School Form 1 (SF 1) School Register

(This replaced Form 1, Master List & STS Form 2-Family Background and Profile)

School ID 127817 Region X Division MISAMIS ORIENTAL District MEDINA

School Name GOVERNOR PELAEZ ELEMENTARY School Year 2018-2019 Grade Level 4 Section DILIGENT

AGE as of
1st Friday ADDRESS NAME OF PARENTS GUARDIAN (If not Parent) REMARK/S
of June
BIRTH BIRTH IP Contact Number
NAME Sex MOTHER
LRN DATE (mm/ PLACE (Specify RELIGION (Parent
(Last Name, First Name, Middle Name) (M/F) (nos. of TONGUE
dd/yy) ( Province) Ethnic Group) House # / Father (1st name only if /Guardian)
years as Mother (Maiden: 1st Name, (Please refer to the
Street/Sitio/ Barangay Municipality/ City Province family name identical to Name Relationship
per last Middle & Last Name) legend on last page)
Purok learner)
birthday)
Medina, Misamis SOUTH
201502140005 BALBOCENA, CHRISTIAN ATIENZA M 9/26/08 9 Oriental Cebuano Roman Catholic POBLACION
MEDINA MIS.OR. CELSO JR. NOVELYN TAHOYNON ATIENZA

Medina, Misamis SOUTH

127817140021 CABREZOS, REEVER JAY NAPONE M 5/6/09 9 Oriental Cebuano Roman Catholic POBLACION
MEDINA MIS. OR EREBERTO JR. LYDIA CAGO NAPONE

Medina, Misamis SOUTH

127817120234 CABILOGAN, LAWRENCE M 9/9/06 11 Oriental Cebuano Roman Catholic POBLACION
MEDINA MIS. OR JOJITH ENGELLIE TAMPOG MAMUGAY 9262393410

Medina, Misamis
127817140194 CAGMAT, JAMES REAL SEMBRANO M 9/13/09 9 Oriental Cebuano Roman Catholic MAANAS MEDINA MIS. OR REX JOIDA BACOLCOL SEMBRANO 9278136709

Medina, Misamis
127823140087 CLOMA, NEIL FRED M 0207/08 10 Oriental Cebuano Roman Catholic CABUG MEDINA MIS. OR REX JOIDA BACOLCOL SEMBRANO

JUVIE ANN SUMUNOD CLOMA

127823140086 CLOMA NIKKO M 2/6/09 9 Gingoog City Cebuano Roman Catholic CABUG MEDINA MIS. OR

Medina, Misamis SOUTH

127817140063 CULLA JASPER ATIENZA M 8/30/09 8 Oriental Cebuano Roman Catholic POBLACION
MEDINA MIS. OR JULIUS CHARMIE LUSAT ATIENZA

Medina, Misamis
126926140005 DALURA, KENTH REY S. M 4/30/09 9 Oriental Cebuano Roman Catholic CABUG MEDINA MIS. OR ARBEN JACKIE LOU ALLOSADA

Medina, Misamis
127817140023 GABULE, DIOBER III PACQUING M 7/7/09 9 Oriental Cebuano Roman Catholic CABUG MEDINA MIS. OR DIOBER Jr. EMALYN KE-E PACQUING

GENEROL, KAIL VINCENT A. M

Medina, Misamis
127817140230 HECHANOVA, JUSTIN ALABATA M 4/3/09 9 Oriental Cebuano Roman Catholic TAMBAGAN MEDINA MIS. OR JOEL MYLENE VALIENTE ALABATA

Medina, Misamis
127817150063 JUBAY, RICO BINTAS M 12/13/09 8 Oriental Cebuano Roman Catholic CABUG MEDINA MIS. OR ELENO JR. NILDA SANDUNGAN BINTAS

Medina, Misamis SOUTH

127817140204 LEGASPI, DRECKER DONNEY BUTALID M 3/2/09 9 Oriental Cebuano Roman Catholic POBLACION
MEDINA MIS.OR. RONALD RUBY LEGASPI

Medina, Misamis NORTH

127817140239 NOCULAN, TEDDY TRISIAN LLACUNA M 3/20/09 9 Oriental Cebuano Roman Catholic POBLACION
MEDINA MIS. OR NERI JR CASIMER BOCAL LLACUNA

