SCHOOL

FORMS
SF1 SF2 SF3
SF4 SF5 SF6
SF7 SF8 SF9
SF10
DepEd Order 58 s. 2017
DepEd Order 3 s. 2018
DepEd Order 54 s. 2016
DepEd Order 58 s. 2017
Adoption of New Forms for Kindergarten,
SHS, ALS, health and Nutrition, and
Permanent Records

This policy institutes new forms to be used in

schools and other institutions delivering basic
education, particularly Kindergarten, SHS, and ALS,
and standardizes the forms for the learners’ Health
and Nutrition, and Permanent Records…which shall
be used starting SY 2017-2018
 SF 1- SCHOOL REGISTER

MASTER LIST OF CLASS ENROLLMENT WHO ARE

OFFICIALLY ENROLLED AND ATTENDING CLASSES
CLASS ADVISER
LIS
BEGINNING OF SCHOOL YEAR (BoSY) AND AS NEEDED
Should provide detailed information per learner of the
summary data being reported to EBEIS
 S c h o o l Fo rm 1 (S F 1 ) S c h o o l Re g is te r
(T h is re p la c e s Fo rm 1, M a s t e r Lis t & S T S Fo rm 2 -F a m ily B a c k g ro u n d a n d P ro f ile )

S c ho ol ID 301 293 Re gion IV-A Divis ion Que z o n

Gra d e Gra d e 7
S c hool Na me Bina g ba g NHS S c hool Ye a r 2018 - 2019 S e c tion J ADE
Le v e l (Ye a r
A GE M O T HE G U A R D IA N C o nt a c t
as A D D R ES S P A R EN TS R E M A R KS
R ( i f N o t P a r e nt ) N um b e r

S e x ( M /F )
NAME B IR T H D A T E o f TO N G U IP o f
R E LIG I M o t he r ' s
LR N ( La s t N a me , F i rs t N a m e , ( mm/ d d / y y y y 1s t E ( Et hnic Ho u s e # / F a t h e r' s N a me P a re nt
ON M a i d e n N a me ( P le a s e re f e r
M i d d l e N a me ) ) F ri d ( G ra d e G ro u p ) S t re e t /
B a ra ng a y
M unic ip a l it
P r o v i nc e
( La s t N a me ,
N a me
R e la t io ns o r
( La s t N a me , t o t he le g e nd
ay 1 to 3 S i t io / y/ Cit y F i rs t N a me , hip G ua r d i a
F i rs t N a me , o n la s t p a g e )
J une O nl y ) P u ro k M i d d l e N a me ) n
M i d d l e N a me )
AD R IA NO ,
AD R IA NO ,KUR T C YR IL, C h ris t ia A GD A NG A P ER NIA,ED N A T /I D A TE :2 0 18 -
10 8 9 4 512 0 0 0 1 M 10 -2 9 -2 0 0 5 12 Ta g a lo g B INA G B A G QUEZ O N B OB B Y
P E R N IA n it y N ,D EN A L, 0 6 -0 4
GO N ZA LES
ALA YAN ,
C h ris t ia A GD A NG A TUB A R ,LO R N T /I D A TE :2 0 18 -
10 8 9 5 7110 0 01 ALAYAN ,M AR K, T UB AR M 0 9 -2 4 -2 0 0 5 12 Ta g a lo g S ILDO R A QUEZ O N ED UA R D O
n it y N A ,, 0 6 -0 4
S ULIT
AS AÑEZ , C UET O ,AN A M
AS AÑEZ ,LO UR E NC E ALF R ED , C h ris t ia A GD A NG A T /I D A TE :2 0 18 -
10 8 9 4 5110 0 02 M 10 -2 0 -2 0 0 6 11 Ta g a lo g B INA G B A G QUEZ O N C R IS A NT O A R IE,M A N A L
C UET O n it y N 0 6 -0 4
ES P INO LA O,
B UEN DIA ,
B UEN D IA ,D HUN UEL M A C KY, C h ris t ia A GD A NG A DO N ALD B AY,LO LIT A ,P T /I D A TE :2 0 18 -
10 8 9 5 7110 0 05 M 12 -18 -2 0 0 5 12 Ta g a lo g S A LVA C IO N QUEZ O N
B AY n it y N M AN UEL EP IT O , 0 6 -0 4
ZA B A LLE R O

C ALLOS ,A N G
B UR C E ,J O H N LEO M A R , C h ris t ia A GD A NG A B UR C E, S ET H T /I D A TE :2 0 18 -
10 8 9 4 512 0 0 0 2 M 0 4 -16 -2 0 0 4 14 Ta g a lo g B INA G B A G QUEZ O N ELIN A,F ER N A
C A LLO S n it y N R E GA C HUELO 0 6 -0 4
N DE Z,

C A B AN A LAN ,
C A B AN A LA N,HA LIEN C h ris t ia A GD A NG A R IEG O ,A N ALIZ T /I D A TE :2 0 18 -
10 8 9 5 712 0 0 4 5 M 11-2 0 -2 0 0 5 12 Ta g a lo g S A LVA C IO N QUEZ O N HA IM AN
GO D WIN , R IEG O n it y N A ,M E R C A DO , 0 6 -0 4
M AR A Y

M EN D IO R O ,J OH N WA LTE R , C h ris t ia A GD A NG A M EN D IO R O , P ELING ON ,M Y T /I D A TE :2 0 18 -

10 8 9 5 712 0 0 5 3 M 0 8 -17 -2 0 0 6 11 Ta g a lo g S A LVA C IO N QUEZ O N
P E LIN G ON n it y N J OE L J OR VIN A R A,DO TA D O, 0 6 -0 4

A B S ALON ,G R
C h ris t ia A GD A NG A M EULLO , R O EL T /I D A TE :2 0 18 -
10 8 9 4 5110 0 12 M EULLO ,J E R O M E , AB S A LO N M 0 6 -15 -2 0 0 6 11 Ta g a lo g B INA G B A G QUEZ O N A C E ,G UA LB E
n it y N AG UILA R 0 6 -0 4
R TO ,

NO TR A , G ON ZA LE S ,M
NO TR A ,J O H N M A R VIN , C h ris t ia P O B LA C IO A GD A NG A T /I D A TE :2 0 18 -
10 8 9 4 412 0 0 4 2 M 0 9 -2 4 -2 0 0 5 12 Ta g a lo g QUEZ O N J AYS O N D ELA A R IVIC ,B A R R
GO N ZA LES n it y N I N 0 6 -0 4
TO R R E ED A ,
C h ris t ia A GD A NG A P E R E Z, M A LEO N,N EN I T /I D A TE :2 0 18 -
10 8 9 5 710 0 0 2 5 P E R E Z,R O N EL, M A LE ON M 0 4 -2 2 -2 0 0 1 17 Ta g a lo g S A LVA C IO N QUEZ O N
n it y N R OM EO M TA ,, 0 6 -0 4
VILLA G R A C IA,
P O ,J OH N B EN ED IC T , C h ris t ia A GD A NG A P O , D EXT ER T /I D A TE :2 0 18 -
10 8 9 4 5110 0 13 M 10 -2 0 -2 0 0 6 11 Ta g a lo g B INA G B A G QUEZ O N M A YLYN ,B AC
VILLA GR A C IA n it y N M AG S IN O 0 6 -0 4
LA OC OS ,
C h ris t ia A GD A NG A S ILVE R IO, A M OR IN,G E R T /I D A TE :2 0 18 -
10 8 9 5 7110 0 24 S ILVE R IO,J A Y-A R , A M O R IN M 10 -2 5 -2 0 0 5 12 Ta g a lo g S A LVA C IO N QUEZ O N
n it y N R A M IL P A LDIN E,, 0 6 -0 4

