Name

Relationship

Contact Number

(Please refer to the legend on last page)

AGE as of ADDRESS LRN NAME (Last Name, First Name, Middle Name) Sex (M/F) BIRTH DATE (mm/ dd/yy) (nos. of years as per last birthday) BIRTH PLACE (Province) MOTHER TONGUE IP (Specify Ethnic Group) RELIGION NAME OF PARENTS GUARDIAN (If not Parent) REMARK/S

House # / Street/Sitio/ Purok

Barangay

Municipality/ City

Province

Father (1st name only if family name identical to learner)

Mother (Maiden)

Name

Relationship

Contact Number

(Please refer to the legend on last page)

List and code of Indicators under REMARK column

Indicator Code Required Information
Name of Public (P) Private (PR) School & Effectivity Date Name of Public (P) Private (PR) School & Effectivity Date Reason and Effectivity Date

Indicator
CCT Recipient Balik-Aral Learner With Dissability Accelarated

Code
CCT B/A LWD ACL

Required Information
CCT Control/reference number & Effectivity Date Name of school last attended & Year
MALE FEMALE TOTAL

BoSY
13 14 27

EoSY
14 14 28

Prepared by:

Certified Correct:

Transferred Out T/O Transferred IN Dropped T/I DRP

(Signature of Adviser over Printed Name)

(Signature of School Head over Printed Name)

Date:

Date:

School Form 2 (SF2) Daily Attendance Report for learner

(This cancel Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

School ID Name of School

*LEARNER'S NAME (Last Name, First Name, Middle Name)

School Year

Month Reporting
Grade Level
DATE (1st row for date, 2nd row for Day: M,T,W,TH,F)

Section
Total for the Month ABSENT TARDY REMARK/S (If DROPPED OUT, state reason, please refer to legend number 2. If TRANSFERRED IN/OUT, write the name of School.)

MALE | TOTAL Per Day

*LEARNER'S NAME (Last Name, First Name, Middle Name)

DATE (1st row for date, 2nd row for Day: M,T,W,TH,F)

Total for the Month ABSENT TARDY

REMARK/S (If DROPPED OUT, state reason, please refer to legend number 2. If TRANSFERRED IN/OUT, write the name of School.)

FEMALE | DAILY TOTAL

Combined TOTAL PER DAY

*LEARNER'S NAME (Last Name, First Name, Middle Name)

* Automatic Generation thru LIS

DATE (1st row for date, 2nd row for Day: M,T,W,TH,F)

Total for the Month ABSENT TARDY

REMARK/S (If DROPPED OUT, state reason, please refer to legend number 2. If TRANSFERRED IN/OUT, write the name of School.)
No. of Days of Classes:

GUIDELINES: 1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance. 2. Dates shall be written in the preceding columns beside Learner's Name. 3. To compute the following: Registered Learner as of End of the Month a. Percentage of Enrolment = Enrolment as of July Total Daily Attendance b. Average Daily Attendance = Number of School Days Average daily attendance Percentage of Attendance for the month = c. Registered Learner as of End of the month 4. Every End of the month, the teacher/adviser submit this form to the office of the principal for recording of summary table into the Form 3. Once signed by the principal, this form should be returned to the adviser. 5. 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

1. CODES FOR CHECKING ATTENDANCE blank- Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer, Lower for Cutting Classes)

Month:

Summary for the Month

M F TOTAL

* Enrolment as of Registered Learner as of end of the month *Percentage of Enrolment as of

x 100

x 100

School Form 2: Page 2 of ________

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 a.4. Family problems b. Individual-Related Factors 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 & clan feuds) d.3. Calamities/Disasters e. Financial-Related e.1. Child labor, work f. Others

Average Daily Attendance Percentage of Attendance for the month Number of students with 5 consecutive days of absences:
Drop out Transferred out Transferred in I certify that this is a true and correct report.

(Signature of Teacher over Printed Name) Attested by: (Signature of School Head over Printed Name)

School Form 3 (SF3) Books Issued and Returned

(This replace Form 1 & Inventory of Text Book)

School ID School Name

Subject Area & Title Subject Area & Title

School Year Grade Level

Subject Area & Title Subject Area & Title

Section
Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

NO.

*LEARNER'S NAME (Last Name, First Name, Middle Name) Date Issued Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned

TOTAL FOR MALE

TOTAL COPIES

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

NO.

*LEARNER'S NAME (Last Name, First Name, Middle Name) Date Issued Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned

TOTAL FOR FEMALE TOTAL LEARNERS

| |

TOTAL COPIES TOTAL COPIES Prepared By:

* Automatic Generation thru LIS GUIDELINES: 1. Title of Books Issued to each learner must be recorded by the class adviser. 2. The Date of Issuance and the Date of Return shall be reflected in the form. 3. The Total Number of Copies issued at BoSY shall be reflected in the form. 4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form.

