Professional Documents
Culture Documents
(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)
School ID
School Name
Region VIII
109745
Division
LUCENA CITY
School Year
District
2015-2016
Grade Level
ADDRESS
LRN
NAME
(Last Name, First Name, Middle Name)
Sex
(M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
MOTHER TONGUE
Friday June
IP
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
WEST
FIVE
Section
PARENTS
Province
109745100010
7/14/04
11
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100019
1/10/05
10
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100021
7/12/03
12
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109740100095
3/22/04
11
TAGALOG
CATHOLIC
ISABANG
LUCENA
QUEZON
109745120099
11/6/01
14
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100034
9/2/05
10
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100040
JUGACAN ,DEXTER
3/9/05
10
TAGALOG
CATHOLIC
ISABANG
LUCENA
QUEZON
109743100074
3/18/05
10
TAGALOG
CATHOLIC
IYAM
LUCENA
QUEZON
109745100044
LUCABA , JOSHUA
1/2/04
11
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100049
10/16/03
12
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100059
1/17/05
10
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100062
8/1/05
10
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100074
12/2/99
16
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100005
AMORIN,MERZIEL,ACLAN
9/18/05
10
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100011
BANAAG,RICA MAY
5/11/04
11
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
112144100011
8/24/04
11
BICOLANA
CATHOLIC
MALVAR
LUCENA
QUEZON
136721100205
CLAVECILLA,NICA ELLA M
10/16/04
11
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100025
2/1/04
11
TAGALOG
CATHOLIC
ISABANG
LUCENA
QUEZON
109745100029
9/2/05
10
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100030
8/12/03
12
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100033
9/13/03
12
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
136901100301
7/1/04
11
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745090013
5/20/03
12
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109708100038
4/29/05
10
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
ADDRESS
NAME
(Last Name, First Name, Middle Name)
LRN
109745120101
109810100033
109745100068
Sex
(M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
MOTHER TONGUE
Friday June
IP
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
PARENTS
Province
12/29/03
11
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
7/26/04
11
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
RAMIENTO , FRANCINE
9/13/02
13
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109744100154
12/15/04
10
TAGALOG
CATHOLIC
IYAM
LUCENA
QUEZON
109745100071
9/18/04
11
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
109745100075
7/5/05
10
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
102731100323
VERGARA,CHARLOTTE ,VILLABROZA
10/10/03
12
TAGALOG
CATHOLIC
SALAZAR
LUCENA
QUEZON
1097451100324
10/10/03
12
TAGALOG
CATHOLIC
SALAZAR
LUCENA
QUEZON
109745100076
12/11/04
10
TAGALOG
CATHOLIC
MALVAR
LUCENA
QUEZON
Code
T/O
Required Information
Name of Public (P) Private (PR) School & Effectivity Date
Code
Required Information
CCT
REGISTERED
MALE
BoSY
EoSY
Prepared by:
ADDRESS
NAME
(Last Name, First Name, Middle Name)
LRN
Transferred IN
Dropped
Late Enrollment
T/I
DRP
LE
Sex
(M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