12 <=== TO TA L M A LE

B A UT IS TA ,
B A UT IS TA ,S TE P H A NIE, C h ris t ia P ES ID ER IO ,R T /I D A TE :2 0 18 -
10 8 9 4 5110 0 04 F 0 1-0 5 -2 0 0 6 12 Ta g a lo g ALAP A N I-B IM US C A VITE AR IE S
P E S IDE R IO n it y O NA ,D EN A L, 0 6 -0 4
EVA N GE LIS TA

C UET O,
C UET O,J A S M INE D IA N NE , C h ris t ia A GD A NG A R IC O,M AR Y T /I D A TE :2 0 18 -
10 8 9 4 512 0 0 0 6 F 12 -11-2 0 0 5 12 Ta g a lo g B INA G B A G QUEZ O N GO N ZA LO
R IC O n it y N G R A C E,-, 0 6 -0 4
C AS AO
EJ O R C A D AS ,
EJ O R C A D AS ,J E NE LYN, C h ris t ia IB AB A NG TO LE DO ,R O DI T /I D A TE :2 0 18 -
10 8 6 3 312 0 0 14 F 0 2 -0 6 -2 0 0 5 13 Ta g a lo g P AG B ILA O QUEZ O N AR TUR O
TO LED O n it y P O LO TA ,D ILAO , 0 6 -0 4
LOB IAN O
LOP E Z,
C h ris t ia A GD A NG A R EYE S ,J O LIE T T /I D A TE :2 0 18 -
10 8 9 4 510 0 0 17 LO P E Z,GR A C E J O Y, R EYES F 0 9 -2 1-2 0 0 5 12 Ta g a lo g B INA G B A G QUEZ O N GE R M AN
n it y N ,LEN EYAN , 0 6 -0 4
ES LAWA N
D OM IN GUEZ,
M AG C ULA N G,M ILKA J O E NE A, C h ris t ia A GD A NG A M AG C ULA N G, T /I D A TE :2 0 18 -
10 9 3 0 6110 0 37 F 0 6 -3 0 -2 0 0 6 11 Ta g a lo g B INA G B A G QUEZ O N A NA B ELLE ,UN
DO M ING UE Z n it y N J OE L AYAG 0 6 -0 4
LA YA O ,
M EN D OZ A, G ER VAC IO ,LE
M EN D OZ A,C H E R YL A S H LE Y, C h ris t ia NUEVA T /I D A TE :2 0 18 -
10 8 9 4 4110 0 53 F 0 3 -11-2 0 0 6 12 Ilo k o P A N IKI B AG B AG C H R IS TO P H E R M A,S A R DA
GE R VA C IO n it y VIZC AYA 0 6 -0 4
R N,

P A S T OR ITE, D ILA O ,S H E R L
P A S T O R ITE ,D IA NA J HA N , C h ris t ia A GD A NG A T /I D A TE :2 0 18 -
10 8 9 4 512 0 0 11 F 12 -12 -2 0 0 4 13 Ta g a lo g B INA G B A G QUEZ O N DA N ILO Y,C A M P A M P
DILA O n it y N 0 6 -0 4
DE S T OR A A NG A N,

C h ris t ia A GD A NG A P IGO N , J E AN EF ER ,A T /I D A TE :2 0 18 -
10 8 9 4 510 0 0 2 0 P IGO N ,KIA N A J A NE , AR P IA F 11-10 -2 0 0 5 12 Ta g a lo g B INA G B A G QUEZ O N
n it y N C R IS O LOG O R P IA,B EULA, 0 6 -0 4

QUIM O R A,
D OT AD O,C HE
QUIM O R A,A NG EL G R A C E C h ris t ia A GD A NG A DA N ILO T /I D A TE :2 0 18 -
10 8 9 4 4110 0 76 F 0 9 -0 2 -2 0 0 6 11 Ta g a lo g S ILDO R A QUEZ O N R R ILIN ,M A S A
DE NIEL, D O TA D O n it y N M EN D OZ A 0 6 -0 4
YA ,
QUIM O R A
R E GE NC IA, C AP IN IG,M A
C h ris t ia A GD A NG A T /I D A TE :2 0 18 -
10 8 9 5 7110 0 18 R E GE N C IA,R E ZZ IE , C A P IN IG F 0 1-0 3 -2 0 0 6 12 Ta g a lo g S A LVA C IO N QUEZ O N EF R E N R OS ALIA,LA N
n it y N 0 6 -0 4
R E YM UND O D EZ,
R E GIO , B AYUNO N ,C R I
C h ris t ia A GD A NG A T /I D A TE :2 0 18 -
10 8 9 4 5110 0 14 R E GIO ,C AM ILLE , B A YUN ON F 10 -18 -2 0 0 6 11 Ta g a lo g B INA G B A G QUEZ O N LEO N ID EZ S T IN A ,P R E VA
n it y N 0 6 -0 4
AYAG LD E,
S A B ID UR IA ,
S A B ID UR IA ,LO UR D ELYN , C h ris t ia A GD A NG A VILLE NA ,LOUR T /I D A TE :2 0 18 -
10 8 9 5 7110 0 21 F 0 4 -17 -2 0 0 4 14 Ta g a lo g S A LVA C IO N QUEZ O N R UF O
VILLEN A n it y N D ES ,R ED, 0 6 -0 4
AN D R A D E
VILLA NUEVA, S A VID OR IA ,J O
VILLA NUEVA,J A NE LLE, C h ris t ia A GD A NG A T /I D A TE :2 0 18 -
10 8 9 5 712 0 0 6 4 F 0 3 -0 4 -2 0 0 6 12 Ta g a lo g S A LVA C IO N QUEZ O N C ES AR S E P H INE,A ND
S A VIDO R IA n it y N 0 6 -11
ELE R IO R AD E,

13 <=== TO TA L F E M ALE
 SF2- LEARNER’S DAILY ATTENDANCE

RECORDING OF ATTENDANCE, ABSENCE, OR TARDINESS

CLASS ADVISER
PARTIALLY THROUGH LIS AND MANUAL
DAILY UPDATING AND FOR SUBMISSION TO THE
OFFICE OF THE SCHOOL HEAD/REGISTRAR ON OR
BEFORE 5TH DAY OF THE SUCCEEDING MONTH
SHOULD BE RETURNED TO THE TEACHER/ADVISER
AFTER POSTING IN SF4
 S c ho o l Fo rm 2 (S F2) Daily Atte ndanc e Re po rt o f Le arne rs
( Th is re p la c e s Fo rm 1, For m 2 & S TS Fo rm 4 - A bse n t e e is m a n d Dro p o u t P ro f ile )

