Professional Documents
Culture Documents
Form 137-School Permanent Record
Form 137-School Permanent Record
Form 137-School Permanent Record
Republika ng Pilipinas
(Republic of the Philippines)
Kagawaran ng Edukasyon
(Department of Education)
Rehiyon: ________
(Region)
M.I.
(Division)
Apelyido
(School)
Kasarian__________Petsa ng Kapanganakan__________________Pook___________________________________Petsa
ng Pagpasok__________________
(Sex)
Entrance)
(Date of Birth)
(Place)
Bayan/lalawigan/Lunsod
(Date of
(Town/Province/City)
Magulang/Tagapagalaga______________________________________________________________________________________________________
______________
(Parent/Guardian)
Hanapbuhay
Pangalan
Tirahan
(Name)
(Address)
(Occupation)
Periodic
Rating
2
3
Remarks
4
Mother Tongue
Filipino
English
Mathematics
Araling Panlipunan
MAPEH
Music
Art
Physical Education
Health
Edukasyon sa
Pagpapakatao (EsP)
Gener
al Average
Eligible for Admission to
Grade______________________________________________
Grade
VSchool_______________________________________________________
________
School
Year__________________________________________________________
________
LEARNING AREAS
1
Gener
al Average
Eligible for Admission to
Grade______________________________________________
Grade
IIISchool_______________________________________________________
_______
School
Year__________________________________________________________
________
LEARNING AREAS
1
Periodic
Rating
2
3
Remarks
4
Periodic
Rating
2
3
Gener
al Average
Eligible
for
admission
_________________________________
Remarks
4
to
Grade
Grade
IISchool_______________________________________________________
_________
School
Year__________________________________________________________
________
LEARNING AREAS
1
Mother Tongue
Filipino
English
Mathematics
Araling Panlipunan
MAPEH
Music
Art
Periodic
Rating
2
3
Remarks
4
Physical Education
Health
Edukasyon sa
Pagpapakatao (EsP)
Gener
al Average
Eligible for Admission to
Grade______________________________________________
Grade
IVSchool_______________________________________________________
________
School
Year__________________________________________________________
________
LEARNING AREAS
1
Periodic
Rating
2
3
Remarks
4
Gener
al Average
Eligible for Admission to
Grade______________________________________________
Grade
VISchool_______________________________________________________
________
School
Year__________________________________________________________
________
LEARNING AREAS
1
Gener
al Average
Eligible for admission to Grade
_________________________________
Periodic
Rating
2
3
Remarks
4
III.
Core
Values
1. MakaDiyos
2. Makatao
3. Makakalikasan
4.Makaban
sa
Core
Values
1. MakaDiyos
2. Makatao
3. Makakalikasan
4.Makaban
sa
Behavior Statements
Gr. 1 S.Y.
________________
Quarter
1
2
3
4
Gr. 2 S.Y.
________________
Quarter
1
2
3
4
Gr. 3 S.Y.
________________
Quarter
1
2
3
4
Gr. 4 S.Y.
_______________
Quarter
1
2
3
4
Gr. 5 S.Y.
________________
Quarter
1
2
3
4
Gr. 6 S.Y.
________________
Quarter
1
2
3
4
Expresses ones
spiritual beliefs while
respecting the spiritual
beliefs of others
Shows adherence to
ethical principles by
upholding truth
Cares for the
environment and
utilizes resources
wisely, judiciously, and
economically
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
Behavior Statements
Expresses ones
spiritual beliefs while
respecting the spiritual
beliefs of others
Shows adherence to
ethical principles by
upholding truth
Cares for the
environment and
utilizes resources
wisely, judiciously, and
economically
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
Not Observed
IV.
SO Sometimes Observed
RO Rarely Observed
NO
ATTENDANCE RECORD
Grade
No. of
Schoo
l
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