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Republika ng Pilipinas

(Republic of the Philippines)


Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYONG ELEMENTARYA

DepEd Form 137-E

(BUREAU OF ELEMENTARY EDUCATION)

Rehiyon I
Region I
PALAGIANG TALAAN SA MABABANG PAARALAN
(ELEMENTARY SCHOOL PERMANENT RECORD)

I.

Pangalan
(Name)

Kasarian:
(Sex)

Sangay: ILOCOS SUR Paaralan: MIRAMAR ELEMENTARY SCHOOL


Apelyido

Unang Pangalan

M.I.

Petsa ng Kapanganakan:
(Date of Birth)

(Division)
Pook
(Place) Bayan/Lalawigan/Lungsod

Magulang/Tagapag-alaga
(Parent / Guardian)

Pangalan
(Name)

Tirahan
(Address)

(School)
Petsa ng Pagpasok

Hanapbuhay
(Occupation)

PALAGIANG TALAAN SA MABABANG PAARALAN


(ELEMENTARY SCHOOL PROGRESS)
Grade I - School
School Year
Learning Areas

Grade II - School
School Year
Periodic Rating

Final
Rating

Remarks

Learning Areas

Periodic Rating

General Average

General Average

Eligible for Admission to Grade

Eligible for Admission to Grade

Grade III - School


School Year

Grade IV - School
School Year

Learning Areas

Periodic Rating

Final
Rating

Remarks

Learning Areas

General Average

Eligible for Admission to Grade


Grade V - School
School Year

Eligible for Admission to Grade


Grade VI - School
School Year
Periodic Rating

Final
Rating

Remarks

Learning Areas

Final
Rating

Remarks

Final
Rating

Remarks

Final
Rating

Remarks

Periodic Rating

General Average

Learning Areas

Periodic Rating

General Average

General Average

Eligible for Admission to Grade

Eligible for Admission to Grade

MENTARYA

ION)

PAARALAN

ECORD)

MIRAMAR ELEMENTARY SCHOOL

PAARALAN
ESS)

Remarks

Remarks

Remarks

III. CHARACTER BUILDING ACTIVITIES


Gr. _____ Sch. Yr. _____
1

Gr. _____ Sch. Yr. _____


F.R.

Gr. _____ Sch. Yr. _____


F.R.

F.R.

1 Honesty
2 Courtesy
3 Helpfulness and Cooperation
4 Obedience
5 Consideration for Others
6 Sportsmanship
7 Resourcefulness and Creativeness
8 Self-Reliance
9 Industry
10 Cleanliness and Orderliness
11 Promptness and Punctuality
12 Sense of Responsibility
13 Love of God
14 Patriotism/Love of Country
AVERAGE
Gr. _____ Sch. Yr. _____

Gr. _____ Sch. Yr. _____

F.R.

Gr. _____ Sch. Yr. _____

F.R.

F.R.

1 Honesty
2 Courtesy
3 Helpfulness and Cooperation
4 Obedience
5 Consideration for Others
6 Sportsmanship
7 Resourcefulness and Creativeness
8 Self-Reliance
9 Industry
10 Cleanliness and Orderliness
11 Promptness and Punctuality
12 Sense of Responsibility
13 Love of God
14 Patriotism/Love of Country
AVERAGE
A - Outstanding

C - Good

B - Very Good

D - Fair

E - Poor

IV. ATTENDANCE RECORD


Grade

No. of School Days

No. of School Days Absent

No. of Times
Tardy

Cause

Cause

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

.
Signature

Date

Designation

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