Adoption of School Forms for

Kindergarten to Grade 6
 DepEd Order 4 s. 2014
Adoption of Modified School Forms for Public
Elementary and Secondary Schools
 DepEd Order 58 s. 2017
Adoption of New Forms in Kindergarten,
SENIOR High School, ALS, Health and Nutrition,
and Permanent Records
SF 1
School Register
 School Form 1 (SF 1) School Register
(This replaces Form 1, M aster List & STS Form 2-Family Background and Profile)

School ID 104795 Region III Division Bulacan District Bustos

Grade
School Name Tibagan Elementary School School Year 2018 - 2019 Kinder Section ALITAPTAP
Level
A GE M OT HE GU A R D IA N C o nt act
as A D D R ESS PA R EN T S R EM A R KS
R N umb er

Sex (M/F)
( if N o t Parent )
NAM E B IR T H D A T E o f T ON GU IP of
R ELIGI M o t her' s
LR N ( Last N ame, F irst N ame, ( mm/ d d / yyyy 1st E ( Et hnic Ho use # / F at her' s N ame Parent
ON M aid en N ame ( Please ref er
M id d le N ame) ) F rid ( Grad e Gro up ) St reet / M unicip alit ( Last N ame, R elat io ns or
B arang ay Pro vince ( Last N ame, N ame t o t he leg end
ay 1 to 3 Sit io / y/ C it y F irst N ame, hip Guard ia
F irst N ame, o n last p ag e)
June Only) Puro k M id d le N ame)
M id d le N ame)
n

CABILDO, GALVEZ,M ON
104795180001 CABILDO,LUIZ EñIGO GALVEZ M 01-16-2013 5 Tagalog
Christia
nity
BONGA
M AYOR
BUSTOS BULACAN ARNOLD STA ALIZA,DE09157011107
M ARIA GUZM AN,

CARPIO,
Christia DIZON,M ISCH
104795180002 CARPIO,JOHN CASEY DIZON M 10-22-2012 5 Tagalog TIBAGAN BUSTOS BULACAN M ICHAEL
nity EL,REYES,
TENORIO

DE LEON, STA
Christia BONGA
104795180003 DE LEON,NIO STA M ARIA M 12-16-2012 5 Tagalog BUSTOS BULACAN RESTYSONIO M ARIA,M YLIN
nity M AYOR
EVANGELISTA E,M ALLARI,

ESTEBAN, ALEJANDRIN
ESTEBAN,CYRUS PAUL Christia
104795180004 M 01-02-2013 5 Tagalog TIBAGAN BUSTOS BULACAN JOSE CHARLIE O,CAROLYN,S
ALEJANDRINO nity
BAUTISTA ALAYA,

GARCIA, GRIPON,ANN
GARCIA,JAM ES GENESIS Christia
104795180005 M 10-12-2012 5 Tagalog TIBAGAN BUSTOS BULACAN RICHARD A,HERNANDE
GRIPON nity
BUAG Z,

M AGNO, GRIM ALDO,LI

M AGNO,JAY VIVEN Christia
104795180006 M 02-15-2014 4 Tagalog TIBAGAN BUSTOS BULACAN JAYSON AN,FORM AR
GRIM ALDO nity
TAPAO AN,
M ARQUEZ, DELA CRUZ,DI
M ARQUEZ,WAYNE STEPHEN Christia
104795180007 M 01-07-2013 5 Tagalog TIBAGAN BUSTOS BULACAN M ICHAEL JHOANA,ROB
DELA CRUZ nity
RIVERA LES,

PANIGBATAN,JAYLORD Christia PANIGBATAN, FORBES,EUNI

 List and Code of Indicators under REMARKS colum n
Co Co R EG
Ind icat o r R eq uir ed Inf o r mat io n Ind icat o r R eq uir ed Inf o r mat io n
de de
T r ansf er ed T / O N ame o f Pub lic ( P) Pr ivat e ( PR ) Scho o l CCT CC C C T C o nt r o l/ r ef er ence numb er &
Out & Ef f ect ivit y D at e R eceip ient T Ef f ect ivit y D at e M