MOTHER TONGUE
Friday June
IP
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
B/A
LWD
ACL
Specify
Specify Level & Effectivity Data
Barangay
Municipality/ City
PARENTS
Province
TOTAL
BoSY Date:
EoSYDate
T
SUNFLOWER
GUARDIAN
(If
REMARKS
not Parent)
Name
Relation-ship
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
Contact Number of
Parent or Guardian
GUARDIAN
(If
REMARKS
not Parent)
Name
Relation-ship
Contact Number of
Parent or Guardian
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
MOTHER
Certified Correct:
GUARDIAN
(If
REMARKS
not Parent)
Name
of Adviser over Printed Name)
EoSYDate:
Relation-ship
Contact Number of
Parent or Guardian
BoSY Date:
EoSYDate:
School ID
109745
School Year
2015-2016
Grade Level
1
M
2
W
3
TH
4
F
7
M
8
T
9
W
10
TH
11
F
14
M
15
T
16
W
TH
18
F
21
M
22
T
23
24
TH
F
G
7 JUGACAN ,DEXTER
F
R
9 LUCABA , JOSHUA
SUNFLOWER
25
2 BANAAG,RICA MAY
Section
Total for the Month
17
1 AMORIN,MERZIEL,ACLAN
FIVE
LEARNER'S NAME
(Last Name, First Name, Middle Name)
MARCH
A
Y
TH
ABSENT
TARDY
LEARNER'S NAME
(Last Name, First Name, Middle Name)
1
M
2
W
3
TH
4
F
7
M
8
T
9
W
10
TH
11
F
14
M
15
T
16
W
17
TH
18
F
21
M
22
T
23
W
24
TH
25
F
TH
ABSENT
TARDY
x 100
x 100
4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summary table into School Form 4. Once signed by
the principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days and/or those at risk of
dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
* Beginning of School Year cut-off report is every 1st Friday of the School Year
Month:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer, Lower
for Cutting Classes)
2. REASONS/CAUSES FOR DROPPING OUT
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
e. Financial-Related
e.1. Child labor, work
f. Others (Specify)
DIANA R. GOMEZ
(Signature of Teacher over Printed Name)
Attested by:
JOSEPHINE E. PERMALINO
(Signature of School Head over Printed Name)
Summary
M
nted Name)
TOTAL
School ID
School Year
School Name
NO.
Section
Grade Level
Subject Area & Title
Date
Date
Date
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
Returned
Issued
Returned
Issued
Returned
Issued
Returned
Issued
Returned
Issued
Returned
Issued
Date
Returned
Issued
NO.
Date
Date
Date
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
Returned
Issued
Returned
Issued
Returned
Issued
Returned
Issued
Returned
Issued
Returned
Issued
Date
Returned
Issued
In case of lost/unreturned books, please provide information with the following code:
Prepared By:
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code FM), TLTR=Teacher
prepared letter/report duly noted by School Head for submission to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code
NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14, 2.2012.
Date BoSY:_____
Date
Returned
Date
Returned
School ID
Region
Division
District
School Name
GRADE/
YEAR LEVEL
School Year
SECTION
NAME OF ADVISER
REGISTERED
LEARNERS
(As of End of the
Month)
M
ATTENDANCE
Daily Average
M
DROPPED OUT
Rep
(A) Cumulative as of
Previous Month
M
TRANSFERRED OUT
(A+B) Cumulative as
of End of the Month
M
(A) Cumulative as of
Previous Month
M
ELEMENTARY/SECONDARY:
KINDER
GRADE 1/GRADE 7
GRADE 2/GRADE 8
GRADE 3/GRADE 9
GRADE 4/GRADE 10
GRADE 5/GRADE 11
GRADE 6/GRADE 12
TOTAL FOR NON-GRADED
TOTAL
GUIDELINES:
1. This form shall be accomplished every end of the month using the summary box of SF2 submitted by the teachers/advisers to update figures for the month.