127817140029 PRAK, JASON OBEDENCIO Jr. M 4/1/09 9 Taytay, Rizal Cebuano Roman Catholic CABUG MEDINA MIS. OR JASORI ANNICAR A. OBEDENCIO

Cagayan de Oro NORTH

126897140166 RANARA, PRINCE LAWRENCE ABIAN M 2/3/09 9 City Cebuano Roman Catholic POBLACION
MEDINA MIS. OR JEREMIAS ELISA MEJARES ABIAN

Cagayan de Oro
136601140997 SEBANDAL, LEOANGELO M. M 6/26/09 9 City Cebuano Roman Catholic MAANAS MEDINA MIS. OR ERIC ELISA MEJARES ABIAN

Medina, Misamis SOUTH

127817140030 TABULONG, JEPOY CAGO M 6/5/09 9 Oriental Cebuano Roman Catholic POBLACION
MEDINA MIS. OR BELMOR ANGELITA CAGO

ANA MARIA FERNANDEZ

127817140068 TUTO, IAN KENT PAGULONG M 7/10/09 9 Gingoog City Cebuano Roman Catholic CABUG MEDINA MIS. OR MESSACH
PAGULONG

Medina, Misamis
127817140017 YAZAR, MARK ARVIN CABATINGAN M 10/27/09 8 Oriental Cebuano Roman Catholic MEDINA MIS. OR MARCK ANTONI LUCIFEN EBDAO CABATINGAN

136481140489 BITAS, LUISA MAE CASANES F 11/6/08 10 Gingoog City Cebuano Roman Catholic CABUG MEDINA MIS. OR JULIUS NORAIDA BALIMBINGAN CASANES 926567390

Medina, Misamis NORTH

127817140073 CARUMBA, SCHENLY ANN GUMAPO F 9/30/09 9 Oriental Cebuano Roman Catholic POBLACION
MEDINA MIS. OR ROBERTO FLORA PABULAR GUMAPO

South Pob. Medina SOUTH

127817140038 JAGAPE, LOVERS DIA NALASA F 8/26/09 9 Mis. Or. Cebuano Roman Catholic POBLACION
MEDINA MIS. OR DISODADO JR. MARIA CAMILLE GUMATAY NALASA 9268989024
 AGE as of
1st Friday ADDRESS NAME OF PARENTS GUARDIAN (If not Parent) REMARK/S
of June
BIRTH BIRTH IP Contact Number
NAME Sex MOTHER
LRN DATE (mm/ PLACE (Specify RELIGION (Parent
(Last Name, First Name, Middle Name) (M/F) (nos. of TONGUE
dd/yy) ( Province) Ethnic Group) House # / Father (1st name only if /Guardian)
years as Mother (Maiden: 1st Name, (Please refer to the
Street/Sitio/ Barangay Municipality/ City Province family name identical to Name Relationship
per last Middle & Last Name) legend on last page)
Purok learner)
birthday)
Pigsalohan,
127817140090 LACRE, PRINCESS TALAROC F 1/30/09 9 Gingoog city Cebuano Roman Catholic CABUG MEDINA MIS. OR RUEL JENNEVY PARDILLO TALAROC

Cabug, Medina Mis. NORTH

127817140288 MACAS, MARYJOY AWAYAN F 9/8/09 8 Or. Cebuano Roman Catholic POBLACION
MEDINA MIS. OR NONILON ALMA ABUHAN AWAYAN 9759471652

Cabug, Medina Mis.

127817140039 PAGULONG, LYCA BROAS F 10/26/09 8 Or. Cebuano Roman Catholic CABUG MEDINA MIS. OR SIDRO CHERRY MAE ALFECHE BROAS

South Pob. Medina SOUTH

127817140203 PON, ALEXIA MEKAILLA MAGBANUA F 8/6/09 8 Mis. Or. Cebuano Roman Catholic POBLACION
MEDINA MIS. OR WILFREDO CLAIRE ANG-OG MAGBANUA

South Pob. Medina SOUTH

127817140036 PON, ASIA TRILLA MAE SAGUBAY F 12/1/08 9 Mis. Or. Cebuano Roman Catholic POBLACION
MEDINA MIS. OR RENANTE MARISSA JENALAN SAGUBAY 9555239875

