DECS Form 137-E

Republika ng Pilipinas
Kagawaran ng Edukasyon, Kultura at Isports
Rehiyon XI
Sangay ng Davao
DON CARLOS CENTRAL ELEMENTARY SCHOOL

ELEMENTARY SHOOL PERMANENT RECORD

I. Name: ____________________________________________ Date of Entrance: _____________

Surname First M.I.

Sex: _________ Date of Birth: ___________________Place of Birth: _______________________

Parent/Guardian:________________________________________________________________
(Name) (Address) (Occupation)

ELEMENTARY SCHOOL PROGRESS

II. School . . . . :____________________:_____________________:_____________________

Grades . . . . :____________________:_____________________:_____________________
School Year. . . :____________________:_____________________:_____________________
________________________________________________________________________________
Learning Areas :____________________:_____________________:______________________
English : : :_____________________
Elem. Mathematics: : :_____________________
Science &Health :___________________ :____________________ :_____________________
Filipino :____________________ :_____________________:_____________________
Sibika / Hekasi : : : _____________________
SMEPK : :____________________ :_____________________
EPP : : :_____________________
C. E. / G.M.R.C. :_____________________:_____________________:______________________
Gen, Ave. : : :_____________________
No. of Sch. Days : : :_____________________
No. of Days Absent:____________________:_____________________:______________________
No. of Days Present: : :_____________________

School . . . . :____________________:_____________________:_____________________
Grades . . . . :____________________:_____________________:_____________________
School Year. . . :____________________:_____________________:_____________________
________________________________________________________________________________
Learning Areas :____________________:_____________________:______________________
English : : :_____________________
Elem. Mathematics: : :_____________________
Science &Health :___________________ :____________________ :_____________________
Filipino :____________________ :_____________________:_____________________
Sibika / Hekasi : : : _____________________
SMEPK : :____________________ :_____________________
EPP : : :_____________________
C. E. / G.M.R.C. :_____________________:_____________________:______________________
Gen, Ave. : : :_____________________
No. of Sch. Days : : :_____________________
No. of Days Absent:____________________:_____________________:______________________
No. of Days Present: : :_____________________
III. CHARACTER BUILDING
_____________________________________________________________________________________
Gr.____ Sch. Yr.____ : Gr.____ Sch. Yr. _____ : Gr._____ Sch. Yr. ______
TRAITS : _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

_____________________1: 2 : 3 : 4 : F.R. : 1: 2 : 3 : 4 : F.R. : 1: 2 : 3 : 4 : F.R. __

Honesty :______________________________________________________________
Courtesy :________________________________________________________________
Helpfulness :________________________________________________________________
Obedience :________________________________________________________________
Consideration for
Others :________________________________________________________________
Sportsmanship :________________________________________________________________
Love of Country :________________________________________________________________
Self-reliance :________________________________________________________________
Industry :________________________________________________________________
Cleanliness and
Orderliness :_________________________________________________________________

_____________________________________________________________________________________
Gr.____ Sch. Yr.____ : Gr.____ Sch. Yr. _____ : Gr._____ Sch. Yr. ______
TRAITS : _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

_____________________1: 2 : 3 : 4 : F.R. : 1: 2 : 3 : 4 : F.R. : 1: 2 : 3 : 4 : F.R. __

Honesty :________________________________________________________________
Courtesy :________________________________________________________________
Helpfulness :________________________________________________________________
Obedience :________________________________________________________________
Consideration for
Others :________________________________________________________________
Sportsmanship :________________________________________________________________
Love of Country :________________________________________________________________
Self-reliance :________________________________________________________________
Industry :________________________________________________________________
Cleanliness and
Orderliness :_________________________________________________________________

CERTIFICATE OF TRANSFER

TO WHOM IT MAY CONCERN:

This is to certify that this is a true record of the Elementary record of _________________.
He/She is eligible for transfer and admission to Grade/Year_________.
Date:__________________________

OPHELIA A. PANGANDOYON
Guidance Counselor