S c ho o l ID 301293 S c ho o l Ye a r 2 0 18 - 2 0 1 9 R e p o r t f o r t he M o nt h o f

Na me o f S c ho o l Bina g b a g NHS Gr a d e Le ve l Gra d e 7 (Ye a r I) S e c t io n J ADE

( 1s t r o w f o r d a t e ) To ta l fo r th e R E MA R K S ( If D R O P P ED O U T, s t a t e
N AM E
No Mo n th re a s o n, ple a s e re f e r t o le g e nd nu mb e r
( La s t N a me , F i r s t N a me , M id d le
. 2 . If T R A N S F E R R E D IN / O U T , writ e t he
N a me )
M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F A B S EN T TA R D Y na m e o f S c ho o l. )

1. A D R IA N O ,KUR T C YR IL, P E R N IA

2. A LA YA N ,M A R K, TUB A R

A S A ÑE Z ,LO UR E N C E A LF R E D ,
3.
C UE T O

4. B UE N D IA ,D H UN UEL M A C KY, B A Y

5. B UR C E ,J O H N LE OM A R , C A LLO S

C A B A N A LA N ,H A LIE N G O D WIN,
6.
R IE G O
M E N D IO R O ,J O H N WA LT E R ,
7.
P E LIN G O N

8. M E ULLO ,J E R O M E, A B S A LO N

N O T R A ,J O H N M AR VIN ,
9.
G O N Z A LE S

10. P E R E Z ,R O N E L, M A LE O N

P O ,J O H N B E N E D IC T ,
11.
VILLA G R A C IA

12. S ILVE R IO ,J A Y-A R , A M O R IN

12. <=== M A LE | T O T A L P e r D a y ===>

B A UT IS T A ,S T E P HA N IE ,
1.
P E S ID E R IO

2. C UE T O ,J A S M IN E DIA N N E , R IC O

3. E J O R C A D A S ,J E NE LYN , T O LE D O

4. LO P E Z ,G R A C E J OY, R E YE S

M A G C ULA N G ,M ILKA J O E N E A ,
5.
D O M IN G UE Z
M E N D O Z A ,C H E R YL A S H LE Y,
6.
G E R VA C IO

7. P A S T O R IT E ,D IA NA J H A N , D ILA O

8. P IG O N ,KIA N A J A NE , A R P IA

Q UIM O R A ,A N GE L G R A C E D E NIE L,
9.
D OTADO

10. R E G E N C IA ,R E Z Z IE, C A P IN IG

11. R E G IO ,C A M ILLE , B A YUN O N

12. S A B ID UR IA ,LO UR DE LYN , VILLEN A

13. VILLA N UE VA ,J A N ELLE , S A VID O R IA

13. <=== F E M A LE | T OT A L P e r D a y ===>

25. C o m b in e d T O T A L P e r D a y

G U ID E LIN E S : 1. C O D ES F OR C H EC K IN G A T T E N D A N C E M o nt h : N o . o f D a ys o f S um m a ry
1. The a t t e nd a nc e s ha ll b e a c c o mp lis he d d a ily. R ef er t o t he c o d e s f o r c he c king le a r ne r s ' a t t e nd a nc e . ( b la n k ) - P r e se n t ; ( x) - Ab se n t ; Ta r d y ( h a lf sh a d e d=Upp e r C las s e s : M F TO TA L
2 . Da t e s s ha ll b e wr it t e n in t he c o lumns a f t e r Le a r ner ' s Na me . f o r La t e C o m m e r , Lo we r f o r C u t t in g C la sse s)
* Enr o lme nt as o f ( 1s t F r id a y o f J une ) 12 12 24
3 . To c o mp ut e t he f o llo w ing : 2 . R EA S O N S / C A U S ES F OR D R O P P IN G O U T
La t e e n ro lm e n t d ur ing t he m o nt h
R eg is t e r e d Le a r ne r s a s o f e nd o f t he mo nt h a . Do m e s t ic - R e la t e d Fa c t o rs
0 1 1
a . P e rc e nt a g e o f Enr o lme nt = x 10 0
Enr o lme nt a s o f 1s t F r id a y o f t he s c ho o l yea r a .1. Ha d t o t a k e c a r e o f sib lin g s ( be y ond c ut - of f )
To t a l Da ily At t e nd a nc e a .2 . Ea r ly m a r r ia g e / p r e g n a n c y R e g ist e re d Le a rn e rs as o f
b . Aver a g e Da ily At t e nd a nc e = a .3 . P a r e nt s ' a t t it u d e t o wa r d sc ho o lin g
N umb e r o f S c ho o l Da ys in r e p o rt ing mo nt h e nd o f m o nt h
a .4 . F a m ily p r o b le m s
Ave ra g e d a ily a t t e nd a nc e P e rc e n t ag e of En ro lm e n t a s o f
c . P e rc e nt a g e o f At t e nd a nc e f o r t he mo nt h = x 10 0
R eg is t e r e d Le a r ne r s a s o f e nd o f t he mo nt h b. In d i v i d u a l - R e l a t e d Fa c t o rs e nd o f m o nt h
b .1. Illn e s s A v e ra g e Da ily A t t e n da n c e
4 . Eve r y e nd o f t he mo nt h, t he c la s s a d vis e r will s ub mit t his f o rm t o t he o f f ic e o f t he p r inc ip a l f o r r e c o r d ing o f s umma r y t a b le int o b .2 . Ov e r a g e
S c ho o l F o r m 4 . Onc e s ig ne d b y t he p r inc ip a l, t his fo r m s ho uld b e r e t ur ne d t o t he a d vis e r . b .3 . De a t h P e rc e n t a g e o f A t t e n d a n c e f o r t h e m o n t h
5. T he a d vis e r will p r o vid e ne c c e s s a ry int e r ve nt io ns inc lud ing b ut no t limit e d t o ho me vis it a t io n t o le a r ne r / s w ho we r e a b s e nt f o r 5 b .4 . Dr u g Ab u se
c o ns e c ut ive d a ys a nd / o r t ho s e a t r is k o f d r o p p ing o ut . b .5 . P o o r a c a d e m ic p e r f o r m a n c e N u m b e r of st u d e n t s a b se n t f o r 5 c o n s e c u t iv e d a y s
6 . At t e nd a nc e p e r f o r ma nc e o f le a r ne r s will b e re f lec t e d in F o r m 13 7 a nd F o r m 13 8 e ve r y g r ad ing p e r io d . b .6 . La c k of int e r e st / Dist r a c t io n s
b .7 . Hu n g e r / Ma ln u t r it io n Dro pp e d o u t
c . S c ho o l- Re la t e d Fa c t o rs
*B e g inning o f Sc ho o l Ye a r c ut - o f f re p o r t is e ve r y 1s t F r id a y o f t he S c ho o l Y e a r Tr a n s f e r r e d o ut
c .1. Te a c h e r Fa c t o r
c .2 . P h y s ic a l c o n d it io n o f c la ssr oo m Tr a n s f e r r e d in
c .3 . P e e r inf lu e n c e

d. G e o g r a p h i c / En v i r o n m e n t a l
I c e rtify th a t this is a tru e a n d c o rre c t re p ort.
d .1. Dist a nc e b e t we e n h o m e a n d sc h o o l
d .2 . Ar m e d c on f lic t ( in c l. Tr ib a l wa r s & c la n f e u d s)
d .3 . C a la m it ie s/ Disa st e r s

e . Fi n a n c i a l - R e l a t e d MYLE NE MAR TINE Z BAR TO LOME

e .1. C hild la b or , wo r k ( S ig na t ur e o f Ad vis e r o ve r P r int e d Na me )
f . Ot h e r s ( S pe c if y )