T/ I N ame o f Pub lic ( P) Pr ivat e ( PR ) Scho o l B alik A r al B / A N ame o f scho o l last at t end ed & Y ear
T r ansf er ed In & Ef f ect ivit y D at e FE
Lear ner W it h LW Sp ecif y
DR R easo n and Ef f ect ivit y D at e D isab ilit y D TO
D r o p p ed P R easo n ( Enr o llment b eyo nd 1st F r id ay A cceler at ed Sp ecif y Level & Ef f ect ivit y D at a
Lat e LE o f June) AC
Generated on: Friday, July 13, 2018

R EGIST ER Pr ep ar ed b y; C er t if ied C o r r ect :

B o SY Eo SY
ED
er &
M A LE 14 14 JOCELYN PRINCIPIO BELTRAN
CITADEL BITANGCOL BAUTISTA ( Sig nat ur e o f Scho o l Head o ver
d & Y ear ( Sig nat ur e o f A d viser o ver Pr int ed Pr int ed N ame)
F EM A LE 12 12 N ame)
06/04/2018 04/05/2019
B o SY D at e: Eo SY D at e:
T OT A L 26 26 06/04/2018 04/05/2019
at a B o SY D at e: Eo SY D at e:
RESTYSONIO E. DE LEON
Gener at ed t hr u LIS
SF 2
Daily Attendance Report of Learners
 Data in blue circles are School Form 2 (SF2) Daily Attendance Report of Learners
generated from LIS (This replaces Form 1, Form 2 & STS Form 4 - Absent eeism and Dropout Prof ile)

School ID 104795 School Year 2018-2019 Report for the M onth of

July
August

Name of School Tibagan Elementary School Grade Level Kinder Section ALITAPTAP
(1st row for date)
NAM E
Total for the R EM A R K S ( I f D R OP P ED OU T , st a t e
N
( Last N ame, F ir st N ame, M id d le 2 3 4 5 6 9 10 11 12 13 16 17 18 19 20 23 24 25 26 27 30 31 Month r e a so n , p l e a se r e f e r t o l e g e n d n u m b e r 2 .
o. I f T R A N S F ER R ED I N / OU T , wr i t e t h e
N ame)
M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F A B S EN T TA R D Y na me of S c hool . )

1. CA B ILDO, LUIZ EÑIGO GA LVEZ 0 0

2. CA RP IO, JOHN CA SEY DIZON 50 0

3. DE LEON, NIO STA . M A RIA 0 0

ESTEB A N, CYRUS P A UL
4.
A LEJA NDRINO
0 10
5. GA RCIA , JA M ES GENESIS GRIP ON 0 0

6. M A GNO, JA Y VIVEN GRIM A LDO 0 0

M A RQUEZ, WA YNE STEP HEN
7.
DELA CRUZ
0 0

8. P A NIGB A TA N, JA YLORD FORB ES 0 0

P LA M ENCO, LUIS VERGEL
9.
M A RQUEZ
0 0
QUIM SON, JOHN M A TTHEW
10.
CA RP IO
0 0

11. RA M OS, NOA H GA RVIE GUA NSING 0 0

REYES, A LJOHN A NGELO
12.
CRISTOB A L
0 0

13. SA NTOS, JEREM Y DELA CRUZ 0 0

TEODORO, KURT M A TTHEW
14.
P A ULINO
0 0

14. <=== M A LE | TOTA L P er Day ===> 5 1

1. A UGUIS, A LLIYA H SHA NE P A DUA 0 0

2. A USTRIA , P A ULA M A Y A NZA NO 0 0

HERNA NDEZ, JA THINA LYNELLE
3.
SA N A NTONIO
0 0
M A NGA HA S, CHA RISSA M A EY
4.
LIWA G
0 0
M A P OY, A YA NA LOURIZ
5.
GUEVA RRA
0 0

6. REYES, GINELLE RA YM UNDO 0 0

SA LA YSA Y, JA DE NICOLE
7.
FA USTINO
0 0

8. SA NTOS, KIA RA LEI SERP A JUA N 0 0

9. ESTEB A N, TRIXIE CELINE SA NTOS 10 0

10. VA LERIO, RA LA INE A NNE ESP IRITU 0 0

P LA M ENCO, ROSELYN M A E
11.
M A RQUEZ
0 0

12. LOP EZ, JA M A ICA LOP EZ 0 0

12. <=== FEM A LE | TOTA L P er Day ===> 1 0

26. Co mbined TOTA L P er Day 6 1
12. <=== FEM A LE | TOTA L P er Day ===>

26. Co mbined TOTA L P er Day

GU ID ELIN ES: 1. C OD ES F OR C H EC K I N G A T T EN D A N C E M o nt h : N o . o f D ays o f S umma r y

