FORM 137-E

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:_______________________

Pangalan ___________________________________________________________________ Sangay__________________Paaralan______________________________

(Name) Apelyido Unang Pangalan M.I. (Division) (School)

Kasarian__________Petsa ng Kapanganakan__________________Pook___________________________________Petsa ng Pagpasok__________________

(Sex) (Date of Birth) (Place) Bayan/lalawigan/Lunsod (Date of Entrance)
(Town/Province/City)
Magulang/Tagapag-alaga____________________________________________________________________________________________________________________
(Parent/Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

PAG-UNLAD SA MABABANG PAARALAN

(Elementary School Progress)

Eligible for Admission to Grade______________________________________________ Science

Grade I-School_________________________________________________________________
Araling Panlipunan
School Year__________________________________________________________________
EPP
Periodic Rating
LEARNING AREAS Remarks MAPEH
1 2 3 4
Mother Tongue 75 Music
Filipino Art
English Physical Education
Mathematics Health
Araling Panlipunan Edukasyon sa Pagpapakatao (EsP)
MAPEH General Average
Music Eligible for admission to Grade _________________________________
Art
Physical Education Grade II-School________________________________________________________________
School Year__________________________________________________________________
Health
Periodic Rating
Edukasyon sa Pagpapakatao (EsP) LEARNING AREAS Remarks
1 2 3 4
General Average Mother Tongue
Eligible for Admission to Grade______________________________________________ Filipino
English
Grade III-School______________________________________________________________
Mathematics
School Year__________________________________________________________________
Araling Panlipunan
Periodic Rating
LEARNING AREAS Remarks MAPEH
1 2 3 4
Filipino Music
English Art
Mathematics Physical Education
Science Health
Araling Panlipunan Edukasyon sa Pagpapakatao (EsP)
EPP General Average
MAPEH Eligible for Admission to Grade______________________________________________
Music
Art Grade IV-School_______________________________________________________________
School Year__________________________________________________________________
Physical Education
Periodic Rating
Health LEARNING AREAS Remarks
1 2 3 4
Edukasyon sa Pagpapakatao (EsP) Filipino
General Average English
Eligible for Admission to Grade______________________________________________ Mathematics
Science
Grade V-School_______________________________________________________________
Araling Panlipunan
School Year__________________________________________________________________
EPP
Periodic Rating
LEARNING AREAS Remarks MAPEH
1 2 3 4
Filipino Music
English Art
Mathematics Physical Education
 Health
Edukasyon sa Pagpapakatao (EsP)
General Average
Eligible for Admission to Grade______________________________________________

Grade VI-School_______________________________________________________________
School Year__________________________________________________________________
Periodic Rating
LEARNING AREAS Remarks
1 2 3 4
Filipino
English
Mathematics
Science
Araling Panlipunan
EPP
MAPEH
Music
Art
Physical Education
Health
Edukasyon sa Pagpapakatao (EsP)
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

Gr. 4 S.Y. _______________ Gr. 5 S.Y. ________________ Gr. 6 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

AO – Always Observed SO – Sometimes Observed RO – Rarely Observed NO – Not Observed

IV. ATTENDANCE RECORD

Grade No. of No. of Cause No. of Cause No. of
School School Days Times School Days
Days Absent Tardy 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