Академический Документы
Профессиональный Документы
Культура Документы
(This replaced Form 1, Master List & STS Form 2-Family Background and Profile)
School ID
300988
Region
School Name
Division
School Year
AGE as of 1st
Friday of June
LRN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
1
2
3
4
5
6
NAME
(Last Name, First Name, Middle Name)
Angeles, Arjay A.
Bartolome, John Carlo V.
Caligagan, Ramilo D.
Castillo II, King Manny M.
Castillo, RJ P.
Dizon, Mark Jamil M.
Dueas, Rafael D.
Estravillo, John Paulo C.
Guiao, Lyndon P.
Juare, Angelo Vincent
Labong Jr., Arthur C.
Madarang, Kevin G.
Manuel, Jomarie M.
Pasuguiran Jr., Danilo D.
Remigio Jr., Arnelio E.
Rosete, Edmerl Iverson D.
Santos, Jayson S.
Tababa, Jeremy
Tababa, Julifer D
Tabios, Ivy S.
Tamayo, Erickson E.
Taniza, Monte Carlo
Ular, Arnie D.
Aguilar, Jovie Ann L.
Alfaro, Trisha C.
Castillo, Joana Marie M.
Corpuz, Kheyzle B.
Cunanan, Janine S.
David, Monica O.
TARLAC CITY
Sex (M/F)
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
M
F
F
F
F
F
F
BIRTH DATE
(mm/ dd/yy)
(nos. of years
as per last
birthday)
District
2015-2016
Grade Level
ADDRESS
BIRTH PLACE
(Province)
MOTHER
TONGUE
IP
(Specify Ethnic
Group)
TARLAC EAST
7
Section
NAME OF PARENTS
DELA COSTA
GUARDIAN (If not Parent)
REMARK/S
Contact Number
(Parent /Guardian)
RELIGION
House # / Street/Sitio/
Purok
Barangay
Municipality/ City
Province
Name
Relationship
11/19/02
12
Tarlac
Tagalog
Roman Catholic
blk 1
San Manuel
Tarlac City
Tarlac
Rodolfo
Milagros G. Aganon
11/28/02
12
Tarlac
Tagalog
Roman Catholic
blk 1
San Manuel
Tarlac City
Tarlac
Bernabe
Marites T. Vallejo
9219605148
9258119191
1/20/02
12
Tarlac
Tagalog
Roman Catholic
blk 6
San Manuel
Tarlac City
Tarlac
Rey
9196400491
8/7/02
12
Tarlac
Tagalog
Roman Catholic
blk 4
San Manuel
Tarlac City
Tarlac
Redencio
9156866734
1/7/02
12
Tarlac
Tagalog
Roman Catholic
blk 1
San Manuel
Tarlac City
Tarlac
Randy
Gina Pingol
9234337378
9/6/02
12
Tarlac
Tagalog
Roman Catholic
blk 2
San Manuel
Tarlac City
Tarlac
Randy
1/23/02
12
Tarlac
Tagalog
Methodist
blk 1
San Manuel
Tarlac City
Tarlac
Edgardo
Mely David
9235166486
12/21/02
12
Tarlac
Tagalog
Roman Catholic
blk 4
San Pascual
Tarlac City
Tarlac
Sydney
Mylene C. Cortez
9498617728
2/4/02
12
Tarlac
Tagalog
INC
blk 5
San Isidro
Lapaz
Tarlac
Abner
Myrna Pascual
9124369112
8/31/01
12
Tarlac
Tagalog
Roman Catholic
blk 5
San Manuel
Tarlac City
Tarlac
Gradencio
11/5/02
12
Tarlac
Tagalog
Roman Catholic
blk 5
San Pascual
Tarlac City
Tarlac
Henry
Olive Calleja
9291005588
8/30/02
12
Tarlac
Tagalog
INC
blk 1
San Pascual
Tarlac City
Tarlac
Noriel
Gina S. Grande
6067060
2/1/02
12
Tarlac
Tagalog
Methodist
zone 6
Maliwalo
Tarlac City
Tarlac
Danny
9176040366
4/26/03
11
Tarlac
Tagalog
Roman Catholic
blk 1
San Manuel
Tarlac City
Tarlac
Gerry
Marilyn M. Dizon
9066433501
9/2/02
12
Tarlac
Tagalog
Roman Catholic
blk 1
San Manuel
Tarlac City
Tarlac
Louie
Dulcie Espejo
9356900902
6/6/02
12
Tarlac
Tagalog
INC
blk 2
Caramutan
Lapaz
Tarlac
Romeo
Melita Dante
9184921464
Myla G. Suriaga
9287858217
9277406509
7/3/02
12
Tarlac
Tagalog
Methodist
blk 2
Caramutan
Lapaz
Tarlac
Nestor
3/22/02
12
Tarlac
Tagalog
Roman Catholic
zone 6
Maliwalo
Tarlac City
Tarlac
Arnel
7/30/02
12
Tarlac
Tagalog
Baptist
