DepEd Form IX

SANTIAGO TRILLANA ACADEMY, INC.

Mabini St., San Sebastian, Hagonoy, Bulacan

Email Address/ Telophone No.

STUDENT'S GRADUATION FORM

LRN:______________________________________________________________________ Track/Strand: ___________________________________________________________________

Name: ____________________________________________________________________ Date of Birth: Year: ______________ Month: _______________ Day: ______________________
Place of Birth: Province:____________________________________________________ Town:___________________________ Barangay ________________________________________

Parent/Guardian:______________________________________________________________________________________Occupation: __________________________________________

Address of Parent/Guardian:_________________________________________________________________________________________________________________________________

Senior High School Completer from (School):______________________________________________________________ School Year:_________________________________________

SCHOOL: _______________________________________________________ SCHOOL:_______________________________________________________________

Classified as ________________ Semester _________School Year ________ Classified as __________________ Semester _________School Year ___________
SUBJECTS Final Grade Action Taken SUBJECTS Final Grade Action Taken

Days of School ________________ Days Present________________ Days of School ________________ Days Present________________
SCHOOL________________________________________ Summer__________ SCHOOL____________________________________________ Summer__________
SUBJECT/S Final Grade Action Taken SUBJECT/S Final Grade Action Taken

Days of School ________________ Days Present________________ Days of School ________________ Days Present________________
SCHOOL:___________________________________________________________ SCHOOL:_______________________________________________________________
Classified as ________________ Semester _________School Year _________ Classified as __________________Semester _________School Year _________
SUBJECTS Final Grade Action Taken SUBJECTS 3rd Quarter Action Taken

Days of School ________________ Days Present________________ Days of School ________________ Days Present________________
SCHOOL________________________________________ Summer__________ SCHOOL____________________________________________ Summer__________
SUBJECT/S Final Grade Action Taken SUBJECT/S Final Grade Action Taken

Days of School ________________ Days Present________________ Days of School ________________ Days Present________________
 Summary of Subjects
Grade 11 Grade 12
Subjects Semester School Year Subjects Semester School Year

CERTIFICATION

I certify that this is a true record of________________________________, Checked against original copy:

as per requirement of the Department of Education. He/She is eligible for graduation

in the School Year/Summer___________________________.

____________________________ CECILIA S. CUSTODIO, Ph. D.

Principal Education Program Supervisor - In charge of Private Schools