Atte s te d b y:

C A T A LIN A P A S T O R E S D E T O B IO
G e n e ra t e d t h ru LIS ( S ig na t ure o f S c ho o l He ad o ve r P r int e d N a me )
 SF3- BOOKS ISSUED AND RETURNED

LIST OF BOOKS (BY TITLE) ISSUE TO/RETURNED BY

LEARNERS
CLASS ADVISER
MANUALLY
BoSY AND EoSY
all textbooks being used should be reported regardless
of number of books per subject area
 S c ho o l Fo rm 3 (S F3) Bo o ks Is s ue d and Re turne d
( Th is r e p la c e s Fo rm 1 & In v e n t o ry o f Te x t b o o k s )

S c ho o l ID 3 0 12 9 3 S c ho o l Ye ar 2 01 8 - 20 1 9

S c ho o l Na me Bina g ba g NHS Gra d e Le ve l Gra d e 8 (Ye a r II) S e ct io n TOPAZ

S u b je c t A re a & S u b je c t A r e a & Tit le S u b je c t A r e a & S u b je c t A re a & Tit le S u b je c t A re a & S u b je c t A r e a & S u b je c t A r e a & S u b je c t A re a & Tit le S u b je c t A re a & Tit le S u b je c t A r e a &
Tit le Tit le Tit le Tit le Tit le Tit le
NAME R E M A R K S / A C T IO N
N T A KE N ( P l e a s e r e f e r
( La s t N a m e , F i rs t N a m e ,
o . t o t h e l e g e n d o n l a s t
M id d le N a m e ) Da t e Da t e Dat e Dat e Dat e Da t e Da t e Da t e Dat e Dat e p a g e )

Issu e d Re t u r ne d Is su e d Re t u r n e d Iss u e d Re t ur ne d Iss u e d Re t ur ne d Is s u e d Re t u r n e d Iss u e d Re t u r n e d Iss u e d Re t u r n e d Iss u e d Re t u r n e d Is s u e d Re t u r n e d Is su e d Re t u r n e d

C A Y,J A N G A B R IEL,
1.
C A P ONP O N
C LA VE R IA ,J O H N H UR R Y,
2.
VILLA N UEVA
D ELF IN ,M IG UEL E M M A N UEL,
3.
E S C OB AR
E S P A ÑO L,R E N AN TE, T A B O -
4.
T AB O

5. J US I,P A O LO , G UA N ZO N

LEG A S P I,A R N O LD ,
6.
P ELIN G O N
M A R TIN EZ ,J ER R Y J R ,
7.
D ES IP ULO
M EN D IO LA ,J ER OM E,
8.
G O N ZA LES
O R ILLO S A ,R A INIER ,
9.
S A M O N TE
O R ILLO S A ,R A M IL,
10 .
R O M A S A N TA
O R O N G A N ,KYLE
11.
N A TH A N IE L, J UAC A LLA
P ES C A D E R O ,J OH N A N G E LO ,
12 .
C A S A R IA

13 . R IEG O ,J ER IC H O, A B ELLA

14 . S A LVA D O R ,A R C H E L, -

15 . Z A B A LLER O ,J E Y-J E Y, LUN A

<=== TO TA L F O R M A LE |
15 .
T O TA L C O P IES ===>
A LC A N T A R A ,R ON A LYN ,
1.
A LVA R E Z

2. A N IE L,C LA R IS S A, LA D IA

3. B IÑA S ,ELLA M AE , -

4. C A IG ,D A N IC A , P R IA G O LA

5. C UE TO ,J EN N ILYN , M US A

6. D E T O R R E S ,S H IE LA , P IG O N

7. LA Q UIO ,A ILIE N , R A M O S

8. N EB R ID A ,J EN N IF ER , -

R EG EN C IA ,R O S A LY,
9.
C A P IN IG

10 . T A B U-TA B O ,LIZA , LLA N ITA

11. T UD IO ,ER M A LYN, H A LUB E R

<=== T O TA L F O R F EM A LE |
11.
T O TA L C O P IES ===>
<=== TO TA L LE A R N ER S |
26.
T O TA L C O P IES ===>
In c a s e o f l o s t / u n re t u rn e d b o o k s , p l e a s e p ro v id e in f o rm a t i o n w i t h P re p a re d B y:
G U ID E LIN E S :
t h e f o l lo w i n g c o d e :
1. Tit le o f B o o ks Is s ue d t o ea c h lea r ne r mus t b e r ec o r d ed b y t he c la s s a d vis er . A. In C o lumn Dat e R e t ur ned , co d e s a r e: F M =F o r ce M a jeur e, TDO: Tra ns f er r ed / Dr o p o ut ,
2 . The Dat e o f Is s ua nc e and t he Dat e o f R et ur n s ha ll b e r e f le c t ed in t he f o r m. NEG=Ne g lig ence IME LDA C ANOY ALTOVAR
3 . The To t a l Numb e r o f C o p ie s is s ued at B o S Y s ha ll b e r e fle c t e d in t he f o r m. B . In C o lumn R emar k/ Act io n Ta ke n, c o d es ar e : LLTR =S ec ur ed Le t t er f ro m Le a rne r d uly s ig ne d b y ( S ig na t ur e o f Ad vis e r o ve r P r int e d Na me )
4 . The To t a l Numb e r o f C o p ie s o f B o o ks R et urned a t t he Eo S Ys ha ll b e re f lec t e d p a r ent / g ua r d ia n ( f o r c o d e F M ), TLTR =Tea c he r p r e p a r ed let t er / re p o r t d uly no t ed b y S cho o l
in t he f o r m. He ad f o r s ub mis s io n t o S c ho o l P ro p e r t y C us t o d ian (f o r c o d e TDO), P TL=P a id b y t he Lea r ne r
5. All t e xt b o o ks b eing us e d mus t b e inc lud e d . Ad d it io na l c o p ies o f t his fo r m may (f o r c o d e NEG) . R e f er e nc e s : DO# 2 3 , s .2 0 0 1, DO# 2 5, s .2 0 0 3 , DO# 14 , 2 .2 0 12 .
b e us ed if nee d e d . G e ne ra t e d t h r u LIS

