Republika ng Pilipinas
(Republic of the Philippines)
Kagawaran ng Edukasyon
Department of Education
FORM
137-E
KAWANIHAN NG EDUKASYONG ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)
Region X Northern Mindanao
PALAGIANG TALAAN SA MABABANG PAARALAN
(Elementary School Permanent Record)
I. Pangalan ________________________________________Sangay__________________Paaralan__________________________
(Name)
Surname
First Name
Middle Name
(Division)
(Sch.) Sch. Contact No.: __________________
Kasarian _______Petsa ng Kapanganakan__________________Pook _________________________Petsa ng Pagpasok___________
(Sex)
(Date of Birth)
(Place) Bayan/Lungsod/Lalawigan
FATHER / GUARDIAN : ___________________________Place
(Date of Entrance)
:_______________________Occupation
:_________________
MOTHER:
__________________________________Occupation:____________________ Parents / Guardians Contact No. _____________
Learners Reference Number ( LRN ): _______________________
II. LEARNING PROGRESS AND ACHIEVEMENT
Grade I School: _________________________________________
DE: _________School Year: _____________________D L: _______
Periodic Rating
Final
Rating
Learning Areas
1
Grade II School: _________________________________________
DE: ___________School Year: __________________D L: _________
Remarks
Mother Tongue
Filipino
English
Mathematics
Araling Panlipunan
Learni
ng
Areas
MAPEH
Music
Arts
Physical Education
Health
Periodi
c
Rating
Final
Rating
Remarks
Mother Tongue
Filipino
English
Mathematics
Araling Panlipunan
MAPEH
Music
Arts
Physical Education
Health
Edukasyon sa Pagpapakatao
GENERAL AVERAGE
Edukasyon sa Pagpapakatao
GENERAL AVERAGE
Eligible for Admission to Grade_____________
Eligible for Admission to Grade______________
Grade III School: _______________________________________________
________________________________________________
DE: _________School Year: _________________ DL: __________
DE: ___________School Year: _________________ DL: __________
Periodic Rating
Final
Rating
Learning Areas
1
Remarks
Mother Tongue
Filipino
English
Mathematics
Science
Araling Panlipunan
MAPEH
Music
Arts
Physical Education
Health
Edukasyon sa Pagpapakatao
Grade IV School:
Periodic Rating
Final
Rating
Learning Areas
1
Remarks
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyong Pantahananan at
Pangkabuhayan
MAPEH
Music
Arts
Physical Education
Health
Edukasyon sa Pagpapakatao
GENERAL AVERAGE
GENERAL AVERAGE
Eligible for Admission to Grade _______________
Eligible for Admission to Grade______________
Grade V School: _______________________________________________
Grade VI School: ______________________________________________
DE: ________School Year: ____________________ DL: _________
DE: _________School Year: ____________________ DL: ________
Periodic Rating
Final
Eligible for Admission to Grade_________________
Eligible
Learning
for Admission
Areas to Grade_________________
Rating Remarks
1
2
3
4
Filipino
III. CHARACTER BUILDING/LEARNERS OBSERVED
English
VALUES
Mathematics
Science
Gr.
Gr.
Gr.
Araling
PanlipunanSch. Yr
Character
Sch. Yr
Sch. Yr
Edukasyong Pantahananan
1 2 at3
Traits
Pangkabuhayan
MAPEH
Music
1. Arts
Honesty
2. Physical
CourtesyEducation
3. Health
Helpfulness
4 F 1 2 3 4 F 1
R
.
R
F
R
A- Outstanding
4. Maka bansa
Legend:
GENERAL AVERAGE
Legend:
3. Maka
kalikasan
1
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao
Resourcefulne
ss &
Creativity
5.
Consideration
for others
6.
Sportsmanship
7. Obedience
8. SelfReliance
9. Industry
10.
Cleanliness &
Orderliness
2. Maka tao
Remarks
MAPEH
Music
Arts
Physical Education
Health
GENERAL
4.
AVERAGE
1. Maka-Diyos
Final
Rating
Edukasyong Pantahananan at
Pangkabuhayan
Edukasyon
sa Pagpapakatao
& Cooperative
Core Values
Periodi
c
Rating
Learni
ng
Areas
Behavior Statements
B- Very Good
Gr.
1
Sch. Yr
3
4
C- Good
FR
Gr.
1
D- Fair
Sch. Yr
3
E- Poor
Gr.
4
FR
Sch. Yr
2
FR
Expresses ones spiritual belief while
respecting the spiritual beliefs of
others
Shows adherence to ethical principles
by upholding the truth
Is sensitive to individual, social, and
cultural differences
Demonstrates contributions toward
solidarity
Cares for the environment and
utilizes resources wisely, judiciously,
and economically
Demonstrates pride in being a
Filipino; exercises the rights and
responsibilities of a Filipino Citizen
Demonstrates appropriate behavior in
carrying out activities in the school,
community, and country
AO Always Observed
SO Sometimes Observed
RO Rarely Observed
NO Not Observed
IV. ATTENDANCE RECORD
Grade
No. of
School
Days
No. of
School
Days
Absent
Cause
No. of
Times
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________________________________________.
He / She is eligible for transfer and admission to Grade________________.
______________________________
Name and Signature
_____________________________
Date
______________________________
Designation
REMARKS: Copy of this form is forwarded to
Name of Sch:
_______________________________________________________________Sch.ID:____________________________________
Add. of Sch:
________________________________________________________Sch. Contact No. ___________________________________
District:
____________________________________________ Division:______________________________ Region: _______________
