DepEd Form 137-E Republic of the Philippines

Department of Education
Region I
DIVISION OF PANGASINAN II

ELEMENTARY SCHOOL PERMANENT RECORD

Pangalan MEDIOS JEROEN ACEL C Paaralan SAN LEON ELEMENTARY SCHOOL

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

Kasarian M Petsa ng Kapanganakan SEPT. 30, 2007 Pook Petsa ng Pagpasok JUNE 5, 2017
(Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod

Magulang/Tagapag-alaga SAN LEON, BALUNGAO POLICEMAN

(Parent / Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

(ELEMENTARY SCHOOL PROGRESS)

Kindergarten: School LRN ###
School Year

ASSESSMENT SCORE REMARKS

START OF THE YEAR
MIDDLE OF TH EYEAR
END OF THE YEAR
Eligible for Admission to Grade

Grade I - School Grade II - School

School Year School Year

Periodic Rating Final Periodic Rating Final

Learning Areas Rating
Remarks Learning Areas Rating
Remarks
1 2 3 4 1 2 3 4
Mother Tongue Mother Tongue
Filipino Filipino
English English
Mathematics Mathematics
Araling Panlipunan Araling Panlipunan
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao
MAPEH MAPEH
Music Music
Arts Arts
PE PE
Health Health
Gen. Average Gen. Average
Eligible for Admission to Grade Eligible for Admission to Grade

Grade III - School Grade IV - School

School Year School Year

Periodic Rating Final Periodic Rating Final

Learning Areas Rating
Remarks Learning Areas Rating
Remarks
1 2 3 4 1 2 3 4
Mother Tongue Filipino 85 86 87 88 87 PASSED
Filipino English 85 86 87 88 87 PASSED
English Mathematics 85 86 85 86 86 PASSED
Mathematics Science 85 85 84 85 85 PASSED
Science Araling Panlipunan 86 86 87 88 87 PASSED
Araling Panlipunan Eduk. sa Pagpapakatao 90 92 92 93 92 PASSED
Eduk. sa Pagpapakatao Eduk.Pangtahanan at
MAPEH Pangkabuhayan 87 88 90 91 89 PASSED
Music MAPEH 87 88 89 90 89 PASSED
Arts Music 86 87 88 90
PE Arts 87 88 88 90
Health PE 87 88 88 90
Gen. Average Health 86 88 89 90
Eligible for Admission to Grade Gen. Average 88
Eligible for Admission to Grade

Grade V - School Grade VI - School

School Year School Year

Periodic Rating Final

Learning Areas Rating
Remarks Learning Areas
1 2 3 4 Periodic Rating Final
Remarks
1 2 3 4 Rating
Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan Araling Panlipunan
Eduk. sa Pagpapakatao Eduk. sa Pagpapakatao

Eduk.Pangtahanan at Eduk.Pangtahanan at
Pangkabuhayan Pangkabuhayan
MAPEH MAPEH
Music Music
Arts Arts
PE PE
Health Health
Gen. Average Gen. Average
Eligible for Admission to Grade Eligible for Admission to Grade
 nt of Education
egion I
F PANGASINAN II

OL PERMANENT RECORD

CHOOL PROGRESS)

Remarks

Remarks

PASSED
PASSED
PASSED
PASSED
PASSED
PASSED

PASSED
PASSED

88

Remarks
III. CHARACTER BUILDING

Gr. Sch. Yr. Gr. Sch. Yr. Gr. Sch. Yr.

Behavioral Values
1 2 3 4 FR 1 2 3 4 FR 1 2 3 4 FR

Expresses one’s spiritual beliefs while

respecting the spiritual beliefs of others
Maka-Diyos
Shows adherence to ethical principles by
upholding truth

Is sensitive to individual, social, and cultural

differences
Makatao
Demonstrates contributions toward
solidarity

Cares for the environment and utilizes

Makakali resources wisely, judiciously, and
kasan economically

Demonstrates pride in being a Filipino;

exercises the rights and responsibilities of a
Filipino citizen
Makabansa
Demonstrates appropriate behaviour in
carrying out activities in the school,
community, and country

Average

Gr. Sch. Yr. Gr. Sch. Yr. Gr. Sch. Yr.

Behavioral Values
1 2 3 4 FR 1 2 3 4 FR 1 2 3 4 FR
Expresses one’s spiritual beliefs while
respecting the spiritual beliefs of others
Maka-Diyos
Shows adherence to ethical principles by
upholding truth

Is sensitive to individual, social, and cultural

differences
Makatao
Demonstrates contributions toward
solidarity

Cares for the environment and utilizes

Makakali resources wisely, judiciously, and
kasan economically

Demonstrates pride in being a Filipino;

exercises the rights and responsibilities of a
Filipino citizen
Makabansa
Demonstrates appropriate behaviour in
carrying out activities in the school,
community, and country

Average

AO - Always Observed RO - Rarely Observed

SO - Sometimes Observed NO - Not Observed
IV. ATTENDANCE RECORD

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

K
I
II
III
IV 195 0 0 195
V
VI

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 to Grade .
 Signature

Date Designation