DepEd Form 137-E Republika ng Pilipinas

(Republic of the Philippines)

Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYONG ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)

Rehiyon IV - CALABARZON
Region IV - CALABARZON

PALAGIANG TALAAN 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

Magulang/Tagapag-alaga
(Parent / Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

PALAGIANG TALAAN SA MABABANG PAARALAN

(ELEMENTARY SCHOOL PROGRESS)
Grade I - School Grade II - School
School Year School Year

Periodic Rating Final Periodic Rating Final

Learning Areas Rating
Remarks Learning Areas Rating
Remarks
1 2 3 4 1 2 3 4
Filipino Filipino
English English
Mathematics Mathematics
Makabayan Makabayan
* Sibika at Kultura * Sibika at Kultura
* MSEP * MSEP
* Character Education * Character Education
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 Rating
Remarks Learning Areas Rating
Remarks
1 2 3 4 1 2 3 4
Filipino Filipino
English English
Mathematics Mathematics
Science and Health Science and Health
Makabayan Makabayan
* Sibika at Kultura * HKS
* MSEP * EPP
* Character Education * MSEP
* Character Education
General Average General Average
Eligible for Admission to Grade Eligible for Admission to Grade

Grade V - School Grade VI - School

School Year School Year

Periodic Rating Final Periodic Rating Final

Learning Areas Rating
Remarks Learning Areas Rating
Remarks
1 2 3 4 1 2 3 4
Filipino Filipino
English English
Mathematics Mathematics
Science and Health Science and Health
Makabayan Makabayan
* HKS * HKS
* EPP * EPP
* MSEP * MSEP
* Character Education * Character Education
General Average General Average
Eligible for Admission to Grade Eligible for Admission to Grade
III. CHARACTER BUILDING

Gr Sch. Yr. Gr Sch. Yr. Gr Sch. Yr.

1 2 3 4 F.R. 1 2 3 4 F.R. 1 2 3 4 F.R.

1 Honesty

2 Courtesy
Helpfulness and
3
Cooperation
4 Obedience

5 Consideration for Others

6 Sportsmanship
Resourcefulness and
7
Creativeness
8 Self-Reliance

9 Industry
Cleanliness and
10
Orderliness
Promptness and
11
Punctuality
12 Sense of Responsibility

13 Love of God
Patriotism and Love of
14
Country

Gr Sch. Yr. Gr Sch. Yr. Gr Sch. Yr.

1 2 3 4 F.R. 1 2 3 4 F.R. 1 2 3 4 F.R.

1 Honesty

2 Courtesy
Helpfulness and
3
Cooperation
4 Obedience

5 Consideration for Others

6 Sportsmanship
Resourcefulness and
7
Creativeness
8 Self-Reliance

9 Industry
Cleanliness and
10
Orderliness
Promptness and
11
Punctuality
12 Sense of Responsibility

13 Love of God
Patriotism and Love of
14
Country
A - Outstanding C - Satisfactory
B - Very Satisfactory D - Needs Improvement
IV. ATTENDANCE RECORD

No. of No. of School No. of Times No. of School Days

Grade Cause Cause
School Days Days Absent Tardy 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/Year .

Signature

Date Designation