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: _______________