South Pob. Medina SOUTH

127817140050 PON, QUEEN RIZY PAGARAN F 12/6/08 9 Mis. Or. Cebuano Roman Catholic POBLACION
MEDINA MIS. OR LEONARDO MERLINA DAGOC PAGARAN

North Pob. Medina NORTH

127817140041 RAMBUYON, JUVY PON F 6/28/09 8 Mis. Or. Cebuano Roman Catholic POBLACION
MEDINA MIS. OR JIMMY KENT DYESEBEL CADELINA PON 9352770473

109463150092 RIVERA, PRINCESS MARIAN SAJULGA F 10/9/09 8 Rodriguez, Rizal Cebuano Roman Catholic CABUG MEDINA MIS.OR. ADRIAN EMA MOSQUIDA SAJULGA

SOUTH
127817140316 SALAS, EVA MAE AMATONG F 5/31/09 9 Gingoog City Cebuano Roman Catholic POBLACION
MEDINA MIS. OR EMMANUEL EVELYN SANOY AMATONG

Maanas, Medina
127817150199 SARAYNO, PRINCESS M. F 1/8/08 10 Mis. Or. Cebuano Roman Catholic CABUG MEDINA MIS. OR MARK

Tambagan, Medina,
127817140214 TION, KIARA LANORIAS F 1/19/09 9 Mis. Or. Cebuano INC CABUG MEDINA MIS. OR LINDO JENELYN LASPONA LANORIAS

Cabug, Medina Mis.

127817140043 TRIPOLE, KATLYN MAPANO F 7/4/09 8 Or. Cebuano Roman Catholic CABUG MEDINA MIS. OR ROLLY ELMA PAJO MAPANO

127817150221 YTING, MILES ALFECHE F 4/24/09 9 Gingoog City Cebuano SDA CABUG MEDINA MIS. OR MICHAEL LAARNI PAHILANGCO ALFECHE 9758831567

List and code of Indicators under REMARK column

Prepared by: Certified Correct:
Indicator Code Required Information Indicator Code Required Information BoSY EoSY

Transferred Out T/O Name of Public (P) Private (PR) School & Effectivi CCT Recipient CCT CCT Control/reference number & Effectivity Date MALE 27 MELISSA L. MACAPAYAD ARLYN A. OMAHOY
(Signature of Adviser over Printed Name) (Signature of School Head over Printed Name)
Transferred IN T/I Name of Public (P) Private (PR) School & Effectivi Balik-Aral B/A Name of school last attended & Year FEMALE 18

Dropped DRP Reason and Effectivity Date Learner With Dissabilit LWD Specify
TOTAL 45
Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) Accelarated ACL Specify Level & Effectivity Data BoSY Date: EoSYDate: BoSY Date: EoSYDate:
 School Form 2 (SF2) Daily Attendance Report of Learners
(This replaced Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

School ID 127817 School Year 2018-2019 Report for the Month of NOVEMBER

Name of School Gov. Pelaez Elem. School Grade Level 4 Section Diligent

LEARNER'S NAME (1st row for date, 2nd row for Day: M,T,W,TH,F) Total for the
REMARK/S (If DROPPED OUT, state reason,
(Last Month please refer to legend number 2.
3 4 5 6 7 10 11 12 13 14 17 18 19 20 21 24 25 26 27 28
Name, First Name, Middle Name) If TRANSFERRED IN/OUT, write the name of

TH

TH

TH

TH

TH
W

W
ABSENT TARDY

M
School.)

F
BALBOCENA, CHRISTIAN A.

CABILOGAN, LAWRENCE M
CABREZOS, REEVER JAY N.

CAGMAT, JAMES REAL S.

CLOMA, NEIL FRED

CLOMA, NIKKO

CULLA, JASPER A.
GABULE, DIOBER III P.

GENEROL, KAIL VINCENT A.

HECHANOVA, JUSTIN A.
JUBAY, RICO B.

NOCULAN, TEDDY TRISIAN L.

PRAK, JASON O.
RANARA, PRINCE LAWRENCE A.

SEBANDAL, LEOANGELO M.
TABULONG, JEPOY C.

TUTO, IAN KENT P.

YAZAR, MARK ARVIN C.

MALE | TOTAL Per Day

BITAS, LUISA MAE C.

CARUMBA, SCHENLY ANN G.

JAGAPE, LOVERS DIA N.

