FORM 137-E

RepublikangPilipinas
(Republic of the Philippines)
KagawaranngEdukasyon
(Department of Education)
KAWANIHAN NG EDUKASYON ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)
Rehiyon:CARAGA

PALAGIANG TALAAN SA MABABANG PAARALAN

(Elementary School Permanent Record)
LRN:____________________________

Pangalan: ________________________________________________________ Sangay: SURIGAO DEL NORTE Paaralan: URBIZTONDO ELEM. SCHOOL
(Name) Apelyido Unang Pangalan M.I. (Division) (School)

Kasarian:_____________Petsa ng Kapanganakan: __________ Pook: URBIZTONDO, CLAVER, SDN Petsa ng Pagpasok: _______________
(Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod (Date of Entrance)
(Town/Province/City)
Magulang/Tagapag-alaga:_____________________________________________________________________________________________________________________
(Parent/Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

PAG-UNLAD SA MABABANG PAARALAN

(Elementary School Progress)

Grade I-School____________________________________________________________________ Grade II-School________________________________________________________________

School Year________________________________________________________________________ School Year__________________________________________________________________
Periodic Rating Final Periodic Rating Final
LEARNING AREAS Remarks LEARNING AREAS Remarks
1 2 3 4 Grade 1 2 3 4 Grade
Mother Tongue Mother Tongue
Filipino Filipino
English English
Mathematics Mathematics
Araling Panlipunan (AP) Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP) Edukasyon sa Pagpapakatao (EsP)
MAPEH MAPEH
Music Music
Art Art
Physical Education (PE) Physical Education (PE)
Health Health
General Average General Average
Eligible for Admission to Grade________________________________________ Eligible for Admission to Grade_____________________________________

Grade III-School_________________________________________________________________ Grade IV-School___________________________________________________________________

School Year________________________________________________________________________ School Year_________________________________________________________________________
Periodic Rating Final Periodic Rating Final
LEARNING AREAS Remarks LEARNING AREAS Remarks
1 2 3 4 Grade 1 2 3 4 Grade
Mother Tongue Filipino
Filipino English
English Mathematics
Mathematics Science
Science Araling Panlipunan (AP)
Araling Panlipunan (AP) Edukasyon sa Pagpapakatao (EsP)
Edukasyon sa Pagpapakatao (EsP) Edukasyong Pantahanan at
MAPEH Pangkabuhayan (EPP)
Music MAPEH
Art Music
Physical Education (PE) Art
Health Physical Education (PE)
General Average Health
Eligible for Admission to Grade______________________________________ General Average
Eligible for Admission to Grade________________________________________
Grade V-School_________________________________________________________________
School Year________________________________________________________________________ Grade VI-School_________________________________________________________________
Periodic Rating School Year________________________________________________________________________
Final
LEARNING AREAS Remarks
Periodic Rating
1 2 3 4 Grade Final
LEARNING AREAS Remarks
Filipino 1 2 3 4 Grade
English Filipino
Mathematics English
Science Mathematics
Araling Panlipunan (AP) Science
Edukasyon sa Pagpapakatao (EsP) Araling Panlipunan (AP)
Edukasyong Pantahanan at Edukasyon sa Pagpapakatao (EsP)
Pangkabuhayan (EPP) Edukasyong Pantahanan at
MAPEH Pangkabuhayan (EPP)
Music MAPEH
Art Music
Physical Education (PE) Art
Health Physical Education (PE)
General Average Health
Eligible for Admission to Grade______________________________________________ General Average
Eligible for Admission to Grade______________________________________________
III. REPORT ON LEARNER’S OBSERVED VALUES
Gr. 1 S.Y. _____________ Gr. 2 S.Y. _____________ Gr. 3 S.Y. _____________
Quarter Quarter Quarter
Core Values Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one’s spiritual beliefs while
respecting the spiritual beliefs of
MAKA- others
DIYOS Shows adherence to ethical principles
by upholding truth
Is sensitive to individual, social, and
cultural differences
MAKATAO Demonstrates contributions toward
solidarity
Cares for the environment and utilizes
MAKA
resources wisely, judiciously, and
KALIKASAN economically
Demonstrates pride in being a Filipino;
exercises the rights and
responsibilities of a Filipino citizen.
MAKABANSA
Demonstrates appropriate behavior in
carrying out activities in the school,
community, and country

Gr. 4 S.Y. ______________ Gr. 5 S.Y. ____________ Gr. 6 S.Y. ____________

Quarter Quarter Quarter
Core Values Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one’s spiritual beliefs while
respecting the spiritual beliefs of
MAKA- others
DIYOS Shows adherence to ethical principles
by upholding truth
Is sensitive to individual, social, and
cultural differences
MAKATAO Demonstrates contributions toward
solidarity
Cares for the environment and utilizes
MAKA
resources wisely, judiciously, and
KALIKASAN economically
Demonstrates pride in being a Filipino;
exercises the rights and
responsibilities of a Filipino citizen.
MAKABANSA
Demonstrates appropriate behavior in
carrying out activities in the school,
community, and country

MARKING NON-NUMERICAL RATING MARKING NON-NUMERICAL RATING

AO Always Observed RO RarelyObserved
SO Sometimes Observed NO Not Observed

IV. ATTENDANCE RECORD

No. of School No. of School No. of Times No. of School
Grade Cause Cause
Days Days Absent Tardy 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
_____________________________________________________. He/She is eligible for transfer and admission of Grade_____________________.

_____________________________________________
Signature

__________________________________________ ____________________________________________________
Date Designation