D a t e o f B o S Y:_ __ /_ _ _/ ___ __ D a t e o f E o S Y: _ __ / __ _/ ___ _ _

 SF4- SUMMARY ENROLLMENT AND
MOVEMENT OF LEARNERS
ENROLLMENT COUNT, TRANSFERRED IN/OUT AND DROPOUT BY
GRADE LEVEL
SUMMARY OF SF2
SCHOOL HEAD
LIS
MONTHLY
This is the summary of enrolment and movement by section and grade level
based from SF2/SF2-SHS prepared and submitted by the Class Adviser. The
schools Division Office, the SGOD in particular, must be furnished a copy of
this report for the months of June, October, November (SHS only) & March
 School Form 4 (SF4) Monthly L earner's Movement and Attendan ce
(This replaced Form 3 & STS Form 4-Absenteeism and Dropout Profile)

Region IV - A Division QUEZON District AGDANGAN

School ID 301293

School Name BINAGBAG NATIONAL HIGH SCHOOL School Year 2018-2019

REGIST ERED ATTENDANCE DROPPED OUT TRANSFERRED OUT

GRADE/ LEARNER
(A) Cumulative (A+B) (A) Cumulative (A+B)
NAME OF ADVISER YEAR SECT ION (As of End of the Percentage for the (B) For the (B) For the
Daily Average as of Previous Cumulative as of as of Previous Cumulative as of
LEVEL Month) Month Month Month
Month End of the Month Month End of the Month
M F T M F T M F T M F T M F T M F T M F T M F T M F
LOIDA M. VILLANUEVA G-7 JADE 12 13 25 12.00 13.00 25.00 100.00 100.00 100.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
AILEEN B. QUIMORA G-7 PEARL 12 12 24 12.00 12.00 24.00 100.00 100.00 100.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
KEVIN MATTHEW S. DE CHAVEZ G-8 DIAMOND 16 15 31 16.00 15.00 31.00 100.00 100.00 100.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
MARCELA C. GARCIA G-8 T OPAZ 15 11 26 15.00 11.00 26.00 100.00 100.00 100.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
GLORIE ANN E. EST RADA G-9 SAPPHIRE 30 18 48 26.00 17.00 43.00 100.00 94.00 97.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
LYN ANT ONET T E S. VISEY G-10 RUBY 27 21 48 27.00 21.00 48.00 100.00 100.00 100.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

ELEMENTARY/SECONDARY:
KINDER
GRADE 1/GRADE 7 24 25 49 12.00 12.50 24.50 100.00 100.00 100.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

GRADE 2/GRADE 8 31 26 57 15.50 13.00 28.50 100.00 100.00 100.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

GRADE 3/GRADE 9 30 18 48 26.00 17.00 43.00 100.00 94.00 97.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

GRADE 4/GRADE 10 27 21 48 27.00 21.00 48.00 100.00 100.00 100.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

GRADE 5/GRADE 11
GRADE 6/GRADE 12
T OT AL FOR NON-GRADED
T OT AL 112 90 202 20.13 15.88 36.00 100.00 98.50 99.25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
GUIDELINES: Prepared an d Sub mi tted by:
1. T his forms shall be accomplished every end of the month using the sum mary box of SF2 submitted by the teachers/advisers to update figures for the month.
2. Furnish copy to Division Office: a week after June 30, October 30 & March 31 IM
3. Only teachers who are handling advisory class shall be reported. May use additional copy/ies of this form if needed. (Signature
4. Small school that has one section per grade/year level is not required to fill the columns "Name of Adviser, Grade/Year Level & Section". Instead, they will only accomplish the
summary column per grade/year level.
 SF5- REPORT ON PROMOTION

LIST OF PROMOTED/RETAINED BY CLASS

CLASS ADVISER
LIS
EoSY
Do not include dropped out/ transferred out. Follow other
relevant instructions stipulated in DepEd Order 4 s. 2014 for SF5
and DepEd Order 47 s. 2016
 S c h o o l Fo rm 5 (S F 5 ) Re p o rt o n Pro mo tio n a n d Le v e l o f P ro fic ie n c y & Ac h ie v e me n t
(T h is re p la c e s F o rm s 18-E 1, 18 -E 2, 18 A an d Lis t o f G ra du a t e s )

R e g io n R e g io n IV- Divis io n Qu e zo n

S c h o o l ID 30 1 2 93 S c h o o l Ye a r 2 0 1 8 - 20 19 C u rric u lu m

S c h o o l Na m e Bin a g b a g NHS Gra d e Le ve l Gra d e 9 (Ye a r S e c tio n S AP P HIR E

S UMMARY TABLE
Did Not Me e t
ACTION TAKEN:
Ex p e c ta tio n s o f the ff.
LEARNER'S NAME GENERAL PROMOTED,
LRN Le a r nin g Are a /s a s o f S TATUS MALE FEMALE TOTAL
(La s t Na m e , Firs t Na m e , Middle Na m e ) AVERAGE CONDITIONAL o r
e n d o f c u rr e nt
RETAINED
S c h o ol Ye a r
PROMOTED 29 17 46

MALE
C O N D IT IO N A LL
Y P R O M O TED
0 0 0
10 8 95 70 9 00 0 2 ABADILLA,DE NNIS R ABI 84 P R OMOTE D

10 8 95 70 9 00 0 3 ALAYAN,J HON E R IC TUBAR 84 P R OMOTE D RETAINED 1 1 2

10 8 94 50 8 00 0 1 ALC ANTAR A,ANTHONY H E R NANDO 77 P R OMOTE D

10 8 94 50 8 00 0 2 ALC ANTAR A,J OMME L ANIE L 79 P R OMOTE D LEVEL OF PROGRES S AND ACHIEVEMENT

10 9 16 10 9 00 1 0 ALVAR E Z,ALJ OHN AR S UA 80 P R OMOTE D De s c rip to r &

Gra d in g MALE FEMALE TOTAL
10 8 95 70 9 00 0 5 C AS TILLO,P ATR IC K P AMAR ANC O 84 P R OMOTE D
Did N o t M e e t
10 8 94 50 9 00 0 5 C OMIA,J OS E MIGUE L NATALIO 85 P R OMOTE D
E xp e c t a t io n s (7 4 1 1 2
a nd b e lo w)
10 8 94 50 9 00 0 6 C UE TO,J ANH J ANH MUS A 80 P R OMOTE D
Fairly
10 8 95 70 9 00 0 6 DE J AP A,J O HN LLOYD R E YMUNDODIA 79 P R OMOTE D
S at is fa c to ry 10 1 11
11 3 62 80 9 00 2 8 DE LABAJ AN,KE NNE TH BR UZA 89 P R OMOTE D (7 5- 79 )

10 8 95 70 9 00 0 7 DIC HOS O,J O HN R ON DE GALIC IA 86 P R OMOTE D

S at is fa c to ry
10 1 11
10 8 94 40 8 00 6 3 GAR C IA,J OHN C AR LOS BOTIAL 76 P R OMOTE D (8 0- 84 )