LACRE, PRINCESS T.
MACAS, MARYJOY A.
PAGULONG, LYCA B.

PON, ALEXIA M.

PON, ASIA TRILLA MAE S.

PON, QUEEN RIZY P.

RAMBUYON, JUVY P.
LEARNER'S NAME (1st row for date, 2nd row for Day: M,T,W,TH,F) Total for the
REMARK/S (If DROPPED OUT, state reason,
(Last Month please refer to legend number 2.
3 4 5 6 7 10 11 12 13 14 17 18 19 20 21 24 25 26 27 28
Name, First Name, Middle Name) If TRANSFERRED IN/OUT, write the name of

TH

TH

TH

TH

TH
W

W
ABSENT TARDY

M
School.)

F
RIVERA, PRINCESS MARIAN S.

SARAYNO, PRINCESS M.

TION, KIARA L.

TRIPOLE, KATLYN M.

YTING, MILES A.

FEMALE | TOTAL Per Day

Combined TOTAL PER DAY
Summary for the
GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month: No. of Days of
Month
Classes:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance. M F TOTAL
blank- Present; (x)- Absent; Tardy (half shaded= Upper
2. Dates shall be written in the preceding columns beside Learner's Name.
for Late Commer, Lower for Cutting Classes) * Enrolment as of (1st Friday of June)
3. To compute the following:
Registered Learner as of End of the Month 2. REASONS/CAUSES OF DROP-OUTS Late Enrollment during the month
a. Percentage of Enrolment = x 100
Enrolment as of 1st Friday of June a. Domestic-Related Factors (beyond cut-off)
Total Daily Attendance a.1. Had to take care of siblings
b. Average Daily Attendance = Registered Learner as of end of the month
Number of School Days in reporting month a.2. Early marriage/pregnancy
Average daily attendance a.3. Parents' attitude toward schooling Percentage of Enrolment as of end of the month
c. Percentage of Attendance for the month = x 100
Registered Learner as of End of the month a.4. Family problems

b. Individual-Related Factors Average Daily Attendance

4. Every End of the month, the class adviser will submit this form to the office of the principal for recording of b.1. Illness
Percentage of Attendance for the month
summary table into the School Form 4. Once signed by the principal, this form should be returned to the adviser. b.2. Overage
5. The adviser will extend neccessary intervention including but not limited to home visitation to learner/s that committed 5 consecutive b.3. Death Number of students with 5 consecutive days of
days of absences or those with potentials of dropping out b.4. Drug Abuse absences:
6. Attendance performance of learner is expected to reflect in Form 137 and Form 138 every grading period b.5. Poor academic performance
Drop out
* Beginning of School Year cut-off report is every 1st Friday of School Calendar Days b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
Transferred out
c. School-Related Factors
c.1. Teacher Factor
Transferred in
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental I certify that this is a true and correct report.
d.1. Distance between home and school
MELISSA L. MACAPAYAD
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
(Signature of Teacher over Printed Name)
d.3. Calamities/Disasters
e. Financial-Related Attested by:
e.1. Child labor, work ARLYN A. OMAHOY
School Form 2: Page 2 of ________ f. Others (Signature of School Head over Printed Name)
 School Form 3 (SF3) Books Issued and Returned
(This replaced Form 1 & Inventory of Text Book)

School ID 127817 School Year 2014-2015

School Name Governor Pelaez Elem. School Grade Level III Section CHEERFUL
Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

LEARNER'S NAME REMARK/ACTION TAKEN

NO. (Last Name, First (Please refer to the
Name, Middle Name) Date Date Date Date Date Date Date Date legend on last page)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned
Abucay , Emmanuel allen T.
1
Abuzo, Neoclark Daniel C.
2
Arias, John Nikko A.
3
Atienza, Jhade L.
4
Awitan Gabriel Jared S.
5
Ayuman, Carmel Jarvin Dirk A.
6
Balistoy, Jairus B.
7
Barcelona, Cael Issacar L.
8
Barcelona, Charles Belo L.
9
Cabiasa, Kert J.
10
Cortes, Jerome
11
Glorie, Justine P.
12
Gumapo, Ruelden M.
13
Jaculan, Andrei Jedrick R.
14
Labiste, Leonard D.
15
Linsanay, Jeof Teo S.
16
Marquez, Marco Antonio T.
17
Mofar , Marc Raven
18
Neri, Josh Carl C.
19
Ocate, Jasper Kirt L.
20
Pabatao, Jeddah A.
21
Ramoso, Shun Rex R.
22
Raňada Jr.,Glenard S.
23
Ruedas, Mark Jhones C.
24
 Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

