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Deped Modified School Forms
Deped Modified School Forms
School Name
AGE as of
NAME Sex BIRTH DATE
LRN 1st Friday
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy)
June
Transferred IN T/I Name of Public (P) Private (PR) School & Effectivity Date
AGE as of
NAME Sex BIRTH DATE
LRN 1st Friday
(Last Name, First Name, Middle Name) (M/F) (mm/dd/ yyyy)
June
Division District
ADDRESS PARENTS
IP
MOTHER
(Ethnic RELIGION House #/ Father's Name (Last Mother's Mai
TONGUE Municipality/
Group) Street/ Sitio/ Barangay Province Name, First Name, (Last Name, F
City
Purok Middle Name) Middle N
ADDRESS PARENTS
IP
MOTHER
(Ethnic RELIGION House #/ Father's Name (Last Mother's Mai
TONGUE Municipality/
Group) Street/ Sitio/ Barangay Province Name, First Name, (Last Name, F
City
Purok Middle Name) Middle N
ADDRESS PARENTS
IP
MOTHER
(Ethnic RELIGION House #/ Father's Name (Last Mother's Mai
TONGUE Municipality/
Group) Street/ Sitio/ Barangay Province Name, First Name, (Last Name, F
City
Purok Middle Name) Middle N
ADDRESS PARENTS
IP
MOTHER
(Ethnic RELIGION House #/ Father's Name (Last Mother's Mai
TONGUE Municipality/
Group) Street/ Sitio/ Barangay Province Name, First Name, (Last Name, F
City
Purok Middle Name) Middle N
umn
Code Required Information REGISTERED BoSY EoSY
LWD Specify
TOTAL
ACL Specify Level & Effectivity Data
Section
GUARDIAN
RENTS REMARKS
(If not Parent)
Contact Number
Mother's Maiden Name of Parent or
Guardian (Please refer to the
(Last Name, First Name, Name Relation-ship
legend on last page)
Middle Name)
GUARDIAN
RENTS REMARKS
(If not Parent)
Contact Number
Mother's Maiden Name of Parent or
Guardian (Please refer to the
(Last Name, First Name, Name Relation-ship
legend on last page)
Middle Name)
GUARDIAN
RENTS REMARKS
(If not Parent)
Contact Number
Mother's Maiden Name of Parent or
Guardian (Please refer to the
(Last Name, First Name, Name Relation-ship
legend on last page)
Middle Name)
GUARDIAN
RENTS REMARKS
(If not Parent)
Contact Number
Mother's Maiden Name of Parent or
Guardian (Please refer to the
(Last Name, First Name, Name Relation-ship
legend on last page)
Middle Name)
(Signature of Adviser over Printed Name) (Signature of School Head over Printed Name)
GUARDIAN
RENTS REMARKS
(If not Parent)
Contact Number
Mother's Maiden Name of Parent or
Guardian (Please refer to the
(Last Name, First Name, Name Relation-ship
legend on last page)
Middle Name)
Section
Drop out
Transferred out
Transferred in
Attested by:
020
Section JOY
Area & Title Subject Area & Title Subject Area & Title
AP
REMARKS/ACTION TAKEN
(Please refer to the
Date Date Date legend on last page)
Returned Issued Returned Issued Returned
Area & Title Subject Area & Title Subject Area & Title
AP
REMARKS/ACTION TAKEN
(Please refer to the
Date Date Date legend on last page)
Returned Issued Returned Issued Returned
Area & Title Subject Area & Title Subject Area & Title
AP
REMARKS/ACTION TAKEN
(Please refer to the
Date Date Date legend on last page)
Returned Issued Returned Issued Returned
Area & Title Subject Area & Title Subject Area & Title
AP
REMARKS/ACTION TAKEN
(Please refer to the
Date Date Date legend on last page)
Returned Issued Returned Issued Returned
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
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.
2. Furnish the Division Office with a copy a week after June 30, October 30 & March 31
M F T M F T M F T M F T M F T
epared and Submitted by:
INCOMPLETE SUBJECT/S
GENERAL
(This column is for K to 12 Curriculum and remain
AVERAGE
ACTION TAKEN: RBEC in High School. Elementary grades level that are stil
(Numerical Value in 2
LEARNER'S NAME PROMOTED, implementing RBEC need not to fill up these columns)
LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
RETAINED From previous school years
honor learners, and
Descriptive Letter) completed as of end of current As of end of current School
School Year
INCOMPLETE SUBJECT/S
GENERAL
(This column is for K to 12 Curriculum and remain
AVERAGE
ACTION TAKEN: RBEC in High School. Elementary grades level that are stil
(Numerical Value in 2
LEARNER'S NAME PROMOTED, implementing RBEC need not to fill up these columns)
LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
RETAINED From previous school years
honor learners, and
Descriptive Letter) completed as of end of current As of end of current School
School Year
TOTAL MALE
INCOMPLETE SUBJECT/S
GENERAL
(This column is for K to 12 Curriculum and remain
AVERAGE
ACTION TAKEN: RBEC in High School. Elementary grades level that are stil
(Numerical Value in 2
LEARNER'S NAME PROMOTED, implementing RBEC need not to fill up these columns)
LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
RETAINED From previous school years
honor learners, and
Descriptive Letter) completed as of end of current As of end of current School
School Year
INCOMPLETE SUBJECT/S
GENERAL
(This column is for K to 12 Curriculum and remain
AVERAGE
ACTION TAKEN: RBEC in High School. Elementary grades level that are stil
(Numerical Value in 2
LEARNER'S NAME PROMOTED, implementing RBEC need not to fill up these columns)
LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
RETAINED From previous school years
honor learners, and
Descriptive Letter) completed as of end of current As of end of current School
School Year
TOTAL FEMALE
COMBINED
ficiency
Section
um and remaining
vel that are still
se columns)
SUMMARY TABLE
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
um and remaining
vel that are still
se columns)
BEGINNNING
(B: 74% and
below)
DEVELOPING (D:
75%-79%)
APPROACHING
PROFICIENCY
(AP:
80%-84%)
PROFICIENT
(P: 85% -89%)
ADVANCED (A:
90% and above)
PREPARED BY:
Class Adviser
School Head
REVIEWED BY:
Division Representative
GUIDELINES:
GRADE 1 /GRADE 7 GRADE 2 / GRADE 8 GRADE 3 / GRADE 9 GRADE 4 / GRADE 10 GRADE 5 / GRADE 11 GRADE 6 / GR
SUMMARY TABLE
MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE
BEGINNNING
(B: 74% and below)
DEVELOPING
(D: 75%-79%)
APPROACHING
PROFICIENCY
(AP: 80%-84%)
PROFICIENT
(P: 85% -89%)
ADVANCED
(A: 90% and above)
TOTAL
Prepared and Submitted by: Reviewed & Validated by: Noted by:
SCHOOL HEAD DIVISION REPRESENTATIVE SCHOOLS DIVISION SUPER
GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the grade level total and school total.
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 is under the discretion of the Schools Division Superintendent.
School Year
(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non Teaching Items (C ) Other Appointments and Funding
School Year
Number of
Incumbent
Fund Source
(SEF, PTA,
NGO's etc.) Teaching Non-
Teaching
Submitted by: