SF 10 -JHS
Republic of the Philippines
Department of Education
Learner's Permanent Academic Record for Junior High School (SF10-JHS)
(Formerly Form 137)
LEARNER'S INFORMATION
LAST NAME: ________________________ FIRST NAME: ____________________ NAME EXTN. (Jr,I,II): _______ MIDDLE NAME: ___________________
Learner Reference Number (LRN): ______________ Birthdate (mm/dd/yyyy): _____________________ Sex: _____________________________
ELIGIBILITY FOR JHS ENROLMENT
Elementary School Completer General Average: ________ Citation: (If Any)
Name of Elementary School: School ID: Adress of School:
Other Credential Presented
PEPT Passer Rating: _________ ALS A & E Passer Rating: _____________ Others (Pls. Specify): ___________
Date of Examination/Assessment (mm/dd/yyyy): ____________ Name and Address of Testing Center: ____________________________________
SCHOLASTIC RECORD
School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____
Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: __________
Quarterly Rating FINAL
LEARNING AREAS REMARKS
1 2 3 4 RATING
General Average
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) __________________
Learning Areas Final Rating Remedial Class Mark Recomputed Final Grade Remarks
School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____
Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: __________
LEARNING AREAS QUARTER FINAL REMARKS
1 2 3 4 RATING
General Average
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) __________________
Learning Areas Final Rating Remedial Class Mark Recomputed Final Grade Remarks
CERTIFICATION
I CERTIFY that this is a true record of _________________________with LRN ______________ and that he/she is eligible for admission to Grade ____.
Name of School: ____________________________________ School ID: __________________ Last School Year Attended: _________________________
________________________
Date Name of Principal/School Head over Printed Name (Affix School Seal here)
SF 10-JHS Pag 2 of ________
School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____
Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: ________
LEARNING AREAS QUARTER FINAL REMARKS
1 2 3 4 RATING
General Average
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _______________
Subject Final Rating Remedial Class Mark Recomputed Final Grade Remarks
School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____
Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: ________
LEARNING AREAS QUARTER FINAL REMARKS
1 2 3 4 RATING
General Average
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _______________
Learning Areas Final Rating Remedial Class Mark Recomputed Final Grade Remarks
School: ______________________ School ID: ________ District: ___________________ Division: __________________ Region: ____
Classified as Grade: ____ Section: ___ School Year: _____ Name of Adviser/Teacher: ________________ Signature: ________
Quarterly Rating FINAL
LEARNING AREAS REMARKS
1 2 3 4 RATING
General Average
Remedial Classes Conducted from (mm/dd/yyyy) ____________________ to (mm/dd/yyyy) _______________
Learning Areas Final Rating Remedial Class Mark Recomputed Final Grade Remarks
For Transfer Out /JHS Completer Only
CERTIFICATION
I CERTIFY that this is a true record of _____________________________with LRN ________________ and that he/she is eligible for admission to Grade ____.
Name of School: ____________________________________ School ID __________________ 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