10 8 94 50 9 00 0 8 ILAGAN,J OHN MAR K C US TO DIO 87 P R OMOTE D

Ve ry
10 8 95 71 2 00 5 7 J UANIC O,ADR IAN E NE R O 77 P R OMOTE D S at is fa c to ry 7 11 18
(8 5- 89 )
10 9 30 50 9 00 2 9 J UMAO-AS ,J HIMM BOY GULIFAR D O 87 P R OMOTE D

17 3 01 20 9 00 4 1 J US I,J OHN KE NNE TH E S P INOS A P R OMOTE D Ou ts ta n d in g

86 2 4 6
( 90 -1 0 0 )
10 8 69 10 9 00 0 8 LAC HIC A,KE NNYDIC K R OC E R O 94 P R OMOTE D

10 8 94 50 9 00 1 2 P AS TOR ITE ,DE LMAR K DILAO 82 P R OMOTE D

PREPARED BY:
10 9 29 70 9 00 1 1 P AULY,J OHN P AUL VILLALOBOS 82 P R OMOTE D
P E N AR E DONDA,E AR L MANUE L GLORIE ANN EROLES ES TRADA
10 8 94 40 8 01 1 2 75 P R OMOTE D
OR ILLOS A C las s Ad vis e r
10 9 30 60 9 01 3 2 R AVALO,J OHN IVAN E NGC O 82 P R OMOTE D (N a m e a n d S ig na ture )
CERTIFIED CORRECT & S UBMITTED BY:
10 8 94 50 9 00 1 4 R E AÑO,J E R IC O S ALVADOR 82 P R OMOTE D

10 8 95 70 9 00 2 4 R E LANE S ,J AC OB FE DE LINO 89 P R OMOTE D CATALINA PAS TORES DE TOBIO

S c h o ol He a d
10 8 94 40 8 01 3 2 R IE GO,ALDR IN ABE LLA 73 R E TAINE D (N a m e a n d S ig na ture )
REVIEWED BY:
10 8 95 70 9 00 2 6 R IE GO,MJ C AÑOAN 79 P R OMOTE D

10 8 98 10 9 00 3 4 R UE LO,ANGE LO BALMAC E D A 91 P R OMOTE D

(N am e a n d S ig na t u re )
10 8 94 50 8 00 2 4 S ANTOC IDAD,R ONE LO ME NC HU R ADO 76 P R OMOTE D

10 8 95 70 9 00 3 1 S ILVE R IO,GE R ALD AMOR IN 84 P R OMOTE D

G e n e ra t e d t h ru LIS
10 9 29 70 9 00 1 8 ZABALLE R O,ZALD Y S ANONE 76 P R OMOTE D GUIDELINES :
10 8 94 50 9 00 2 2 ZAMOR A,R YINMHE L - 75 P R OMOTE D
1. D o no t in c lu de D ro po u t s a nd T ra n s f e rre d O u t (D .O .4 , 20 14)
2 . T o be p re p are d b y t he A d v is e r. F in a l ra t in g pe r le arn in g a re a
30 <= == TOTAL MALE s h o u ld be t ak e n f ro m t h e re c o rd o f s u b je c t t e ac h e rs . T h e c las s
a d v is e r s h o uld c o m p ut e f o r t he G e n e ral A v e ra g e . (le av e it b la n k f o r
FEMALE *c o n dit io n a lly pro m o t e d ).
3. O n th e s u m m a ry t ab le , re f le c t t h e t o t a l n u m b e r o f le arne rs
10 8 95 70 9 00 0 4 BR UZA,C HR IS TINE MAE C ONE L 88 P R OMOTE D P R O M O T E D (F in al G rad e o f a t le as t 75 % in A LL le arn in g a re as ),
R E T A IN E D (D id n o t m e e t e xp e c t a t io n s in t h re e (3 ) o r m o re le arn ing
10 8 94 50 9 00 0 3 BU R C E ,ADE LE NE C ALLOS 91 P R OMOTE D a re as ) and *C O N D IT IO N A LLY P R OM OT ED (*d id no t m eet
e xp e c t a t io n s in n o t m o re t h an t wo (2 ) le arnin g a re a s ) a n d t h e Le v e l o f
10 8 95 71 3 00 1 3 C ABAÑA,DHE NNIE S ME R C ADO P R OMOTE D P ro g re s s a nd A c h ie v e m e n t a c c o rd in g to the in d iv idu a l G e n e ra l
87
A v e ra ge . A ll p ro v is io n s o n c la s s ro o m a s s e s s m e n t an d t h e gra d in g
s ys t e m in t he s a id O rde r s ha ll b e in e f f e c t f o r a ll gra de le v e ls - D e p e d
10 8 94 40 9 00 3 4 C AS TILLO,ANGE L TIR AMBULO 87 P R OMOTE D
O rde r 29 , s . 20 15.
4. In c o m ple t e Le a rning A re as . T h e 1s t s u b-c o lu m n re f e rs to
10 9 29 70 9 00 0 5 C UE TO,J E R IC A ZABALLE R O 91 P R OMOTE D le a rn in g a re a / s t ha t f a ile d f ro m p re v io u s S Y b u t ha d b e e n c o m p le t e d
in t h e c urre nt S Y . T h e 2 nd s u b-c o lu m n p re s e n t e d t h e lis t o f le arn ing
a re a/ s t h a t did n o t m e e t e xpe c t a t io n du ring t h e c u rre n t S Y .
5 . P ro t o c o ls o f v alid at io n & s u bm is s io n is u n de r t h e d is c re t io n o f
 SF6- SUMMARY REPORT ON
PROMOTION
NUMBER OF PROMOTED/RETAINED BY
GRADE LEVEL
SUMMARY OF SF5
SCHOOL HEAD
LIS
EoSY
 S c ho o l Fo rm 6 (S F6)
S ummarize d Re po rt o n Pro mo tio n and Le arning Pro g re s s & Ac hie ve me nt
S ch oo l ID 30 1 29 3 R e gio n IV-A Divis ion Qu e zo n

S cho o l Na m e Bin a gba g NHS Dis trict P a d re Bu rg o s - S ch oo l Ye a r 2018

GRADE 7 GR ADE 8 GR ADE 9 GR ADE 1 0 Gra d e 11 GR ADE 12 TOTAL

S UMMAR Y TABLE
Femal
M a le F e m a le To ta l M a le F e m a le To ta l M a le F e m a le To ta l M a le F e m a le To ta l M a le F e m a le To ta l M a le F e m a le To ta l M a le To ta l
e

P R OMOTED 23 25 48 30 26 56 29 17 46 25 20 45 0 0 0 0 0 0 107 88 195

CONDITIONAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

RETAINED 1 0 1 1 0 1 1 1 2 2 1 3 0 0 0 0 0 0 5 2 7

LEARNING P ROGRES S AND Femal

M a le F e m a le To ta l M a le F e m a le To ta l M a le F e m a le To ta l M a le F e m a le To ta l M a le F e m a le To ta l M a le F e m a le To ta l M a le To ta l
ACHIEVEMENT e

