SF 10 -JHS

Republic of the Philippines

Department of Education
Learner Permanent Record for Junior High School (SF10-JHS)
(Formerly Form 137)

LEARNER'S INFORMATION
LAST NAME: ________________________FIRST NAME: ____________________ NAME EXTN. (Jr,I,II): _______ MIDDLE NAME:
Learner Reference Number (LRN): ______________ Birthdate (mm/dd/yyyy): _____________________ Sex: __________

ELIGIBILITY FOR JHS ENROLMENT

Elementary School Completer General Average: ________ Citation: (If Any)
Name of Elementary School: School ID: Adress of School:
Other Credential Presented
PEPT Passer Rating: _________ ALS A & E Passer Rating: _____________ Others (Pls. Speci
Date of Examination/Assessment (mm/dd/yyyy): ____________ Name and Address of Testing Center: ___________________

SCHOLASTIC RECORD
School: ______________________ School ID: ________ District: ___________________ Division: ____________
Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Sig
Quarterly Rating FINAL
LEARNING AREAS R
1 2 3 4 RATING
Filipino
English
Mathematics
Science
Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP)
Technology and Livelihood Education (TLE)
MAPEH
Music
Arts
Physical Education
Health

General Average
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _________________
Recomputed Final
Learning Areas Final Rating Remedial Class Mark Grade

School: ______________________ School ID: ________ District: ___________________ Division: ____________

Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Sign
QUARTER FINAL
LEARNING AREAS R
1 2 3 4 RATING
Filipino
English
Mathematics
Science
Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP)
Technology and Livelihood Education (TLE)
MAPEH
Music
Arts
Physical Education
Health

General Average

Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _________________

Recomputed Final
Learning Areas Final Rating Remedial Class Mark Grade

CERTIFICATION

I CERTIFY that this is a true record of _________________________with LRN ______________ and that he/she is eligible for adm
Name of School: ____________________________________ School ID: __________________ Last School Year Attended: _____

________________________
Date Name of Principal/School Head over Printed Name (Affix School Sea
of the Philippines
ent of Education
or Junior High School (SF10-JHS)
erly Form 137)

S INFORMATION
MIDDLE NAME: ___________________
Sex: _____________________________

OR JHS ENROLMENT

Rating: _____________ Others (Pls. Specify): ___________

and Address of Testing Center: ____________________________________

STIC RECORD
: ___________________ Division: __________________ Region: ____
Name of Adviser/Teacher: ________________ Signature: __________

REMARKS

_____________ to (mm/dd/yyyy) __________________

Remarks

: ___________________ Division: __________________ Region: ____

me of Adviser/Teacher: ________________ Signature: __________

REMARKS
____________ to (mm/dd/yyyy) __________________
Remarks

IFICATION

RN ______________ and that he/she is eligible for admission to Grade ____.

_________________ Last School Year Attended: _________________________

(Affix School Seal here)

SF 10-JHS
School: ______________________ School ID: ________ District: ___________________ Division: ___________

Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Si

LEARNING AREAS QUARTER FINAL RE

1 2 3 4 RATING
Filipino
English
Mathematics
Science
Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP)
Technology and Livelihood Education (TLE)
MAPEH
Music
Arts
Physical Education
Health

General Average
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _______________
Recomputed Final
Subject Final Rating Remedial Class Mark R
Grade

School: ______________________ School ID: ________ District: ___________________ Division: ___________

Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Si
LEARNING AREAS QUARTER FINAL RE
1 2 3 4 RATING
Filipino
English
Mathematics
Science
Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP)
Technology and Livelihood Education (TLE)
MAPEH
Music
Arts
Physical Education
Health

General Average
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _________
Recomputed Final
Learning Areas Final Rating Remedial Class Mark R
Grade

School: ______________________ School ID: ________ District: ___________________ Division: ___________

Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Si
Quarterly Rating FINAL
LEARNING AREAS RE
1 2 3 4 RATING
Filipino
English
Mathematics
Science
Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP)
Technology and Livelihood Education (TLE)
MAPEH
Music
Arts
Physical Education
Health

General Average
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _________
Recomputed Final
Learning Areas Final Rating Remedial Class Mark R
Grade

For Transfer Out /JHS Completer Only

CERTIFICATION

I CERTIFY that this is a true record of _____________________________with LRN ________________ and that he/she is eligib
Name of School: ____________________________________ School ID __________________ Last School Year Attended: ____

_____________________
Date Name of Principal/School Head over Printed Name (Affix School Seal her
(May add Certification box if needed)
 Pag 2 of ________
ct: ___________________ Division: __________________ Region: ____

Name of Adviser/Teacher: ________________ Signature: ________

REMARKS

______________ to (mm/dd/yyyy) _______________

Remarks

ct: ___________________ Division: __________________ Region: ____

Name of Adviser/Teacher: ________________ Signature: ________

REMARKS

_________________ to (mm/dd/yyyy) _______________

Remarks

ct: ___________________ Division: __________________ Region: ____

Name of Adviser/Teacher: ________________ Signature: ________

REMARKS
_________________ to (mm/dd/yyyy) _______________
Remarks

RTIFICATION

_with LRN ________________ and that he/she is eligible for admission to Grade ____.
__________________ Last School Year Attended: _________________________

(Affix School Seal here)

SFRT Revised 2017