blk 3
San Pascual
Tarlac City
Tarlac
Ryan
Mawie Q. Davidao
11/22/03
12
Tarlac
Tagalog
Roman Catholic
blk 3
San Manuel
Tarlac City
Tarlac
Floren
9439256183
7/12/02
12
Tarlac
Tagalog
Roman Catholic
blk 1
San Manuel
Tarlac City
Tarlac
Wilfred
Monnette P. Estrada
91625525216
12/7/02
12
Tarlac
Tagalog
Roman Catholic
blk 2
San Manuel
Tarlac City
Tarlac
Edgardo
9124369442
12/7/02
12
Tarlac
Tagalog
Roman Catholic
blk 5
San Manuel
Tarlac City
Tarlac
Jose Marie
9275300413
9/13/02
3/19/02
10/8/02
11/28/02
1/20/02
11/12/02
12
12
12
12
12
12
Tarlac
INC
blk 1
San Pascual
Tarlac City
Tarlac
Rocky
Tarlac
Tagalog
Tagalog
Roman Catholic
blk 6
San Jose
Tarlac City
Tarlac
Rizaldo
Tarlac
Tagalog
Roman Catholic
blk 6
San Jose
Tarlac City
Tarlac
Rodolfo
Tarlac
Tagalog
INC
blk 1
San Manuel
Tarlac City
Tarlac
Bien
Tarlac
Tagalog
Roman Catholic
blk 6
San Jose
Tarlac City
Tarlac
Jeffrey
Tarlac
Tagalog
Roman Catholic
blk 2
San Manuel
Tarlac City
Tarlac
Amelito
9197485963
Tricia Cortez
9997233165
9993656306
Jasmine Solomon
9075064303
9461502751
AGE as of 1st
Friday of June
NAME
(Last Name, First Name, Middle Name)
LRN
7
8
9
10
11
12
13
14
15
16
17
18
Sex (M/F)
Escao, Rochelle S.
Juliano, Ronalyn C.
F
F
Mananquil, Hazel N.
Mangaco, Jenalyn C.
Miranda, Rocel
Oate, Regine D.
BIRTH DATE
(mm/ dd/yy)
(nos. of years
as per last
birthday)
6/12/02
1/1/02
1/3/02
1/29/02
7/28/01
8/11/02
7/12/02
12
12
12
12
13
12
12
ADDRESS
BIRTH PLACE
(Province)
MOTHER
TONGUE
IP
(Specify Ethnic
Group)
NAME OF PARENTS
Code
House # / Street/Sitio/
Purok
Barangay
Municipality/ City
Province
Jehovah's Witness
blk 1
San isidro
Lapaz
Tarlac
Jet
Tarlac
Tagalog
Tarlac
Tagalog
Methodist
blk 2
San Manuel
Tarlac City
Tarlac
Jovito
Tarlac
Tagalog
Roman Catholic
blk 2
San Manuel
Tarlac City
Tarlac
Ronaldo
Tarlac
Tagalog
Born Again
blk 1
Caramutan
Lapaz
Tarlac
Tarlac
Tagalog
Roman Catholic
blk 1
Balingcanaway
Tarlac City
Tarlac
Tarlac
Tagalog
INC
blk 5
San Manuel
Tarlac City
Tarlac
Tarlac
Tagalog
Roman Catholic
blk 1
San Isidro
Lapaz
Tarlac
5/1/02
12
Tarlac
Tagalog
Methodist
blk 1
Balingcanaway
Tarlac City
Tarlac
5/3/02
12
Tarlac
Tagalog
Roman Catholic
blk 6
San Jose
Tarlac City
Tarlac
2/29/2002
12
Tarlac
Tagalog
Born Again
blk 6
San Manuel
Tarlac City
Tarlac
8/28/01
12
Tarlac
Tagalog
Roman Catholic
blk 6
San Jose
Tarlac City
Tarlac
9/11/02
12
Tarlac
Tagalog
INC
blk 5
San Manuel
Tarlac City
Tarlac
Required Information
Indicator
Code
REMARK/S
Contact Number
(Parent /Guardian)
Required Information
BoSY
Transferred Out
T/O
CCT Recipient
CCT
MALE
Transferred IN
Dropped
Late Enrollment
T/I
DRP
LE
Balik-Aral
Learner With Dissability
Accelarated
B/A
LWD
ACL
FEMALE
TOTAL
Name
Relationship
9336696453
9193911844
Milanda D. Baltazar
9166621427
Neil
Gille Castillo
9176234559
Edgardo
Oliverio C. Nunag
9985473329
Enrico
Nelia S. Castillo
9153246099
Rey
Biena Garcia
Jonas
Alfred
Jessa David
Gerald
Rosa Quinto
Richard
Edwardo
May Ramos
RELIGION
EoSY
9461522751
9336496454
9193811833
9177621427
9276234549
9206564549
Prepared by:
Certified Correct:
BoSY Date:
EoSYDate:
BoSY Date:
EoSYDate:
(This replaced Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile
300988
School Year
Name of School
2015-2016
Grade
(1st row for date, 2nd row for Day: M,T,W,TH,F)