Did Not Me e t Expe c t a t ions ( 74%

1 0 1 1 0 1 1 1 2 2 1 3 0 0 0 0 0 0 5 2 7
a nd be low)

Fa ir ly S a t isf a c t or y ( 75%- 79%) 8 3 11 14 2 16 10 1 11 11 1 12 0 0 0 0 0 0 43 7 50

S a t isf a c t or y
10 8 18 9 9 18 10 1 11 11 0 11 0 0 0 0 0 0 40 18 58
( 80%- 84%)

Ve r y S a t isf a c t or y (85%-89%) 3 11 14 7 8 15 7 11 18 1 10 11 0 0 0 0 0 0 18 40 58

Out st a nding
2 3 5 0 7 7 2 4 6 2 9 11 0 0 0 0 0 0 6 23 29
( 90%- 100%)

TOTAL 24 25 49 31 26 57 30 18 48 27 21 48 0 0 0 0 0 0 112 90 202

P re pa re d a nd S ubm itte d by: R e vie we d a nd Va lida te d by: No te d by:

IMELDA C . ALTOVAR , Ed D
(S igna ture o f S c ho o l He a d o ve r P rinte d Na m e ) DIVIS ION R EP R ES ENTATIVE S C HOOL DIVIS ION S UP ER INTENDENT Ge ne ra te d thru LIS
 SF7- INVENTORY OF SCHOOL
PERSONNEL
LIST OF SCHOOL PERSONNEL WITH BASIC PROFILE AND
TEACHING LOAD/ASSIGNMENT
SCHOOL HEAD
MANUALLY (ORIGINALLY DESIGNED IN HUMAN RESOURCE
INFORMATION SYSTEM
BoSY AND AS NEEDED
All school personnel regardless of nature of appointment shall be
included in this form. Any movement or reassignment of
personnel should be reported using SF7-SHS and submit to the
 School For m 7 (SF7) School Per sonnel Assignm ent List and Basic Pr of ile
(This replaced Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)

School ID 301293 Region IV - A Division Qu ezo n

School Name Bin ag b ag Natio n al Hig h Sc h o o l District Ag d an g an School Year 2018-2019
(A) Nati o n al l y -Fu n d ed Teach i n g & Teac h i n g Rel ated Item s (B) Nat i o n al l y-Fu n d ed No n Teach i n g Items (C ) Oth er Ap p o i n tmen ts an d Fu n d i n g So u r ces
Title of Designation Appointment:
N umber of Incumbent
Title of Plantilla Position (as Title of Plantilla Position N umber of (Designation as appeared in the (C ontractual, Fund Source
N umber of Incumbent
appeared in the appointment document/PSIPOP) (as appeared in the appointment document/PSIPOP) Incumbent contract/document: Teacher, C lerk, Security Substitute, Volunteer, (SEF, PTA, N GO's etc.) Non-
Teaching
Guard, Driv er etc.) others specify ) Teaching
Principal I - 19 1 C omputer Instreuctor C asual N GO 1
Teacher III - 13 5 Security Guard Contract of Serv ice M OOE 1
Teacher II - 12 1 Janitorial Serv ices Job Order M OOE 1
Teacher I - 11 5

EDUCATIONAL QUAL IFICATION Subject Taught * Daily Program (time duration)

Remark/s (For
Em ployee No. Nature of (include Grade &
Name of Sc hool Personnel Total Actual Detailed Items,
(o r Ta x Fund Position/ Appointment/ Section), Advisory
(Arrange by Position, Sex DAY Teaching Indicate nam e of
I de nti fi ca ti on
Sourc e Designation Employ ment Degree / Post M ajor/ Class & Other From To
Nu mbe r - Descending) Minor (M /T /W/ M inutes school/offic e, For
Status Graduate Specialization Ancillary (00:00) (00:00)
T.I .N.) Assignment per
T H/F) IP's -Ethnic ity)
Assignment Week

DE T OBIO, CAT ALINA

4645780 F National Princ ipal I Permanent Administrative
PAST ORES

Aral. Pan 7 - Jade MWF 7:15 8:15 180

Aral. Pan 7 - Pearl MWF 8:20 9:20 180
Aral. Pan 8 - Topaz TWTh 9:55 10:55 180
Aral. Pan. 10 - Ruby M 11:00 12:00 60
BART OLOME, M YLENE SS- T eacher TTh 7:15 8:15 120
4268482 F National Permanent BSED/M AT Social Studies None Aral Pan. 9 - Sapphire TThF 2:05 3:05 180
M ART INEZ III SSG Adv iser
SBM C oordinator
AP C oordinator
AIP/SIP C oordinator
Ave. Minutes per Day 180
Mathematics 9 Sapphire M -F 8:20 9:20 300
M athematics 7 Jade M-F 9:55 10:55 300
EsP 8 - Topaz Th 1:00 2:00 60
F 2:05 3:05 60
Grade 8 Topaz - Adv iser
SS- T eacher BSE w/ M A
4645769 EVORA, SEVERA T AGULINAO F National Permanent Math None
III Units School Testing C oordinator

DORP C oordinator
ADOPT C oordinator
M ath C oordinator
Ave. Minutes per Day 144
TW 7:15 8:15 120
English 8 - Topaz Th 8:20 9:20 60
MF 9:55 10:55 120
English 9 - Sapphire M-F 11:00 12:00 300
English 8 - Diamond M-F 2:05 3:05 300
SS- T eacher AB M assCom/ English 10- Ruby M-F 1:00 2:00 300
4532312 ALT OVAR, IM ELDA CANOY F National Permanent English None
III Ed. D. Designated Guidance
School Publication
Adviser
Red Cross Coordinator
English Coordinator
Ave. Minutes per Day 240
SF8- LEARNER BASIC HEALTH PROFILE

PER LEARNER ASSESSMENT OF BODY

MASS INDEX
MAPEH TEACHER/CLASS ADVISER
LIS
BoSY AND EoSY
SF 8

Dep artm en t o f Ed u c atio n

Sc h o o l Fo r m 8 L earn er ' s Bas ic Health an d Nu tritio n Rep o rt (SF8)
(For All Grade Levels)

Schoo l Name Distric t Division Region

Scho o l ID Grade Sec tion T rac k/Strand (SHS) Sc hool Year

L ear n er ' s Name Nu tr i ti o n al Statu s

B i rth d ate Wei g h t Hei g h t Hei g h t² Hei g h t fo r
No. L RN (Last Name, First Name, Nam e Ag e B MI B MI Rem ark s
(M M/DD/YYYY) (kg) (m) (m²) A g e (HFA)
Extension, M iddle Name) (kg/m²) Categ o r y
MALE
 SF9- LEARNER PROGRESS REPORT CARD