LEARNER'S NAME REMARK/ACTION TAKEN

NO. (Last Name, First (Please refer to the
Name, Middle Name) Date Date Date Date Date Date Date Date legend on last page)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned
Tabamo ,Antonio Gabriel L.
25
Virtudazo, Russel D.
26
Zamora, Christian Alvin D.
27

27 TOTAL FOR MALE | TOTAL COPIES

10

11

12

13

14

15

16

17

18
TOTAL FOR FEMALE | TOTAL COPIES

TOTAL LEARNERS | TOTAL COPIES

GUIDELINES:
1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form.
5. All textbooks being used must be included. Additional copy/ies of this form may use if needed.
In case of losses/unreturned, please provide information with the following code: Prepared By:
A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for (Signature over printed name)
code FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property
Custodian (for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, Date BoSY:____________ Date EoSY: ___________
DO#14, 2.2012.
School Form 3: Page 2 of ________
 School Form 4 (SF4) Monthly Learner's Movement and Attendance
(This replaced Form 3 & STS Form 4-Absenteeism and Dropout Profile)

Region Division District

School ID

School Name School Year Report for the Month of

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN

REGISTERED
GRADE/ LEARNER
NAME OF ADVISER YEAR SECTION (As of End of the (A+B) Cumulative (A+B) Cumulative (A+B)
Percentage for (A) Cumulative as (A) Cumulative as (A) Cumulative as
LEVEL Month) Daily Average (B) For the Month as of End of the (B) For the Month as of End of the (B) For the Month Cumulative as of
the Month of Previous Month
Month
of Previous Month
Month
of Previous Month
End of the Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T

ELEMENTARY/SECONDARY:
KINDER
GRADE 1/GRADE 7
GRADE 2/GRADE 8
GRADE 3/GRADE 9
GRADE 4/GRADE 10
GRADE 5/GRADE 11
GRADE 6/GRADE 12
TOTAL FOR NON-GRADED
TOTAL
GUIDELINES: Prepared and Submitted by:
1. This forms 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.
2. Furnish copy to Division Office: a week after June 30, October 30 & March 31
3. Only teachers who are handling advisory class shall be reported. May use additional copy/ies of this form if needed. (Signature of School Head over Printed Name)
4. Small school that has one section per grade/year level is not required to fill the columns "Name of Adviser, Grade/Year Level & Section". Instead, they will only accomplish the
summary column per grade/year level.
 School Form 5 (SF 5) Report on Promotion & Level of Proficiency
(This replaced Forms 18-E1, 18-E2, 18A and List of Graduates)

Region X Division Misamis Oriental District Medina

127817
School ID School Year 2016-2017 Curriculum K to 12

School Name Governor Pelaez Elementary School Grade Level IV Section Diligent

GENERAL INCOMPLETE SUBJECT/S

AVERAGE (This column is for K to 12 Curriculum and remaining
(Numerical Value ACTION TAKEN: RBEC in High School. Elementary grades level that still
LEARNER'S NAME in 3 decimal PROMOTED, implementing RBEC need not to fill up this column)
LRN places for honor
(Last Name, First Name, Middle Name) learner, 2 for non-
*IRREGULAR or
RETAINED
honor &
Descriptive Completed as of end of as of End of the current
Letter) current SY SY

127817130155 Alpas, Westlie S. SUMMARY TABLE

127817110021 Aripal, Mejie G. STATUS MALE FEMALE TOTAL

127817110063 Bomediano, Darwin

PROMOTED 27 18 45
127817110078 Cayetuna, Kyle

128059120038 Cena, Elmar L.

*IRREGULAR 0 0 0
129769120069 Cimafranca, Lyster Jay F.

127817140403 Guaynon, Rico Jr.

RETAINED 0 0 0
127647130209 Gumatay, Ariel G.

