SF10-ES

Republic of the Philippines

Department of Education

Learner Permanent Record for Elementary School (SF10-ES)

(Formerly Form 137)

LEARNER'S PERSONAL INFORMATION

LAST NAME: FIRST NAME: NAME EXTN. (Jr,I,II) MIDDLE NAME:

Learner Reference Number (LRN): ______________ Birthdate (mm/dd/yyyy): Sex:

ELIGIBILITY FOR ELEMENTARY SCHOOL ENROLMENT

Credential Presented for Grade 1: Kinder Progress Report ECCD Checklist Kindergarten Certificate of Completion
Name of School: _____________________________________ School ID: __________ Address of School:

Other Credential Presented

PEPT Passer Rating: _________ Date of Examination/Assessment (mm/dd/yyyy): ____________ Others (Pls. Specify): _________________________
Name and Address of Testing Center:____________________________________________________ Remark:____________________________________

SCHOLASTIC RECORD

School: ______________________________________ School ID: School: __________________________________ School ID:

District: _____________ Division: _______________ Region: ____ District: _________________ Division: _____________________ Region:

Classified as Grade: ________ Section: _____________ School Year: ________ Classified as Grade: ____ Section: ___________________ School Year:
Name of Adviser/Teacher: ___________________ Signature: Name of Adviser/Teacher: ________________________ Signature:
Quarterly Rating Final Quarterly Rating Final
LEARNING AREAS Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating

Mother Tongue Mother Tongue

Filipino Filipino

English English

Mathematics Mathematics

Science Science

Araling Panlipunan Araling Panlipunan

EPP / TLE EPP / TLE

MAPEH MAPEH

Music Music

Arts Arts

Physical Education Physical Education

Health Health

Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao

*Arabic Language *Arabic Language

*Islamic Values Education *Islamic Values Education

General Average General Average

Remedial Classes Conducted from: to Remedial Classes Conducted from: to

Recomputed Final Recomputed Final
Learning Areas Final Rating Remedial Class Mark Remarks Learning Areas Final Rating Remedial Class Mark Remarks
Grade Grade

School: ______________________________________ School ID: School: ____________________________________ School ID:

District: ______________________ Division: ________________ Region: District: ______________________ Division: ________________ Region:

Classified as Grade: ______ Section: __________ School Year: Classified as Grade: ______ Section: __________ School Year:

Name of Adviser/Teacher: ______________________ Signature: Name of Adviser/Teacher: ______________________ Signature:

Quarterly Rating Final Quarterly Rating Final

Learning Areas Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating

Mother Tongue Mother Tongue

Filipino Filipino

English English

Mathematics Mathematics

Science Science

Araling Panlipunan Araling Panlipunan

EPP / TLE EPP / TLE

MAPEH MAPEH

Music Music

Arts Arts

Physical Education Physical Education

Health Health

Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao

*Arabic Language *Arabic Language

*Islamic Values Education *Islamic Values Education

General Average General Average

Remedial Classes Date Conducted: to Remedial Classes Date Conducted: to

Recomputed Final Recomputed Final
Learning Areas Final Rating Remedial Class Mark Remarks Learning Areas Final Rating Remedial Class Mark Remarks
Grade Grade

SFRT 2017
SF10-ES 9 Page 2 of ________
SCHOLASTIC RECORD
School: _____________________________________ School ID: School: _____________________________ School ID:
District: ______________________ Division: ________________ Region: District: ______________________ Division: _________ Region:
Classified as Grade: ______ Section: __________ School Year: Classified as Grade: ______ Section: _____ School Year:
Name of Adviser/Teacher: ______________________ Signature: Name of Adviser/Teacher: ______________ Signature:

Quarterly Rating Final Quarterly Rating Final

LEARNING AREAS Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating

Mother Tongue Mother Tongue

Filipino Filipino

English English
Mathematics Mathematics

Science Science

Araling Panlipunan Araling Panlipunan

EPP / TLE EPP / TLE

MAPEH MAPEH
Music Music
Arts Arts
Physical Education Physical Education
Health Health
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Education
General Average General Average
Remedial Classes Date Conducted: to Remedial Classes Date Conducted: to
Remedial Class Recomputed Remedial Recomputed
Learning Areas Final Rating Remarks Learning Areas Final Rating Remarks
Mark Final Grade Class Mark Final Grade

School: _____________________________________ School ID: School: _____________________________ School ID:

District: ______________________ Division: ________________ Region: District: ______________________ Division: _________ Region:
Classified as Grade: ______ Section: __________ School Year: Classified as Grade: ______ Section: _____ School Year:
Name of Adviser/Teacher: ______________________ Signature: Name of Adviser/Teacher: ______________ Signature:

Quarterly Rating Final Quarterly Rating Final

Learning Areas Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating

Mother Tongue Mother Tongue

Filipino Filipino
English English

Mathematics Mathematics

Science Science
Araling Panlipunan Araling Panlipunan

EPP / TLE EPP / TLE

MAPEH MAPEH
Music Music
Arts Arts
Physical Education Physical Education
Health Health
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Education
General Average General Average
Remedial Classes Date Conducted: to Remedial Classes Date Conducted: to
Remedial Class Recomputed Remedial Recomputed
Learning Areas Final Rating Remarks Learning Areas Final Rating Remarks
Mark Final Grade Class Mark Final Grade

For Transfer Out /Elementary School Completer Only

CERTIFICATION
I CERTIFY that this is a true record of ___________________________________ with LRN ___________________ and that he/she is eligible for admission to Grade ________.
School Name: __________________________________ School ID ________________ Division: ___________ Last School Year Attended: _________________________

___________________
Date Name of Principal/School Head over Printed Name (Affix School Seal here)

CERTIFICATION
I CERTIFY that this is a true record of ___________________________________ with LRN ___________________ and that he/she is eligible for admission to Grade ________.
School Name: __________________________________ School ID ________________ Division: ___________ Last School Year Attended: _________________________

____________________________________
Date Name of Principal/School Head over Printed Name (Affix School Seal here)

CERTIFICATION
I CERTIFY that this is a true record of ___________________________________ with LRN ___________________ and that he/she is eligible for admission to Grade ________.
School Name: __________________________________ School ID ________________ Division: ___________ Last School Year Attended: _________________________
 ____________________________________
Date Name of Principal/School Head over Printed Name (Affix School Seal here)
May add Certification Box if needed SFRT Revised 2017