DepEd Form 137-E

__________________

LRN

Republika ng Pilipinas
(Republic of the Philippines)
Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYONG ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)
Rehiyon XIII (Caraga)
(Region)

PALAGIANG TALAAN NG SA MABABANG PAARALAN

(ELEMENTARY SCHOOL PERMANENT RECORD)

I. Pangalan _____________________________________________ Sangay _______________________ Paaralan

____________________________________
(Name) Apelyido
Unang Pangalan M.I. (Division)
(School)
Kasarian _____ Petsa ng Kapanganakan ___________ Pook __________________________________ Petsa ng
Pagpasok _________________
(Sex)
(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)
Grade I - School ___________________
School Year ____________________
Teacher ____________________

Grade II - School ________________

School Year ________________
Teacher ________________
Periodic
Remark
Rating
Learning Areas
s
1 2 3 4

Eligible for Admission to Grade ___________

Eligible for Admission to Grade
___________
Grade III - School ___________________
Grade IV - School
________________
School Year _____________________
School
Year
_________________
Teacher ______________________
Periodic
Remark
Rating
Learning Areas
s
1 2 3 4
English
Mathematics
Science & Health
Filipino
MAKABAYAN
Hekasi
EPP
MSEP
Character Education

Mother Tongue
Filipino
English
Mathematics
Araling Panlipunan
MAPEH
Music
Art
Physical Education
Health
Edukasyon sa Pagpapakatao
General Average

Teacher
__________________
Eligible for Admission to Grade __________
Eligible for Admission to Grade ___________
Grade V - School ___________________
Grade VI - School
________________
School Year ____________________
School
Year
_________________
Teacher _____________________
Periodic
Remark
Rating
Learning Areas
s

English
Mathematics
Science & Health
Filipino
MAKABAYAN
Hekasi
EPP
MSEP
Character Education

Teacher __________________

Eligible for Admission to Grade ___________

Eligible for Admission to Grade ___________

III. CHARACTER BUILDING

1. Honesty
2. Courtesy

Grade ____ Sch.

Yr._________
1
2
3
4

F.R.

Grade ____ Sch.

Yr.________
1
2
3
4

F.R.

Grade ____ Sch.

Yr._________
2
3
4

F.R.

3.

Helpfulness
Cooperation

&

4.

Resourcefulness
Creativity

&

5.
Consideration
Others
6. Sportsmanship
7. Obedience
8. Self-Reliance
9. Industry
10.
Cleanliness

for

&

Orderliness
11.
Promptness
Punctuality

&

12.
Sense
Responsibility
13. Love of God
14. Patriotism

of

Grade ____ Sch.

Yr.________
1
2
3
4

1. Honesty
2. Courtesy
3.
Helpfulness

&

4.

&

Cooperation

Resourcefulness
Creativity

5.
Consideration
Others
6. Sportsmanship
7. Obedience
8. Self-Reliance
9. Industry
10.
Cleanliness

F.R.

Grade ____ Sch.

Yr._________
1
2
3
4

F.R.

Grade ____ Sch.

Yr._________
2
3
4

F.R.

for

&

Orderliness
11.
Promptness
Punctuality

&

12.
Sense
Responsibility
13. Love of God
14. Patriotism

of

A
B

Outstanding
Very Good

C
-

Good
Fair

Poor

IV. ATTENDANCE RECORD

Grade

No. Of
Schoo
l Days

No. of
School
Days
Absent

Cause

No. Of
Tardy

Cause

No. of
School
Days
Present

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 ____________________________________________. She/he is eligible for transfer
and admission to Grade/Year ______________.
______________________
Signature
________________________
______________________
Date

Designation