1 Angeles, Arjay A.
2 Bartolome, John Carlo V.
3 Caligagan, Ramilo D.
4 Castillo II, King Manny M.
9 Guiao, Lyndon P.
12 Madarang, Kevin G.
13 Manuel, Jomarie
14 Pasuguiran Jr., Danilo D.
18 Tababa, Jeremy
19 Tababa, Julifer
25
W
24
T
23
M
20
F
19
7 Dueas, Rafael D.
8 Estravillo, John Paulo C.
20 Tabios, Ivy S.
18
5 Castillo, RJ P.
6 Dizon, Mark Jamil M.
17 Santos, Jayson S.
17
TH
16
13
12
11
10
TH
3
T
TH
LEARNER'S NAME
(Last Name, First Name, Middle Name)
School ID
25
W
23
T
20
M
19
F
18
TH
17
W
16
T
13
M
12
F
11
TH
10
W
9
T
6
M
5
F
4
TH
3
T
LEARNER'S NAME
(Last Name, First Name, Middle Name)
21 Tamayo, Erickson E.
22 Taniza, Monte Carlo
23 Ular, Arnie D.
21
23
23
23
23
21
23
22
22
23
21
23
22
23
23
23
7 Escao, Rochelle S.
8 Juliano, Ronalyn C.
9 Laxamana, Heart Darren
10 Macadangdang, Madonna Marie
11 Mananquil, Hazel N.
12 Mangaco, Jenalyn C.
13 Miranda, Rocel
14 Nucup, Mary Joy
X
X
21
23
24
25
W
20
19
18
17
TH
16
13
M
12
F
11
TH
10
W
9
T
6
M
5
F
4
TH
3
T
LEARNER'S NAME
(Last Name, First Name, Middle Name)
15 Oate, Regine D.
17
18
17
17
18
17
16
18
18
18
17
18
18
18
18
17
18
18
38
41
40
40
41
38
39
40
40
41
38
41
40
41
41
40
39
41
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
Percentage of Enrolment =
b.
x 100
x 100
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
4. Every End of the month, the class adviser will submit this form to the office of the principal for recording of
summary table into the School Form 4. Once signed by the principal, this form should be returned to the adviser.
5. The adviser will extend neccessary intervention including but not limited to home visitation to learner/s that committed 5 consecutive days of absences or those with
potentials of dropping out
6. 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
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
25
W
23
T
20
M
19
F
18
TH
17
W
16
T
13
M
12
F
11
TH
10
W
9
T
6
M
5
F
4
TH
3
T
LEARNER'S NAME
(Last Name, First Name, Middle Name)
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
e. Financial-Related
e.1. Child labor, work
f. Others
port of Learners
Dropout Profile)
NOVEMBER
Grade Level
Section
DELA COSTA
Total for the Month
30
M
27
F
TH
26
ABSENT
TARDY
H
O
L
I
D
A
Y
H
O
L
I
D
A
Y
1
3
1
2
1
1
1
1
1
21
30
M
27
F
TH
26
ABSENT
TARDY
15
X H
O
L
X I
D
A
Y
H
O
L
I
D
A
Y
1
1
1
3
1
1
30
ABSENT
TH
26
15
11
36
26
11
ENDANCE
P-OUTS
TARDY
Month:
19
OCTOBER
TOTAL
23
18
41
23
18
41
100
100
100
22.21
17.42
39.63
96.57
96.78
96.66
Drop out
Transferred out
Transferred in
27
F
TH
26
ABSENT
TARDY
PERLA C. PALMA
(Signature of School Head over Printed Name)
School ID
School Year
School Name
NO.
Grade Level
Subject Area & Title
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
Returned
Issued
Returned
Issued
Returned
Issued
NO.
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
Returned
Issued
Returned
Issued
Returned
Issued
NO.
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
Returned
Issued
Returned
Issued
Returned
Issued
NO.