127817130030 Hubella, Jerold S.

127817130033 Labiste, Renier LEVEL OF PROFICIENCY

127817120172 Macas, Nathaniel A. MALE FEMALE TOTAL

127817110133 Magallanes, Paulo Gabriel P. BEGINNNING

(B: 74% and 0 0 O
127817120174 Mamugay, John Poul A. below)

127817120176 Moralde, Jaymar C. DEVELOPING

(D: 75%-79%) 1 0 1
127817140330 Oga, Jameswil Jr. G.

127817120212 Padero, Alverzon B. APPROACHING

PROFICIENCY
(AP: 10 3 13
127817140331 Paje, John Michael Fulpay B. 80%-84%)

127817130293 Ranoa, Isagani Jr. G.

PROFICIENT
(P: 85% -89%) 13 11 24
127817130043 Riola, Joven P.

127817130311 Ronday, John CJ S.

127817120178 Sanoy, Arsan A

 GENERAL INCOMPLETE SUBJECT/S
AVERAGE (This column is for K to 12 Curriculum and remaining
(Numerical Value RBEC in High School. Elementary grades level that still
in 3 decimal ACTION TAKEN:
LEARNER'S NAME PROMOTED, implementing RBEC need not to fill up this column)
LRN places for honor
(Last Name, First Name, Middle Name) learner, 2 for non- *IRREGULAR or
honor & RETAINED
Descriptive Completed as of end of as of End of the current
Letter) current SY SY

127817130170 Serada, Stephen

127817130279 Tagaro, John Christian ADVANCED

(A: 90% and 3 4 7
127824120047 Tion, Johenes L. above)

127817120209 Abad, Jannah M. PREPARED BY:

127817120180 Aban, Roelyn M. FE M. BABANTO

125128120056 Amatong, Karyel S. Class Adviser

127817120183 Atienza, Nina Kristy E. (Name and Signature)

131143130498 Bao, mary Jorich S.

127817130345 Culla, April Rose A. CERTIFIED CORRECT & SUBMITTED:

126607120079 Dalugdog, Ashley Nicole L ELLY H. LOFRANCO

127817110091 Edulan, Angelica Sheena P. School Head

127817130171 Edulan, PJ Rose L. (Name and Signature)

127817140405 Jerezon, Alrish Mae S.

127817130172 Llanita, Nikka Marielle S. REVIEWED BY:

127817130285 Lorejo, Jhealou U. BEATRIZ E. ACDAL

127817110173 Prak, Kyla O. (Name and Signature)

127817120195 Pon, Hanna Kim L. Division Representative

127817130348 Quilla, Melfie A. GUIDELINES:

127817130350 Saray,Shiela Mae B. 1. For All Grade/Year Levels

127817130288 Seva, Roshnie Megan P. 2. To be prepared by the Adviser. Final rating

per subject area should be taken from the
127817120230 Veluz, Cassandra K. record of subject teacher. The class adviser
should make the computation of General
127759120015 Yana, Mecca Chedhe B. Average.

3. On the summary table, reflect the total

number of learners promoted, retained and
irregular ( *for grade 7 onwards only) and the
level of proficiency according to the individual
general average
 GENERAL INCOMPLETE SUBJECT/S
AVERAGE (This column is for K to 12 Curriculum and remaining
(Numerical Value RBEC in High School. Elementary grades level that still
in 3 decimal ACTION TAKEN:
LEARNER'S NAME PROMOTED, implementing RBEC need not to fill up this column)
LRN places for honor
(Last Name, First Name, Middle Name) learner, 2 for non- *IRREGULAR or
honor & RETAINED
3. On the summary table, reflect the total
Descriptive Completed as of end of as of End of the current number of learners promoted, retained and
Letter) current SY SY irregular ( *for grade 7 onwards only) and the
level of proficiency according to the individual
general average

4. Must tallied with the total enrollment report

as of End of School Year GESP /GSSP (BEIS)

5. Protocols of validation & submission will

remain under the discretion of the Schools
18 TOTAL FEMALE Division Superintendent

45 COMBINED School Form 5: Page 2 of ________

 School Form 6 (SF6) Summarized Report on Promotion
and Level of Proficiency
(This replaced Form 20)

School ID Region Division

School Name District School Year

GRADE 1 /GRADE 7 GRADE 2 / GRADE 8 GRADE 3 / GRADE 9 GRADE 4 / GRADE 10 GRADE 5 / GRADE 11 GRADE 6 / GRADE 12 TOTAL
SUMMARY TABLE