1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance. (blank) - Present ; (x)- Absent ; Tardy (half shaded=Upper C lasses: M F T OT A L
2. Dates shall be written in the columns after Learner's Name. f or Lat e Commer, Lower f or Cut t ing Classes)
* Enrolment as of (June 30) 14 12 26
3. To compute the following:
2 . R EA S ON S / C A U S ES F OR D R OP P I N G OU T
Lat e enrolment dur i ng t he mont h
Registered Learners as of end of the month a . D o m e st i c - R e l a t e d F a c t o r s
a. Percentage of Enrolment = x 100
Enrolment as of 1st Friday of the school year a.1. Had t o t ake care of siblings (beyond cut -of f )

Total Daily Attendance a.2. Early marriage/ pregnancy Regist ered Learners as of
b. Average Daily Attendance = a.3. Parent s' at t it ude t oward schooling
Number of School Days in reporting month e nd of mont h
a.4. Family problems
Average daily attendance Percent age of Enrolment as of
c. Percentage of Attendance for the month = x 100
Registered Learners as of end of the month b. I ndi v i dua l - R e l a t e d Fa c t or s e nd of mont h
b.1. Illness Average Daily At t endance
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 b.2. Overage
School Form 4. Once signed by the principal, this form should be returned to the adviser. b.3. Deat h Percent age of At t endance f or t he mont h
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 b.4. Drug Abuse
consecutive days and/or those at risk of dropping out. b.5. Poor academic perf ormance Number of st udent s absent f or 5 consecut ive days
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period. b.6. Lack of int erest / Dist ract ions
b.7. Hunger/ Malnut rit ion D r oppe d out
c . S c hool - R e l a t e d Fa c t or s
*Beginning of School Year cut-off report is every June 30 T r a n sf e r r e d o u t
c.1. Teacher Fact or
c.2. Physical condit ion of classroom T r a n sf e r r e d i n
c.3. Peer inf luence

d . Ge o g r a p h i c / En v i r o n m e n t a l
d.1. Dist ance bet ween home and school
I certify that this is a true and correct report.
d.2. Armed conf lict (incl. Tribal wars & clanf euds)
d.3. Calamit ies/ Disast ers

e . Fi na nc i a l - R e l a t e d CITADEL BITANGCOL BAUTISTA

e.1. Child labor, work (Signature of Adviser over Printed Name)
f . Ot h e r s ( S p e c i f y )

Attested by:

JOCELYN PRINCIPIO BELTRAN

(Signature of School Head over Printed Name)
 data in blue circles are
generated from LIS

data in red circles are to be

filled up by the teacher
M o nt h : July N o . o f D ays o f S umma r y
C lasses: 2 2 M F T OT A L

* Enrolment as of (June 30) 14 12 26

Lat e enrolment dur i ng t he mont h
0 1 1
(beyond cut -of f )

Compute for the missing data

Regist ered Learners as of
14 13 27
e nd of mont h

Percent age of Enrolment as of 108.33

100% 103.85%
%
e nd of mont h
No. of Absences
Average Daily At t endance 13.77 12.95 26.72 Male-5
98.36 99.62 Female-1
Percent age of At t endance f or t he mont h 98.96%
% %

Number of st udent s absent f or 5 consecut ive days 1 0 1

Dr oppe d out 0 0 0

T r a n sf e r r e d o u t 0 0 0

T r a n sf e r r e d i n 0 0 0
SF 3
Books Issued and Returned
 data in blue circles are School Form 3 (SF3) Books Issued and Returned data in red circles are to be
generated from LIS (This replaces Form 1& Invent ory of Text books) filled up by the teacher
School ID 104795 School Year 2018 - 2019

School Name Tibagan Elementary School Grade Level Kinder Section ALITAPTAP
M ga Kasanayan P ara sa Kahandaan Subject Area & Tit le Subject Area & Subject Area & Tit le Subject Area & Subject Area & Subject Area & Subject Area & Tit le Subject Area & Tit le Subject Area &
sa P agkatuto , M ga P agsasanay sa Tit le Tit le Tit le Tit le Tit le R E M A R K S/ A C T I O N
NAM E
N Tagalo g T AKE N (P l ease r ef er
( La s t N a m e , F irs t N a m e , t o t he l egend on l ast
o.
M iddle N a m e ) Date Date Date Date Date Date Date Date Date Date page)

Issued Ret urned Issued Ret urned Issued Ret urned Issued Ret urned Issued Ret urned Issued Ret urned Issued Ret urned Issued Ret urned Issued Ret urned Issued Ret urned

1. CA B ILDO,LUIZ EñIGO GA LVEZ 6/8/2018 4/5/2019

2. CA RP IO,JOHN CA SEY DIZON 6/8/2018

3. DE LEON,NIO STA M A RIA 6/8/2018

ESTEB A N,CYRUS P A UL
4.
A LEJA NDRINO 6/8/2018
GA RCIA ,JA M ES GENESIS
5.
GRIP ON 6/8/2018
M A GNO,JA Y VIVEN
6.
GRIM A LDO 6/8/2018
M A RQUEZ,WA YNE STEP HEN
7.
DELA CRUZ 6/8/2018
P A NIGB A TA N,JA YLORD
8.
FORB ES 6/8/2018
P LA M ENCO,LUIS VERGEL
9.
M A RQUEZ 6/8/2018
QUIM SON,JOHN M A TTHEW
10.
CA RP IO 6/8/2018
RA M OS,NOA H GA VRIE
11.
GUA NSING 6/8/2018
REYES,A LJOHN A NGELO
12.
CRISTOB A L 6/8/2018
SA NTOS,JEREM Y DELA
13.
CRUZ 6/8/2018
TEODORO,KURT M A TTHEW
14.
P A ULINO 6/8/2018
<=== TOTA L FOR M A LE |
14.
TOTA L COP IES ===> 14
 P LA M ENCO,ROSELYN M A E
8.
M A RQUEZ 6/8/2018

9. REYES,GINELLE RA YM UNDO 6/8/2018

SA LA YSA Y,JA DE NICOLE
10.
FA USTINO 6/8/2018
SA NTOS,KIA RA LEI SERP A
11.
JUA N 6/8/2018
VA LERIO,RA LA INE A NNE
12.
ESP IRITU 6/8/2018
<=== TOTA L FOR FEM A LE |
12.
TOTA L COP IES ===> 12
<=== TOTA L LEA RNERS |
26.
TOTA L COP IES ===> 26
In c a s e o f lo s t / unre t urne d bo o k s , ple a s e pro v ide inf o rm a t io n wit h P re pa re d B y:
G UID E LIN E S :
t he f o llo wing c o de :
1. Title of Books Issued to each learner must be recorded by the class adviser. A. In Column Date Returned, codes are: FM =Force M ajeure, TDO: Transferred/Dropout,
2. The Date of Issuance and the Date of Return shall be reflected in the form. NEG=Negligence CITADEL BITANGCOL BAUTISTA
3. The Total Number of Copies issued at BoSY shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by
(Signature of Adviser over Printed Name)
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. parent/guardian (for code FM ), TLTR=Teacher prepared letter/report duly noted by School
5. All textbooks being used must be included. Additional copies of this form may be used if needed. Head for submission to School Property Custodian (for code TDO), PTL=Paid by the Learner

06/04/2018
(for code NEG). References: DO# 23, s.2001, DO# 25, s.2003, DO# 14, 2.2012. JOCELYN P. BELTRAN
( Sig nat ur e o f scho o l Head o ver Pr int ed N ame)