(Signature over printed name) School Form 3: Page 2 of ________

Region:

Division:

District

School Form 4 (SF4) Monthly Learner's Movement and Attendance

(This replace Form 3 & STS Form 4-Absenteeism and Dropout Profile) Region Division District

School ID School Name

REGISTERED LEARNER (As of End of the Month) M F T M ATTENDANCE DROPPED OUT (A) Cumulative as (B) For the Month of Previous Month T M F T M F T

School Year
TRANSFERRED OUT

Month Reporting
TRANSFERRED IN

NAME OF ADVISER

GRADE/ YEAR LEVEL

SECTION

Average
F T

Percentage M F

(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 F T M F T M F T M F T M F T M F T M F T

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 # Need home visitation as per DECS Service Manual (page, section) GUIDELINES: 1. This forms shall be accomplished every end of the month using the summary box of Form 1 submitted by the teachers/advisers to update figures for the month. Columns for "Cumulative as of Previous Month" require the figures in "cumulative total reported from previous month". 2. Furnish copy to Division Office: a week after July 31, October 30 & March 31 3. Teachers who are handling advisory class shall be reported. 4. Small school that has one section per grade/year level are 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. Prepared and Submitted by:

(Signature of School Head over Printed Name)

School Form 5 (SF 5) Report on Promotion & Level of Proficiency

(This replace Forms 18-E1, 18-E2, 18A)

Region
School ID School Name

Division School Year

District Curriculum
Grade Level Section

LRN

LEARNER'S NAME (Last Name, First Name, Middle Name)

GENERAL AVERAGE (Numerical Value in 3 decimal places)

ACTION TAKEN: PROMOTED or RETAINED (RBEC only)

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

SUMMARY TABLE
MALE FEMALE TOTAL

PROMOTED

RETAINED

LEVEL OF PROFICIENCY
MALE FEMALE TOTAL

BEGINNNING (B: 74% and below) DEVELOPING (D: 75%-79%)

APPROACHING PROFICIENCY (AP: 80%-84%)

PROFICIENT (P: 85% -89%) ADVANCED (A: 90% and above)

LRN

LEARNER'S NAME (Last Name, First Name, Middle Name)

GENERAL AVERAGE (Numerical Value in 3 decimal places)

ACTION TAKEN: PROMOTED or RETAINED (RBEC only)

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

TOTAL MALE

PREPARED BY:

DANALYN V. SERVILLON Class Adviser (Name and Signature)

CERTIFIED CORRECT & SUBMITTED:

School Head (Name and Signature)

GUIDELINES: 1. For All Grades Level 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 computation of General Average. 2. On the summary table, reflect the total number of learners promoted, retained and the level of proficiency according to the individual general average TOTAL FEMALE COMBINED 3. 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)

ACTION TAKEN: PROMOTED or RETAINED (RBEC only)

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

* May generate thru Learner's Information System or may lift from Master List of Learners.
School Form 5: Page 2 of ________

School Form 6 (SF6) Summarized Report on Promotion and Level of Proficiency

(This cancel Form 20)

School ID School Name

GRADE 1 / GRADE 7 GRADE 2 / GRADE 8

Region

Division District
School Year
GRADE 5 / GRADE 11 GRADE 6 / GRADE 12 TOTAL

SUMMARY TABLE

GRADE 3 / GRADE 9

GRADE 4 / GRADE 10

MALE PROMOTED RETAINED (RBEC) LEVEL OF PROFICIENCY MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE FEMALE

TOTAL MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE FEMALE

TOTAL MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

MALE

FEMALE

TOTAL

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

Prepared and Submitted by: SCHOOL HEAD

Reviewed & Validated by: DPO/EPS

Noted by: SCHOOLS DIVISION SUPERINTENDENT

GUIDELINES: 1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the Total for Grade Level in order to reflect the result in each data field. 2. This report together with the copy of Report for Promotion submitted by the class adviser shall be forwarded to the Division Office by the end of the school year. 3. The Report on Promotion per Grade Level is reflected in the End of School Year Report of GESP/GSSP

School Form 7 (SF7) School Personnel Assignment List and Basic Profile
(This replace Form 12-Monthly Status Report for Teachers, Form 19-Assignment List, Form 29-Teacher Program and Form 31-Summary Information of Teachers)

School ID School Name

(A) Nationally-Funded Teaching Related Items Title of Plantilla Position (as appeared in the appointment document) Number of Incumbent

Region

Division District
Number of Incumbent Nature of Appointment and Designation (Contractual, Substitute, Volunteer & others) KINDER

School Year
(C ) Other Appointments Fund Source LOCALLY FUNDED Number of Incumbent NonTeaching Teaching 1

(B) Nationally-Funded Non Teaching Items Title of Plantilla Position (as appeared in the appointment document)

EDUCATIONAL QUALIFICATION Name of School Personnel No. (Arrange by Position, Descending) Sex Fund Source Position/ Designation Nature of Appointment

Degree / Post Graduate

Major/ Specialization

Minor

Subject Taught (include Grade & Section) & Other Ancillary Assignment (Please Specify)

* Daily Program (time duration) Actual Teaching/ Service Render (Mins/Day) Remark/s (For Detailed Items, Indicate name of school/office, For IP's Ethnicity)