2. Furnish the Division Office with a copy a week after June 30, October 30 & March 31
(A+B) Cumulative as
of End of the Month
M
(Signature of S
Page _____ of _____ pages
(A+B) Cumulative as
of End of the Month
M
Region
Division
School ID
District
School Year
Curriculum
School Name
LRN
Grade Level
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
Section
INCOMPLETE SUBJECT/S
(This
column is for K to 12 Curriculum and remaining RBEC in High School. Elementary
grades level that are still implementing RBEC need not to fill up these columns)
From previous school years completed as
of end of current School Year
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
TOTAL MALE
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/S
(This
column is for K to 12 Curriculum and remaining RBEC in High School. Elementary
grades level that are still implementing RBEC need not to fill up these columns)
From previous school years completed as
of end of current School Year
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
TOTAL FEMALE
COMBINED
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/S
(This
column is for K to 12 Curriculum and remaining RBEC in High School. Elementary
grades level that are still implementing RBEC need not to fill up these columns)
From previous school years completed as
of end of current School Year
SUMMARY TABLE
STATUS
MALE
FEMALE
TOTAL
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
MALE
BEGINNNING
(B: 74% and below)
DEVELOPING (D:
75%-79%)
APPROACHING
PROFICIENCY
(AP: 80%-84%)
PROFICIENT
(P:
85% -89%)
ADVANCED
(A: 90%
and above)
FEMALE
TOTAL
ADVANCED
(A: 90%
and above)
PREPARED BY:
Class Adviser
(Name and Signature)
School Head
(Name and Signature)
REVIEWED BY:
GUIDELINES:
1. For All Grade/Year Levels
2. To be prepared by the Adviser. Final rating per subject area should
be taken from the record of subject teachers. The class adviser
should compute for the General Average.
3. On the summary table, reflect the total number of learners
promoted, retained and *irregular (*for grade 7 onwards only) and the
level of proficiency according to the individual General Average.
4. Must tally with the total enrollment report as of End of School Year
GESP /GSSP (EBEIS)
5. Protocols of validation & submission is under the discretion of the
Schools Division Superintendent
School ID
Region
Division
School Name
District
GRADE 1 /GRADE 7
GRADE 2 / GRADE 8
GRADE 3 / GRADE 9
GRADE 4 / GRADE 10
GRADE 5 / GRADE 11
GRADE 6 / GRADE 12
SUMMARY TABLE
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
BEGINNNING
74% and below)
DEVELOPING
75%-79%)
(B:
(D:
APPROACHING PROFICIENCY
(AP: 80%-84%)
PROFICIENT
85% -89%)
(P:
ADVANCED
90% and above)
(A:
TOTAL
Noted by:
DIVISION REPRESENTATIVE
GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the grade level total and school total.
2. This report together with the copy of Report for Promotion submitted by the class adviser shall be forwarded to the Division Office by the end of the school year.
3. The Report on Promotion per grade level is reflected in the End of School Year Report of GESP/GSSP.
4. Protocols of validation & submission is under the discretion of the Schools Division Superintendent.
School Year
GRADE 12
NDENT
TOTAL
TOTAL
MALE
FEMALE
TOTAL
TOTAL
MALE
FEMALE
TOTAL
School Form 7 (SF7) School Personnel Assignment List and Basic Profile
(This replaces Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)
School ID
Region
Division
School Name
District
Number of
Incumbent
Appointment:
(Contractual,
Substitute, Volunteer,
others specify)
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment
Status
Degree / Post
Graduate
Major/ Specialization
Daily Program (t
Minor
DAY
(M/T/W/TH
/F)
From
(00:00)
Ave. Minutes p
Ave. Minutes p
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment
Status
Degree / Post
Graduate
Major/ Specialization
Daily Program (t
Minor
DAY
(M/T/W/TH
/F)
From
(00:00)
Ave. Minutes p
Ave. Minutes p
Ave. Minutes p
Ave. Minutes p
Ave. Minutes p
GUIDELINES:
Submitted by:
1. This form shall be accomplished at the beginning of the school year by the school head. In case of movement of teachers and other personnel during the school year, an updated Form 19 must be submitted to the
Division Office .
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank down to the lowest.
3. Please reflect subjects being taught and if teacher handling advisory class or Ancillary Assignment. Other administrative duties must also reported.
(Sig
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment
Status
Degree / Post
Graduate
Major/ Specialization
Daily Program (t
Minor
DAY
(M/T/W/TH
/F)
From
(00:00)
Updated as of: _
School Year
Teaching
NonTeaching
To (00:00)
Total Actual
Teaching
Minutes per
Week
To (00:00)
Total Actual
Teaching
Minutes per
Week
ubmitted by:
To (00:00)
Total Actual
Teaching
Minutes per
Week