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: III
(Region)
PALAGIANG TALAAN SA MABABANG PAARALAN
(Elementary School Permanent Record) LRN:_______________________

Zambales Little Baguio ES

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

Iba, Zambales
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)

Grade I-School _________________________________________________________________ EPP/TLE

School Year ____________________
Edukasyon sa Pagpapakatao (EsP)
Periodic Rating FINAL
MAPEH
LEARNING AREAS RATING
Remarks
1 2 3 4
Mother Tongue Music

Filipino Art

English Physical Education

Mathematics General Average

Science and Health Eligible for admission to Grade _________________________________

Araling Panlipunan
Grade II-School _________________________________________________________________
Edukasyon sa Pagpapakatao (EsP) School Year ____________________
MAPEH Periodic Rating FINAL
LEARNING AREAS RATING
Remarks
Music 1 2 3 4
Mother Tongue
Art
Filipino
Physical Education
English
General Average
Mathematics
Eligible for Admission to Grade______________________________________________
Science and Health
Grade III-School Araling Panlipunan
________________________________________________________________ Edukasyon sa Pagpapakatao (EsP)
School Year ____________________ SIX
Periodic Rating FINAL MAPEH
LEARNING AREAS Remarks
1 2 3 4 RATING Music
Mother Tongue Art
Filipino Physical Education
English General Average
Mathematics Eligible for Admission to Grade______________________________________________
Science and Health
Araling Panlipunan Grade IV-School
________________________________________________________________
Edukasyon sa Pagpapakatao (EsP)
School Year ____________________
MAPEH Periodic Rating FINAL
LEARNING AREAS Remarks
Music 1 2 3 4 RATING
Filipino
Art
English
Physical Education
Mathematics
General Average
Science and Health
Eligible for Admission to Grade______________________________________________
Araling Panlipunan
Grade V-School ________________________________________________________________ EPP/TLE
School Year ____________________ Edukasyon sa Pagpapakatao (EsP)
Periodic Rating FINAL
LEARNING AREAS Remarks MAPEH
1 2 3 4 RATING
Filipino Music
English Art
Mathematics Physical Education
Science and Health General Average
Araling Panlipunan Eligible for Admission to Grade______________________________________________
Grade VI-School _______________________________________________________________
School Year ____________________
Periodic Rating FINAL
LEARNING AREAS Remarks
1 2 3 4 RATING
Filipino
English
Mathematics
Science and Health
Araling Panlipunan
EPP/TLE
Edukasyon sa Pagpapakatao (EsP)
MAPEH
Music
Art
Physical Education
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