Department of Education

Region X Northern Mindanao

Division of Iligan City
__________________________ District
_________________________________________________
School

CUMMULATIVE RECORD FOR KINDERGARTEN

Name of Pupil: ___________________________________________________ LRN: ________________
(Family Name,
Given Name,
Middle Name)
I.

School Performance Records

A. Academic Achievements
Grade One

Grade Two

Grade Three

Grade Four

Grade Five

Grade Six

S.Y. 20 __ - 20____
Subject
Gr.
MTB
Filipino
English
Math
Aral. Pan.
MAPEH
Music
Art
P.E.
Health
E.P.
Gen. Ave.

S.Y. 20 __ - 20____
Subject
Gr.
MTB
Filipino
English
Math
Aral. Pan.
MAPEH
Music
Art
P.E.
Health
E.P.
Gen. Ave.

S.Y. 20 __ - 20____
Subject
Gr.
MTB
Filipino
English
Math
Aral. Pan.
MAPEH
Music
Art
P.E.
Health
E.P.
Gen. Ave.

S.Y. 20 __ - 20____
Subject
Gr.
MTB
Filipino
English
Math
Aral. Pan.
MAPEH
Music
Art
P.E.
Health
E.P.
Gen. Ave.

S.Y. 20 __ - 20____
Subject
Gr.
MTB
Filipino
English
Math
Aral. Pan.
MAPEH
Music
Art
P.E.
Health
E.P.
Gen. Ave.

S.Y. 20 __ - 20____
Subject
Gr.
MTB
Filipino
English
Math
Aral. Pan.
MAPEH
Music
Art
P.E.
Health
E.P.
Gen. Ave.

Teacher

Teacher

Teacher

Teacher

Teacher

Teacher

Awards Recvd.
Awards Recvd.
Awards Recvd.
Awards Recvd.
Awards Recvd.
Awards Recvd.
Legend:
MT - Mother Tongue
E.P. Edukasyon sa Pagkatao LRN Learners Reference Number
B. Attendance Record
I
II
III
IV
V
VI
Days of School
Days Present
Days Absent
No. of Times Tardy
C. Co Curricular Participation
Activity
Grade I
Grade II
Grade III
Grade IV
Grade V
Grade VI
A. 1. Boy Scout
2. Girl Scount
3. Arts
4. Dramatics
5. Glee Club
6. Class Org.
7. Club Mem.
8. Sports
Others:
B. Honors Garnered
C. Out-of-School Act.
D. Graduation Facts Graduated: ________________________________________________ Rank in Class (First Term): ____________
(Month )
(Day)
(Year)

II.
TEST RECORD
1. Mental Ability Test
RAVENS
OLMAT
2. Diagnostic Test

Grade I

TEST PERFORMANCE RECORD

Grade II

Grade III

Grade IV

Grade V

Grade VI

3. Periodical Test
1st
2nd
3rd
4th
4. Speed & Comprehension
5. Achievements Test

III.
INDIVIDUAL IDENTIFICATION DATA
A. Family
Name : ________________________________________________________________________________________________
(Last)
(First)
(Middle Name)
(Nickname)
Date of Birth: _____________________________________ Place of Birth: ____________________________________
(Year)
(Month)
(Day)
(Street/Barrio)
(City)
Current Address: ________________________________________________________________________________________
Permanent Address: ______________________________________________________________________________________
Parents/Guardian

Date of Birth

Place of Birth

Highest Grade
Attained

Religious Sec.

