Professional Documents
Culture Documents
Form 137-School Permanent Record
Form 137-School Permanent Record
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:_______________________
Grade III-School______________________________________________________________
Grade IV-School_______________________________________________________________
School Year__________________________________________________________________
School Year__________________________________________________________________
Periodic Rating Remarks
LEARNING AREAS Periodic Rating Remarks
1 2 3 4 LEARNING AREAS
1 2 3 4
General Average
Eligible for Admission to Grade______________________________________________ General Average
Eligible for Admission to Grade______________________________________________
Grade V-School_______________________________________________________________
School Year__________________________________________________________________ Grade VI-School_______________________________________________________________
School Year__________________________________________________________________
Periodic Rating Remarks
LEARNING AREAS Periodic Rating Remarks
1 2 3 4 LEARNING AREAS
1 2 3 4
General Average
Eligible for admission to Grade _________________________________ General Average
Eligible for admission to Grade _________________________________
III. REPORT ON LEARNER’S OBSERVED VALUES
Gr. 1 S.Y. ________________ Gr. 2 S.Y. ________________ Gr. 3 S.Y. ________________
Core Values Quarter Quarter Quarter
Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one’s spiritual
1. Maka- beliefs while respecting the
Diyos spiritual beliefs of others
Shows adherence to ethical
2. Makatao principles by upholding
truth
Cares for the environment
3. Maka- and utilizes resources
kalikasan wisely, judiciously, and
economically
Demonstrates pride in
being a Filipino; exercises
the rights and responsibi-
4.Makabansa lities of a Filipino citizen.
Demonstrates appropriate
behavior in carrying out
activities in the school,
community, and country
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