Date of BoSY:06/04/2018 Date of EoSY: 04/05/2019

04/05/2019
SF 4
Monthly Learners Movement &
Attendance
 ELEMENTARY/SECONDARY:
KINDER 72 62 134 67.95 59.42 127.37 94.38 95.84 95.05 1 0 1 0 0 0 1 0 1 2 3 5 0 0 0 2 3 5 1 3 4 0 0 0 1 3 4
GRADE 1 60 58 118 60.50 53.10 113.60 100.83 91.55 96.27 1 2 3 0 0 0 1 2 3 1 0 1 0 0 0 1 0 1 2 1 3 0 0 0 2 1 3
GRADE 2 63 54 117 61.69 52.89 114.58 97.92 97.94 97.93 1 1 2 0 0 0 1 1 2 0 2 2 0 0 0 0 2 2 2 2 4 0 0 0 2 2 4
GRADE 3 77 58 135 76.57 57.67 134.24 99.44 99.43 99.44 1 1 2 0 0 0 1 1 2 1 0 1 0 0 0 1 0 1 2 2 4 0 0 0 2 2 4
GRADE 4 81 59 140 79.74 58.26 138.01 98.44 98.75 98.58 3 1 4 0 0 0 3 1 4 1 0 1 0 0 0 1 0 1 0 2 2 0 0 0 0 2 2
GRADE 5 72 73 145 71.42 72.27 143.68 99.19 99.00 99.09 3 0 3 0 0 0 3 0 3 1 0 1 0 0 0 1 0 1 1 0 1 0 0 0 1 0 1
GRADE 6 73 93 166 68.87 89.81 158.68 94.34 96.57 95.59 1 1 2 0 0 0 1 1 2 0 4 4 0 1 1 0 5 5 1 3 4 0 0 0 1 3 4
TOTAL FOR NON-GRADED
TOTAL 498 457 955 486.74 443.42 930.16 97.74 97.03 97.40 11 6 17 0 0 0 11 6 17 6 9 15 0 1 1 6 10 16 9 13 22 0 0 0 9 13 22
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.
copy a week after June 30, October 30 & March 31
Prepared and Submitted by: Noted by:
_____ of _____ pages
Remarks: JOCELYN P. BELTRAN ESPERANZA F. PEREZ, Ed.D.
No. of Late Enrollees = 6 Principal II Public Schools District Supervisor
SF 5/5K
Report on Promotion and Level of
Proficiency
 School Form 5 Report on Promotion and Level of Proficiency For Kinder (SF5-K)
End of School Year Kindergarten Appraisal Report
School Name Tibagan Elementary School District Bustos Division Bulacan Region Region III

School ID 104795 Section ALITAPTAP School Year 2018-2019

S um m a t iv e Appraised (Grade SUMMARY TABLE

LEARNER'S NAME A s s e s m e nt One Ready or
NO LRN Interpretation
(Last Name, First Name, Middle Name) S t a nda rd needs Further
S c o re S T A T US MALE FEMALE TOTAL
Intervention

MALE GR A D E ON E R EA D Y 14 12 26

1 104795180001 CABILDO,LUIZ EñIGO GALVEZ 0 SSDOD GRA DE ONE REA DY

Needs Further Intervention 0 0 0
2 104795180002 CARPIO,JOHN CASEY DIZON 0 SSDOD GRA DE ONE REA DY

3 104795180003 DE LEON,NIO STA MARIA 0 SSDOD GRA DE ONE REA DY LEVEL OF PROFICIENCY

4 104795180004 ESTEBAN,CYRUS PAUL ALEJANDRINO 0 SSDOD GRA DE ONE REA DY D e s c ript o r &
G ra ding MALE FEMALE TOTAL
5 104795180005 GARCIA,JAMES GENESIS GRIPON 0 SSDOD GRA DE ONE REA DY S c a le
Suggest Highly Advanced
6 104795180006 MAGNO,JAY VIVEN GRIMALDO 0 SSDOD GRA DE ONE REA DY Development - SHAD (130 0 0 0
and above)

7 104795180007 MARQUEZ,WAYNE STEPHEN DELA CRUZ 0 SSDOD GRA DE ONE REA DY Suggest Slight Advanced
Development - SSAD (120- 0 0 0
8 104795180008 PANIGBATAN,JAYLORD FORBES 0 SSDOD GRA DE ONE REA DY 129)

Average Development -
9 104795180009 PLAMENCO,LUIS VERGEL MARQUEZ 0 SSDOD GRA DE ONE REA DY
AD (80-119) 0 0 0

10 104795180010 QUIMSON,JOHN MATTHEW CARPIO 0 SSDOD GRA DE ONE REA DY Suggest Slight Delay in
Overall Development - 0 0 0
11 104795180011 RAMOS,NOAH GAVRIE GUANSING 0 SSDOD GRA DE ONE REA DY SSIDOD (70-79)