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
Returned
Issued
Returned
Issued
Returned
Issued
Section
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Prepared By:
Region
Division
School ID
School Name
ATTENDANCE
NAME OF ADVISER
GRADE/
YEAR
LEVEL
SECTION
REGISTERED
LEARNER
(As
of End of the Month)
Daily Average
M
DROPPED OUT
(A) Cumulative as of
Previous Month
M
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
GUIDELINES:
1. This forms shall be accomplished every end of the month using the summary box of SF2 submitted by the teachers/advisers to update figures for the month.
2. Furnish copy to Division Office: a week after June 30, October 30 & March 31
3. Only teachers who are handling advisory class shall be reported. May use additional copy/ies of this form if needed.
4. Small school that has one section per grade/year level is not required to fill the columns "Name of Adviser, Grade/Year Level & Section". Instead, they will only accomplish the summary column per grad
District
School Year
OPPED OUT
TRANSFERRED OUT
TRANSFERRED IN
(A+B) Cumulative as
of End of the Month
M
Region
Division
School ID
School Year
School Name
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
GENERAL AVERAGE
(Numerical Value in 3
decimal places for honor
learner, 2 for non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/
(This column is for K to 1
Elementary grades level
Completed as of end of
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
TOTAL MALE
GENERAL AVERAGE
(Numerical Value in 3
decimal places for honor
learner, 2 for non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/
(This column is for K to 1
Elementary grades level
Completed as of end of
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
GENERAL AVERAGE
(Numerical Value in 3
decimal places for honor
learner, 2 for non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/
(This column is for K to 1
Elementary grades level
Completed as of end of
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
TOTAL FEMALE
COMBINED
GENERAL AVERAGE
(Numerical Value in 3
decimal places for honor
learner, 2 for non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/
(This column is for K to 1
Elementary grades level
Completed as of end of
District
Curriculum
Grade Level
Section
LETE SUBJECT/S
olumn is for K to 12 Curriculum and remaining RBEC in High School.
tary grades level that still implementing RBEC need not to fill up this
column)
MALE
FEMALE
PROMOTED
*IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
TOTAL
LETE SUBJECT/S
olumn is for K to 12 Curriculum and remaining RBEC in High School.
tary grades level that still implementing RBEC need not to fill up this
column)
FEMALE
BEGINNNING
(B: 74% and below)
ADVANCED
(A: 90%
and above)
PREPARED BY:
Class Adviser
(Name and Signature)
TOTAL
LETE SUBJECT/S
olumn is for K to 12 Curriculum and remaining RBEC in High School.
tary grades level that still implementing RBEC need not to fill up this
column)
School Head
(Name and Signature)
REVIEWED BY:
LETE SUBJECT/S
olumn is for K to 12 Curriculum and remaining RBEC in High School.
tary grades level that still implementing RBEC need not to fill up this
column)
School ID
Region
Division
School Name
District
GRADE 1 /GRADE 7
GRADE 2 / GRADE 8
GRADE 3 / GRADE 9
GRADE 4 / GRADE 10
SUMMARY TABLE
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
Nos. of BEGINNNING
74% and below)
Nos. of DEVELOPING
75%-79%)
(B:
(D:
Nos. of APPROACHING
PROFICIENCY
(AP: 80%-84%)
Nos. of PROFICIENT
85% -89%)
(P:
Nos. of ADVANCED
90% and above)
(A:
TOTAL
Noted by:
DIVISION REPRESENTATIVE
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
4. Protocols of validation & submission will remain under the discretion of the Schools Division Superintendent
Promotion
School Year
GRADE 5 / GRADE 11
GRADE 6 / GRADE 12
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
d.
(This replaced Form 12-Monthly Status Report for Teachers, Form 19-Assignmen
Form 29-Teacher Program and Form 31-Summary Information of Teachers)
School ID
Region
Division
School Name
District
Number of
Incumbent
Title of Designation
(Designation
contract/document: Teac
Guard, Driver etc.)
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
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
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
personnel.
3. Please reflect subjects being taught and if teacher handling advisory class or Ancillary Assignment. Other administrative duties must also reported.
4. * Daily Program Column is for teaching personnel only.
School Year
(C ) Other Appointments and Funding Sources
Title of Designation
(Designation as appeared in the
contract/document: Teacher, Clerk, Security
Guard, Driver etc.)
Appointment:
Fund Source
(Contractual, Substitute,
(SEF, PTA, NGO's etc.)
Volunteer, others specify)
Number of Incumbent
Teaching
Non-Teaching
DAY
(M/T/W/TH/
F)
From
(00:00)
DAY
(M/T/W/TH/
F)
From
(00:00)
DAY
(M/T/W/TH/
F)
From
(00:00)