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL

PROMOTED

IRREGULAR

RETAINED

LEVEL OF PROFICIENCY MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL

Nos. of BEGINNNING
(B: 74% and below)

Nos. of DEVELOPING
(D: 75%-79%)

Nos. of APPROACHING
PROFICIENCY
(AP: 80%-84%)

Nos. of PROFICIENT
(P: 85% -89%)

Nos. of ADVANCED
(A: 90% and above)

TOTAL

Prepared and Submitted by: Reviewed & Validated by: Noted by:
SCHOOL HEAD DIVISION REPRESENTATIVE SCHOOLS DIVISION SUPERINTENDENT
GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the Total for Grade Level in order to reflect the result in each data field.
2. This report together with the copy of Report for Promotion submitted by the class adviser shall be forwarded to the Division Office by the end of the school year.
3. The Report on Promotion per Grade Level is reflected in the End of School Year Report of GESP/GSSP
4. Protocols of validation & submission will remain under the discretion of the Schools Division Superintendent
 School Form 7 (SF7) School Personnel Assignment List and Basic Profile
(This replaced Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)

School ID 127817 Region x Division MISAMIS ORIENTAL

School Name GOVERNOR PELAEZ ELEM. SHOOL District MEDINA School Year 2016-2017

(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non Teaching Items (C ) Other Appointments and Funding Sources

Title of Designation Appointment:

Title of Plantilla Position Title of Plantilla Position (Contractual, Fund Source Number of Incumbent
Number of Number of (Designation as appeared in the
(as appeared in the appointment (as appeared in the appointment Substitute, (SEF, PTA,
Incumbent Incumbent contract/document: Teacher, Clerk, Security Volunteer, others
document/PSIPOP) document/PSIPOP) NGO's etc.) Teaching
Guard, Driver etc.) specify) Non-Teaching
OSEC-DECSB TCH1-660479-2012

EDUCATIONAL QUALIFICATION * Daily Program (time duration)

Employee Nature of
No. (or Tax Name of School Personnel Fund Position/ Appointment/
Subject Taught (include Grade & Total Actual Remark/s (For Detailed Items,
Identification (Arrange by Sex Section), Advisory Class & Other DAY Teaching Indicate name of school/office,
Source Designation Employment Degree / Post Major/ From To
Number Position, Descending) Minor Ancillary Assignment (M/T/W/ Minutes For IP's -Ethnicity)
-T.I.N.) Status Graduate Specialization (00:00) (00:00)
TH/F) Assignment
per Week
Edukasyon sa Pagpapakatao (EsP) Daily 7:30 8:00 150
TEACHER 1

English IV- Divine Daily 8:00 8:50 250

English IV- Diligent Daily 8:50 9:40 250
412-312;896 ALMONIA, JUVIE A. F PERMANENT BEED
English IV- Dynamic Daily 10:05 10:55 250
English IV- Delight Daily 1:00 1:50 250
Araling Panlipunan Daily 1:50 2:30 200
Edukasyong Pantahanan at Pangkabuhayan (EPP) Daily 2:40 3:30 250

Ave. Minutes per Day 360

GUIDELINES: Submitted by:

1. This form shall be accomplished at the beginning of the school year by the school head. In case of movement of teachers and other personnel during SY, updated Form 19 must submit
to the Division Office . EMERE C. JENISAN, Ph. D.
 EDUCATIONAL QUALIFICATION * Daily Program (time duration)
Employee Nature of
No. (or Tax Name of School Personnel Fund Position/ Appointment/
Subject Taught (include Grade & Total Actual Remark/s (For Detailed Items,
Identification (Arrange by Sex Section), Advisory Class & Other DAY Teaching Indicate name of school/office,
Source Designation Employment Degree / Post Major/ From To
Number Position, Descending) Minor Ancillary Assignment (M/T/W/ Minutes For IP's -Ethnicity)
-T.I.N.) Status Graduate Specialization (00:00) (00:00)
TH/F) Assignment
per Week

2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank down to the lowest. This form shall also (Signature of School Head over Printed Name)
serve as inventory list of school personnel.
3. Please reflect subjects being taught and if teacher handling advisory class or Ancillary Assignment. Other administrative duties must also reported. Updated as of: ___________________________
4. * Daily Program Column is for teaching personnel only.
School Form 7, Page 2 of ________
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Excel 97-2003