Suggest Significant Delay

12 104795180012 REYES,ALJOHN ANGELO CRISTOBAL 0 SSDOD GRA DE ONE REA DY in Overall Development - 0 0 0
SSDOD (69 and below)
13 104795180013 SANTOS,JEREMY DELA CRUZ 0 SSDOD GRA DE ONE REA DY
PREPARED BY:
14 104795180014 TEODORO,KURT MATTHEW PAULINO 0 SSDOD GRA DE ONE REA DY

CITADEL BITANGCOL BAUTISTA

14 <=== TOTAL MALE
Class A dviser
 Class A dviser
(Name and Signature)
S um m a t iv e Appraised (Grade
CERTIFIED CORRECT & SUB M ITTED B Y:
LEARNER'S NAME A s s e s m e nt One Ready or
NO LRN Interpretation
(Last Name, First Name, Middle Name) S t a nda rd needs Further
S c o re
Intervention
JOCELYN PRINCIPIO BELTRAN
Scho o l Head
FEMALE
(Name and Signature)

15 104795180015 AUGUIS,ALLIYA SHANE PADUA 0 SSDOD GRA DE ONE REA DY REVIEWED BY:

16 104795180016 AUSTRIA,PAULA MAY ANZANO 0 SSDOD GRA DE ONE REA DY

(Name and Signature)
17 104795180017 ESTEBAN,TRIXIE CELINE SANTOS 0 SSDOD GRA DE ONE REA DY Division Representative

18 104795180018 HERNANDEZ,JATHINA LYNELLE SAN ANTONIO 0 SSDOD GRA DE ONE REA DY

G e ne ra t e d t hru LIS
19 104795180026 LOPEZ,JAMAICA LOPEZ 0 SSDOD GRA DE ONE REA DY
GUIDELINES:
20 104795180019 MANGAHAS,CHARISSA MAEY LIWAG 0 SSDOD GRA DE ONE REA DY
1. 1. Do no t include Dro po uts and Transferred Out (D.O.4,
2014)
21 104795180020 MAPOY,AYANA LOURIZ GUEVARRA 0 SSDOD GRA DE ONE REA DY
2. 2. This sho ud be prepared by A dviser. P o st Test
Standard Sco re sho ud be taken fro m the reco rd submitted
22 104795180021 PLAMENCO,ROSELYN MAE MARQUEZ 0 SSDOD GRA DE ONE REA DY
to the Divisio n Office.
3. 3. The summary table sho ud reflect the to tal number o f
23 104795180022 REYES,GINELLE RAYMUNDO 0 SSDOD GRA DE ONE REA DY learners. Fo r GRA DE ONE REA DY, Summative A ssesment
Standard Sco re must be 80 and abo ve, while NEEDS
24 104795180023 SALAYSAY,JADE NICOLE FAUSTINO 0 SSDOD GRA DE ONE REA DY FURTHER INTERVENTION must be 79 and belo w.
4. P ro to co ls o f validatio n & submissio n is under the
25 104795180024 SANTOS,KIARA LEI SERPA JUAN 0 SSDOD GRA DE ONE REA DY discretio n o f the Scho o ls Divisio n Superintendent.
5. TE - Tempo rary Enro lled
26 104795180025 VALERIO,RALAINE ANNE ESPIRITU 0 SSDOD GRA DE ONE REA DY

12 <=== TOTAL FEMALE

26 <=== COMBINED
SF 6
Summarized Report on Promotion and
Level of Proficiency
 School Form 6 (SF6)
Summarized Report on Promotion and Learning Progress & Achievement
School ID 104795 Region III Division Bulacan

School Name Tibagan Elementary School District Bustos School Year 2017

GRADE 1 GRADE 2 GRADE 3 GRADE 4 Grade 5 TOTAL

SUMMARY TABLE
Femal
M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale To tal
e

PROMOTED 60 58 118 63 54 117 76 58 134 82 59 141 72 73 145 426 395 821

CONDITIONAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

RETAINED 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 1

LEARNING PROGRESS AND Femal

M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale To tal
ACHIEVEMENT e

Did Not Meet Expect at ions (74%

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
and below)

Fairly Sat isf act ory (75%-79%) 26 11 37 18 4 22 38 13 51 30 9 39 13 2 15 129 40 169

Sat isf act ory

28 33 61 35 39 74 30 31 61 44 37 81 39 42 81 220 223 443
(80%-84%)