DAY

From

To

Ave. Minutes per Day

Ave. Minutes per Day

EDUCATIONAL QUALIFICATION Name of School Personnel No. (Arrange by Position, Descending) Sex Fund Source Position/ Designation Nature of Appointment

Degree / Post Graduate

Major/ Specialization

Minor

Subject Taught (include Grade & Section) & Other Ancillary Assignment (Please Specify)

* Daily Program (time duration) Actual Teaching/ Service Render (Mins/Day) Remark/s (For Detailed Items, Indicate name of school/office, For IP's Ethnicity)

DAY

From

To

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day GUIDELINES: 1. This form shall be accomplished at the beginning of the school year by the school head. In case of movement of teachers and other personnel during SY, updated Form 19 must submit to the Division Office . 2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank down to the lowest. This form shall also serve as inventory list of school personnel. 3. * Daily Program Column is for teaching personnel only Submitted by:

(Signature of School Head over Printed Name) School Form 7, Page 2 of ________

Republic of the Philippines Department of Education Region: _____________________________ Division : ____________________________ School: _______________________________ LEARNER DATA SHEET Pls. Check: ( ) Transferee ( ) Balik-Aral ( ) Private ( ) Public Name of Previous School: _________________________________________________________ Division: ______________________________ Province/Region : ______________________________ A. PERSONAL DATA (to be accomplished by the parent/pupil during enrolment) Name of Learner: ______________________________________ LRN: __________________ Date of Birth : _________________________________ Place of Birth : ____________________ Sex: ___________ Current Address/Residence: SY House #/Street Barangay SY SY SY SY SY Nationality: __________________________ Religion: ______________ Name of Father: _______________________________ Occupation : ___________________ Highest Educational Attainment of Father: ______________________________ Name of Mother: _______________________________ Occupation : ______________________ Highest Educational Attainment of Mother: ______________________________ Name of Guardian (if Guardian is not the parent): ______________________________________ Relationship to Guardian: ________________________________ Contact Number of Parents/Guardian: _________________________________ Currently living with at least one of the parents : ( ) yes ( ) no Dialect use to communicate within the family: ______________________ Recipient of 4P's* : Yes/ No SY SY SY SY *Programang Pantawid ng Pamilyang Pilipino SY SY B. MEDICAL / HEALTH RECORD (annual updating by the health officer/teacher) b.1 Nutritional Status SY_____ SY_____ SY_____ SY_____ SY_____ Weight (kg) Height (m) Body Mass Index (BMI) Nutritional Status (e.g.Normal,Below Normal,Above Normal,Severely Wasted) b.2 Learner's record of ailments: (pls. check) (to be examined by the nurse) SY_____ SY_____ SY_____ SY_____ SY_____ ( ) Pediculosis ( ) Tinea Flava ( ) Scabies ( ) Eye infection ( ) Squinting eyes ( ) Otitis Media ( ) Impacted Cerumen ( ) Colds/Cough ( ) Sinusitis ( ) Ringworm ( ) Nosebleed ( ) Decayed Tooth ( ) defective speech ( ) Sore Throat ( ) Tonsilitis ( ) Asthma ( ) Allergy ( ) Bronchitis ( ) Primary Complex ( ) Convulsions ( ) Frequent headache ( ) Heart problem ( ) Frequent Stomach Ache Other illness(specify):

Municipality/Province

SY_____

SY_____

SY_____

SY_____

*Order of ailments (eyes, ears, etc.)

b.3 Immunization

Learner's immunization shots are complete and current: yes /no SY b.4 Physical Fitness and Sports Talent Test (PFSTT) SY_____ SY_____ SY_____ b.4.1. Muscular Fitness Partial: Curl Ups Trunk: Lift (cm) 90-Degrees push- ups b.4.2. Flexibility Fitness Sit and Reach Left leg bent (cm) Right leg bent (cm) Shoulder Flexibility Right arm up (cm) Left arm up (cm) b.4.3. Physiological Fitness 1km run - Time: (min/sec) b.5. Sports Talents b.5.1 Anthropometrics Sitting Height (cm) Arm Span (cm) b.5.2. Muscular Power Standing Long Jump (m) Basketball Pass (m) b.5.3 Speed 40-meter sprint (sec.) C. FAMILY& COMMUNITY PROFILE

SY SY_____

SY_____

SY_____

SY_____

*to be commented by PE Teachers

Type of community ( ) Residential ( ) Commercial ( )Agricultural ( ) Industrial ( ) Fishing Disaster Prone/ Armmed Conflict ( ) Yes ( ) No Identified as IP Community? If yes, specify: _____________________________________________ With electrical services (Home) ( ) Yes ( ) No With water services (Home) ( ) Yes ( ) No Distance of Home from/to school: ___________ (km) Estimated time in going to school : ______ (hour) Means of going to school: ( ) walking ( ) by boat ( ) vehicles D. EDUCATIONAL PROFILE (see attached Form 137)

( ) Mining

GUIDELINE: The Learner Data Sheet shall be accomplish by the parent/pupil during enrolment. While, the medical/health record shall be accomplish by the