Occupation

Monthly
Income

1. Father
2. Mother
3. Guardian
Parents
__________ Living Together
__________ Temporarily Separated
__________ Permanently Separated
__________ Father OFW
__________ Marriage Annulled/Legally Separated
__________ Mother OFW
__________ Father with another partner
__________ Mother with another partner
Guardian (if not living with Parents): ______________________________________________________________
Address: _____________________________________________________________________________________
Landline: _____________________________ Cellphone: ______________________________________________
Relationship with guardians _____________________________________________________________________
Person to contact in case of emergency: _____________________________________________________________
Name: ________________________________________________ Contact No.: ____________________________
Brothers & Sisters according to position in the Family: (Include yourself)
a.
b.
c.
d.
e.
f.
g.
Language use at Home :
__________________________________________________________________________________
Other Languages Spoken :
__________________________________________________________________________________
Note: Significant Home Conditions: ________________________________________________________________________________

IV.

HEALTH INFORMATION RECORD

A. Physical Growth & Development:

Gr. 1

Gr. II

Gr. III

Gr. IV

Gr. V

Gr. VI

1. Height (cm)
2. Weight (kg.)
3. Nutritional Level
4. Health Condition
5. Vision
6. Hearing
7. Indicator any physical
disability handicaps
Chronic Illness: _____________________________________________
Legend:

Nutritional Level

Health Conditions

SW

Severely Weight

OW

Excellent

Wasted

VS

Very Satisfactory

Overweight

Good

OB

Obese

Fair

Normal

Poor

VP

Very Poor

B. Health Examination/Inspection Record / ETC

()Immunization you have had
a. Chicken pox
b. Mumps
c. Booster
d. Influence
e. Measles (MMR)
f. Small pox
g. Hepatitis B
h.Other (Please specify)
C. Disease Experience:

Gr. 1

Gr. II

Gr. III

Gr. IV

Gr. V

Gr. VI

()Immunization you have had

a. mumps
b. allergy
c. chicken pox
d. dysentery
e. malaria
f. measles
g. tonsillitis
h. whooping cough
i. parasitism
j. Other (Please specify)

Gr. 1

Gr. II

Gr. III

Gr. IV

Gr. V

Gr. VI

Medicines regularly taken

: _______________________________________________________________________________

Vitamins regularly taken

: _______________________________________________________________________________

Accidents experienced/effect

: _______________________________________________________________________________

Operations experience/effect

: _______________________________________________________________________________

V.

BEHAVIORAL CHARACTERISTICS

Leader Class Discussion

Participation in Subject Matters Understanding of

Assignments

Preparation of

with others Ability to get along Initiative and Panning Reliability and Dependability

Description of behavior made by those who have/had opportunities to observe the pupils in specific situations.
I
II
III
IV
V
VI
Conscientious always right and on time; meets
all schedules
Usually very conscientious; practically always
on time
Regular habits usually in time; seldom tardy
or absent
Indifferences to responsibility; often tardy or
absent.
Requires no guidance; plans his works
effectively.
Seldom requires guidance
Little planning ability
Never works without guidance; No planning
ability
Sociable, responsible, tactful & adaptable to
new situations.
Generally agreeable, usually sociable,
optimistic
Seldom agreeable, tasteless, unresponsive
Antagonistic, pessimistic, disagreeable,
tactless

Always well prepared; always turn in outside

work.
Always prepared and seldom needs urging
Seldom prepared assignments, seldom turns
outside work.
Has excellent understanding of subject matter

Has excellent understanding of subject matter.

Has good understanding of subject matter
Has fair understanding of subject matter
Has poor understanding of subject matter

Volunteers contribution; intelligent thoughtful

participation
Participates when called upon; Shows interest.
Seldom participates; shows little interest
No participantion; not interested in discussion

Leads in Class Discussion

Shows interest in assuming/follower

Comment

ship
Maturity

Contended to be member /follower

No interest at all
Acts in accordance with his age and group.
Overacting in his age group
Very timid & shy with his age group
VI.

OUT OF SCHOOL RECORD

A. Date of School: _____________________________

Activities
Type of Work
Status
Earning

B. Date of Re-entered: ________________________

Employer

Firm Establishment

Address

Indicate any activities participated: _________________________________________________________________________________

_____________________________________________________________________________________________________________
Marriages and children:
_____________________________________________________________________________________