Very Sat isf act ory (85%-89%) 5 11 16 6 8 14 5 14 19 4 8 12 18 28 46 58 111 169

Out st anding
1 3 4 4 3 7 3 0 3 4 5 9 2 1 3 19 21 40
(90%-100%)

TOTAL 60 58 118 63 54 117 77 58 135 82 59 141 72 73 145 427 395 822

P repared and Submitted by: Reviewed and Validated by: No ted by:

DOORES O. GATUZ ZENIA G. MOSTOLES Ed. D., CESO V RESTYSONIO E. DE LEON

(Signature o f Scho o l Head o ver P rinted Name) DIVISION REP RESENTA TIVE SCHOOL DIVISION SUP ERINTENDENT Generated thru LIS
 School Form 6 (SF6)
Summarized Report on Promotion and Learning Progress & Achievement
School ID 104795 Region III Division Bulacan

School Name Tibagan Elementary School District Bustos School Year 2018-2019

KINDER GRADE 1 GRADE 2 GRADE 3 Grade 4 Grade 5 Grade 6 TOTAL

SUMMARY TABLE
M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal

PROMOTED 60 58 118 63 54 117 76 58 134 82 59 137 72 59 141 72 73 145 78 60 138 503 421 924

CONDITIONAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

RETAINED 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1

LEARNING PROGRESS AND

M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal M ale Female To tal
ACHIEVEMENT

Did Not Meet Expect at ions (74%

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
and below)

Fairly Sat isf act ory (75%-79%) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169

Sat isf act ory

60 58 118 53 43 96 70 44 114 74 47 121 39 42 81 52 43 58 35 406 312 443
(80%-84%)

Very Sat isf act ory (85%-89%) 0 0 0 6 8 14 3 14 17 4 8 12 18 28 46 15 28 16 8 62 94 169

Out st anding
0 0 0 4 3 7 3 0 3 4 4 8 2 1 3 5 2 4 7 22 17 40
(90%-100%)

TOTAL 60 58 118 63 54 117 76 58 134 82 59 137 72 59 141.00 72 73 427 395 822

P repared and Submitted by: Reviewed and Validated by: No ted by:

DOORES O. GATUZ ZENIA G. MOSTOLES Ed. D., CESO V RESTYSONIO E. DE LEON

(Signature o f Scho o l Head o ver P rinted Name) DIVISION REP RESENTA TIVE SCHOOL DIVISION SUP ERINTENDENT Generated thru LIS
 shall bear only the DepEd
official seal and logo

 will be adopted effective

school year 2017-2018
Procedures
in the
Preparation
of SF10-ES
 The Grade 1 teacher will prepare one
( 1 ) copy only of SF10-ES and attach the
relevant supporting documents

 If the learner continues to study in the

same Elementary School , SF10 will be
forwarded to the adviser of the next
grade level.
  In case of learners
who transferred out to
continue the elementary
level to another school
 Receiving Originating
School School
Request for the original Create one certified true
copy of SF10 copy of SF10

Update the LIS upon Send the original SF10

receipt

Continue fill up the

original SF10
 The ES where the learner
completed elementary level shall
keep the original copy of SF10-ES

 If the learner proceeded to JHS,

the ES will create one certified true
copy of SF10-ES and send it along
with other pertinent documents to
the requesting JHS.
Any erasures or alterations on the
document should be validated and bear the
signature of the School Head in ink.

The SF10-ES shall be prepared at the end

of the school year or in the event of learner
transfers within the school year.

The SF10-ES shall be printed using

ordinary legal size bondpaper
Name: Jamie Elisha Lopez Fernandez
Birthday: September 20, 2012
Gender: Female
LRN: 104795201274
Credential presented to Grade 1: ECCD
Checklist, Kinder Certificate of Completion
School Attended in Kinder : Tibagan
Elementary School
School ID: 104795
Address: Purok 2, Tibagan, Bustos, Bulacan
Name of Grade 1 teacher: Nida L. Dizon
Section: Hope
 School: Tibagan Elementary School School ID: 104795
District: Bustos Division: Bulacan Region: III
Classified as Grade: 1 Section: __________
Hope School Year: 2017-2018
Name of Adviser/Teacher: Nida L. Dizon Signature: nldizon
Quarterly Rating Final
Sample
LEARNING AREAS Remarks
1 2 3 4 Rating
86 PASSED
Scholastic
Mother Tongue 84 85 86 87
Filipino 82 83 84 85 84 PASSED