INDIVIDUAL ACADEMIC, BEHAVIORAL

AND ATTENDANCE REPORT BY QUARTER
FORMERLY FORM 138
CLASS ADVISER
MANUALLY
QUARTERLY
 SF10- LEARNER’S PERMANENT
ACADEMIC RECORD
INDIVIDUAL ACADEMIC RECORD BY QUARTER AND
SY
SIMPLIFIED AND STANDARDIZED
FORMERLY FORM 137
CLASS ADVISER
MANUALLY
EOSY
SF 10 -JHS
SF 10-JHS Pag 2 of ________
Republic of the Philippines
Department of Education School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____
Learner Permanent Record for Junior High School (SF10-JHS)
(Formerly Form 137) Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: ________
LEARNER'S INFORMATION QUARTER FINAL
LEARNING AREAS REMARKS
LAST NAME: ________________________ FIRST NAME: ____________________ NAME EXTN. (Jr,I,II): _______ MIDDLE NAME: ___________________ 1 2 3 4 RATING
Learner Reference Number (LRN): ______________ Birthdate (mm/dd/yyyy): _____________________ Sex: _____________________________
Filipino
ELIGIBILITY FOR JHS ENROLMENT English
Elementary School Completer General Average: ________ Citation: (If Any)
Mathematics
Name of Elementary School: School ID: Adress of School: Science
Other Credential Presented Araling Panlipunan (AP)
PEPT Passer Rating: _________ ALS A & E Passer Rating: _____________ Others (Pls. Specify): ___________
Edukasyon sa Pagpapakatao (EsP)
Date of Examination/Assessment (mm/dd/yyyy): ____________ Name and Address of Testing Center: ____________________________________
Technology and Livelihood Education (TLE)
SCHOLASTIC RECORD MAPEH
School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____ Music
Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: __________ Arts
LEARNING AREAS
Quarterly Rating FINAL
REMARKS Physical Education
1 2 3 4 RATING
Health
Filipino
English
Mathematics General Average
Science
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _______________
Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP) Subject Final Rating Remedial Class Mark Recomputed Final Remarks
Technology and Livelihood Education (TLE)
MAPEH
Music
Arts School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____
Physical Education
Health Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: ________
LEARNING AREAS QUARTER FINAL REMARKS
1 2 3 4 RATING
General Average
Filipino
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) __________________
Recomputed Final
English
Learning Areas Final Rating Remedial Class Mark Remarks
Grade Mathematics
Science
Araling Panlipunan (AP)
School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____ Edukasyon sa Pagpapakatao (EsP)
Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: __________ Technology and Livelihood Education (TLE)
QUARTER FINAL
LEARNING AREAS REMARKS MAPEH
1 2 3 4 RATING
Filipino Music
English Arts
Mathematics Physical Education
Science
Health
Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP)
Technology and Livelihood Education (TLE)
MAPEH General Average
Music
Arts Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _______________
Physical Education Learning Areas Final Rating Remedial Class Mark Remarks
Recomputed Final
Health

General Average
School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) __________________
Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: ________
Recomputed Final
Learning Areas Final Rating Remedial Class Mark Remarks
Grade Quarterly Rating FINAL
LEARNING AREAS REMARKS
1 2 3 4 RATING
Filipino
CERTIFICATION English
I CERTIFY that this is a true record of _________________________with LRN ______________ and that he/she is eligible for admission to Grade ____.
Mathematics
Name of School: ____________________________________ School ID: __________________ Last School Year Attended: _________________________ Science
________________________
Araling Panlipunan (AP)
Date Name of Principal/School Head over Printed Name (Affi x School Seal here) Edukasyon sa Pagpapakatao (EsP)
DepEd Order 58 s. 2017
Adoption of New Forms for Kindergarten,
SHS, ALS, health and Nutrition, and
Permanent Records

SF10 will only bear the DepEd official logo and

seal. This will provide consistency and uniformity to
lessen the bulk of stapled forms even re-writing the
same information to school-customized Form 137
whenever a learner transfers to another school.
DepEd Order 58 s. 2017
Adoption of New Forms for Kindergarten,
SHS, ALS, health and Nutrition, and
Permanent Records

a. Effective SY 2017-2018, the updated and

standardized SF10 will be adopted for Grade 1
and 7
b. For other grade levels (G2-G6,G8-10) the
old/existing format of Form 137 will be used
until the learners complete the elementary and
junior high school level respectively. There is no
need to rename SF10.
DepEd Order 58 s. 2017
Adoption of New Forms for Kindergarten,
SHS, ALS, health and Nutrition, and
Permanent Records

e. Procedures in preparation of SF10-JHS

e.1 The Grade 7 class adviser will prepare one (1) copy
only of SF10-JHS and attach the relevant supporting
documents. If the Form 137 or Sf10-ES is not available due
to learner’s acceleration, the certified true copy of
assessment result or certificate shall be used as reference and
attachment in SF10 JHS
DepEd Order 58 s. 2017
Adoption of New Forms for Kindergarten,
SHS, ALS, health and Nutrition, and
Permanent Records

e. Procedures in preparation of SF10-JHS

e.3 If the learner transferred out to continue to another JHS, the
receiving ES shall request the transfer of original copy of SF10-ES and
other pertinent documents. The originating JHS, upon receipt of a written
request or system notification of transfer through the LIS, whichever
comes first, will create one certified true copy of SF10-JHS for their file
and send the original SF10-JHS along with other pertinent document to
the receiving JHS. The receiving JHS will update the LIS once the
documents have been received, and will continue filling up the original
SF10-JHS.
DepEd Order 58 s. 2017
Adoption of New Forms for Kindergarten,
SHS, ALS, health and Nutrition, and
Permanent Records

e. Procedures in preparation of SF10-JHS

e.4 The JHS where the learner completed his/her junior high school
level shall keep the original copy of SF10-JHS. If the learner requests for
additional copies for his/her employment, or for any reason other than to
enroll for Senior High School (SHS), the school may create a certified
true copy from the original SF10-JHS. The certified true copy that has
the school seal and School Head’s signature in ink shall be provided to
the learner.
DepEd Order 58 s. 2017
Adoption of New Forms for Kindergarten,
SHS, ALS, health and Nutrition, and
Permanent Records

e. Procedures in preparation of SF10-JHS

e.5 If the learner proceeded to SHS, the JHS, upon receipt of a
written request or system notification of transfer through the LIS
whichever comes first, will create one certified true copy of SF10-JHS
and send it along with other pertinent documents such as copy of SF10
-ES to the requesting SHS. The receiving SHS, through the Grade 11
adviser, shall use the certified true copy of SF10-JHS as a reference to
create SF10-SHS. (DO69 s.2016)
DepEd Order 58 s. 2017
Adoption of New Forms for Kindergarten,
SHS, ALS, health and Nutrition, and
Permanent Records

e. Procedures in preparation of SF10-JHS

e.6 Any erasures or alterations on the document should be validated
and bear the signature of the School Head in ink.
e.7 The SF10-JHS shall be prepared at the end of school year or in
the event of learner transfers within the school year
e.8 The SF10-JHS shall be printed using ordinary legal size bond
paper. Commercial printing that will result in unnecessary expenses is
hereby discouraged.
DepEd Order 58 s. 2017
Adoption of New Forms for Kindergarten,
SHS, ALS, health and Nutrition, and
Permanent Records
https://lis.deped.gov.ph