Form 137 school permanent record

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1. FORM 137-E
Republika ng Pilipinas
(Republic of the Philippines)
Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYON ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)
Rehiyon: ________
(Region)
PALAGIANG TALAAN SA MABABANG PAARALAN
(Elementary School Permanent Record) LRN:_______________________

Pangalan ___________________________________________________________________ Sangay__________________Paaralan______________________________
(Name) Apelyido Unang Pangalan M.I. (Division) (School)

Kasarian__________Petsa ng Kapanganakan__________________Pook___________________________________Petsa ng Pagpasok__________________
(Sex) (Date of Birth) (Place) Bayan/lalawigan/Lunsod (Date of Entrance)
(Town/Province/City)
Magulang/Tagapag-alaga____________________________________________________________________________________________________________________
(Parent/Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

PAG-UNLAD SA MABABANG PAARALAN
(Elementary School Progress)

Eligible for Admission to Grade______________________________________________
Grade I-School_________________________________________________________________
School Year__________________________________________________________________

LEARNING AREAS
Periodic Rating
Remarks
1 2 3 4
Mother Tongue
Filipino
English
Mathematics
Araling Panlipunan
MAPEH
Music
Art
Physical Education
Health
Edukasyon sa Pagpapakatao (EsP)
General Average
Eligible for Admission to Grade______________________________________________

Grade III-School______________________________________________________________
School Year__________________________________________________________________

LEARNING AREAS
Periodic Rating
Remarks
1 2 3 4
Mother Tongue
Filipino
English
Mathematics
Araling Panlipunan
MAPEH
Music
Art
Physical Education
Health
Edukasyon sa Pagpapakatao (EsP)

General Average
Eligible for Admission to Grade______________________________________________

Grade V-School_______________________________________________________________
School Year__________________________________________________________________

LEARNING AREAS
Periodic Rating
Remarks
1 2 3 4
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao (EsP)
Edukasyong Pantahanan at Pangkabuhayan
(EPP)

MAPEH
Music
Art
Physical Education
Health
General Average
Eligible for admission to Grade _________________________________

Grade II-School________________________________________________________________
School Year__________________________________________________________________

LEARNING AREAS
Periodic Rating
Remarks
1 2 3 4
Mother Tongue
Filipino
English
Mathematics
Araling Panlipunan
MAPEH
Music
Art
Physical Education
Health
Edukasyon sa Pagpapakatao (EsP)
General Average
Eligible for Admission to Grade______________________________________________

Grade IV-School_______________________________________________________________
School Year__________________________________________________________________

LEARNING AREAS
Periodic Rating
Remarks
1 2 3 4
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao (EsP)
Edukasyong Pantahanan at Pangkabuhayan
(EPP)

MAPEH
Music
Art
Physical Education
Health
General Average
Eligible for Admission to Grade______________________________________________

Grade VI-School_______________________________________________________________
School Year__________________________________________________________________

LEARNING AREAS
Periodic Rating
Remarks
1 2 3 4
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao (EsP)
Edukasyong Pantahanan at Pangkabuhayan
(EPP)

MAPEH
Music
Art
Physical Education
Health
General Average
Eligible for admission to Grade _________________________________

2. III. REPORT ON LEARNER’S OBSERVED VALUES
Gr. 1 S.Y. ________________ Gr. 2 S.Y. ________________ Gr. 3 S.Y. ________________
Core Values
Behavior Statements
Quarter Quarter Quarter
1 2 3 4 1 2 3 4 1 2 3 4

1. Maka-
Diyos
Expresses one’s spiritual
beliefs while respecting the
spiritual beliefs of others


2. Makatao
Shows adherence to ethical
principles by upholding
truth


3. Maka-
kalikasan
Cares for the environment
and utilizes resources
wisely, judiciously, and
economically




4.Makabansa
Demonstrates pride in
being a Filipino; exercises
the rights and responsibi-
lities of a Filipino citizen.

Demonstrates appropriate
behavior in carrying out
activities in the school,
community, and country


Gr. 4 S.Y. _______________ Gr. 5 S.Y. ________________ Gr. 6 S.Y. ________________
Core Values
Behavior Statements
Quarter Quarter Quarter
1 2 3 4 1 2 3 4 1 2 3 4

1. Maka-
Diyos
Expresses one’s spiritual
beliefs while respecting the
spiritual beliefs of others


2. Makatao
Shows adherence to ethical
principles by upholding
truth


3. Maka-
kalikasan
Cares for the environment
and utilizes resources
wisely, judiciously, and
economically




4.Makabansa
Demonstrates pride in
being a Filipino; exercises
the rights and responsibi-
lities 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 of Grade/Year_____________________.

_____________________________________________
Signature

___________________________________________ ____________________________________________
Date Designation