Record English 80 81 81 PASSED

Mathematics 81 80 82 83 82 PASSED

Science
Araling Panlipunan 82 84 86 88 85 PASSED

EPP / TLE
MAPEH 80 81 82 84 82 PASSED

Music 80 81 82 83 82 PASSED

Arts 80 81 83 85 82 PASSED

Physical Education 80 81 84 84 82 PASSED

Health 80 81 84 85 83 PASSED

Eduk. sa Pagpapakatao 88 87 89 90 89 PASSED

*Arabic Language
*Islamic Values Education
General Average 83 83 84 85 84 PASSED
 Situation
• Jamie Elisha L. Fernandez was promoted to Grade 2
at Tibagan Elementary School, however , after the
First Quarter she transferred to another school.
How would her new adviser fill out the SF10?
• Consider the following data:
• San Pedro E/S-104793; Bustos District
• Adviser: Sheila F. Mendoza;Section-Matapat
• Grades in 1st Quarter:
• Fil-84 ESP-87 Music-81
• AP-83 Mother Tongue-85 Arts-82
• Math-82 MAPEH- 83 PE-83
• English-83 Health-84
 In cases of transfer
School: Tibagan Elementary School School ID: 104795 School: San Pedro Elementary School School ID: 104793
District: Bustos Division: Bulacan Region: III District: Bustos Division: Bulacan Region: III
Classified as Grade: 2 Section: Charity School Year: 2018-2019 Classified as Grade: 2 Section: Matapat School Year: 2018-2019
Name of Adviser/Teacher: Gloria V. Raya Signature: Name of Adviser/Teacher: Sheila F. Mendoza Signature:
Quarterly Rating Final Quarterly Rating
Learning Areas Remarks Final
1 2 3 4 Rating Learning Areas Remarks
1 2 3 4 Rating
Mother Tongue 83
Mother Tongue 83 85 86 87 PASSED
Filipino 85
Filipino 85 86 87 88 PASSED
English 82
English 82 84 85 86 PASSED
Mathematics 85
Mathematics 85 87 88 88 PASSED
Science TRANSFERRED OUT
Science
85 August 30, 2018
Araling Panlipunan PASSED
Araling Panlipunan 85 85 86 87
EPP / TLE
EPP / TLE
MAPEH 83
MAPEH 83 84 85 87 PASSED

Music 81 PASSED
Music 81 83 84 85
Arts 82 PASSED
Arts 82 82 84 86
Physical Education 84 PASSED
Physical Education 84 84 86 87
Health 85 PASSED
Health 85 86 87 88
Eduk. sa Pagpapakatao 88 PASSED
Eduk. sa Pagpapakatao 88 89 90 92
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Education
General Average 84 General Average 84 86 87 88 PASSED
For Transfer Out /Elementary School Completer Only
CERTIFICATION
I CERTIFY that this is a true record of Jamie Elisha L. Fernandez with LRN 104795201274 and that he/she is eligible for admission to Grade ____2____.
School Name: Tibagan Elementary School School ID 104795 Division: _Bulacan__________ Last School Year Attended: __2018-2019_______________

___08/30/2018______________ JOCELYN P. BELTRAN

Date Name of Principal/School Head over Printed Name (Affix School Seal here)

important
 SF9 Guidelines
The Progress Report Card was renamed to Learner’s Progress
Report Card or SF9
(DO 58 s. 2017)
 The format and content as prescribed in
DO 8 s. 2015 will still be adopted
 Beginning SY 2018-2019 , the arrangement of learner’s name
must follow the format in SF5
( DO 11 s. 2018 )
 proper

all caps
6
6
PASSED
1. grades in the
PASSED PASSED different subject
PASSED areas should be
PASSED placed at the center
PASSED

2. grades under the

PASSED
MAPEH subject
PASSED should be aligned left

3. Boxes for REMARKS

should be filled in
with the word
PASSED

PASSED PASSED
(all caps)
 Other Reminders
For SF9 of honor pupils in Grade 6 indicate the honors received
by the pupils at the top of the deped logo.
For Form 137 indicate the honors received at the top of the
deped seal.
Thank you for
listening