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Form 137 k 12
This document is a student's permanent record from the Philippine Department of Education containing information about their education progress from Kindergarten through 6th grade. It includes their personal details, academic performance in various subjects for each grade, character evaluations, attendance records, and certification of transfer eligibility. The record tracks the student's development, grades, attendance, and character building over their elementary school years.
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Form 137 k 12
- 1. Republikang Pilipinas (Republic ofthe Philippines) Kagawaran ng Edukasyon (Department of Education) KAWANIHAN NG EDUKASYONG ELEMENTARYA (BUREAU OFELEMENTARY EDUCATION) Rehiyon IX (Region IX) PALAGIANG TALAAN SA MABABANG PAARALAN (ELEMENTARY SCHOOL PERMANENT RECORD Pangalan Sangay___________________Paaralang Elementarya ng ____ ____________________ (Name) Apelyido Unang Pangalan M.I. (Division) (School) Kasarian______________Petsang kapanganakan______________________________Pook__________________________________________Petsang Pagpasok____________ (Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod (Date of Entrance) (Town/Province/City) Magulang/Tagapag-alaga Pangalan Tirahan Hanapbuhay (Name) (Address) (Occupation) LRN:______________________________ PAG-UNLAD SA MABABANG PAARALAN (ELEMENTARY SCHOOL PROGRESS) Kindergarten-School__________________________ School Year___________________ LEARNING AREAS PERIODIC RATING LEARNING AREAS PERIODIC RATING 1 2 3 4 1 2 3 4 ENGLISH NUMBERS READINESS Identifies/reads theletterof the alphabet/words Can count, write & recognized 1-20 Can produce phonetical soundsof letters/words Can count by rote to 100 Can answer questions accurately Can group objects as directed Can recite, simple rhymes/poems Has number concept Can write his/her name Can identify shapes/colors/sizes/positions Can trace, copy letters/word forms C. MUSIC INTEREST Can followsimple instructions Enjoy listening music FILIPINO Takes part in Singing/Activities Can recognize/say letters/words D. ART INTEREST Can name common objects & people Can express through art Can followsimple instructions Can reproduce figures/symbols Uses crayons properly Grade I – School _________________________________ School Year _________________________________ Grade II – School _____________________________ School Year _______________________________ LEARNING AREAS PERIODIC RATING Remarks 1 2 3 4 LEARNING AREAS PERIODIC RATING REMARKS Mother Tongue 1 2 3 4 Filipino Mother Tongue English Filipino Mathematics English Araling Panlipunan Mathematics MAPEH Araling Panlipunan Music MAPEH Art Music Physical Education Art Health Physical Education Edukasyon saPagpapakatao Health AVERAGE Edukasyon saPagpapakatao Eligible for Admission to Grade _____________________________________ Grade III – School _______________________________ School Year _________________________________ AVERAGE Eligible for Admission to Grade _____________________________________ Grade IV – School _______________________________ School Year _________________________________ LEARNING AREAS PERIODIC RATING Remarks 1 2 3 4 LEARNING AREAS PERIODIC RATING Remarks 1 2 3 4 Mother Tongue Filipino Filipino English English Mathematics Mathematics Science & Health Science & Health MAKABAYAN Araling Panlipunan Heograpiya, Kasaysayan at Sibika (HKS) MAPEH Edukasyong Pantahanan at Pangkabuhayan (EPP) Music Musika Sining at Edukasyon sa Pagpapalakas ng Katawan (MSEP) Art Edukasyon saPagpapakatao Physical Education AVERAGE Edukasyon saPagpapakatao Eligible for Admission to Grade _____________________________________ Grade VI – School _______________________________ School Year _________________________________ AVERAGE Eligible for Admission to Grade _____________________________________ Grade V – School _______________________________ School Year _________________________________ LEARNING AREAS PERIODIC RATING Remarks LEARNING AREAS PERIODIC RATING Remarks 1 2 3 4 1 2 3 4 Filipino Filipino English English Mathematics Mathematics Science & Health Science & Health MAKABAYAN MAKABAYAN Heograpiya, Kasaysayan at Sibika (HKS)
- 2. Heograpiya, Kasaysayanat Sibika (HKS) Edukasyong Pantahanan at Pangkabuhayan (EPP) Edukasyong Pantahanan at Pangkabuhayan (EPP) Musika Sining at Edukasyon sa Pagpapalakas ng Katawan (MSEP) Musika Sining atEdukasyon sa Pagpapalakas ng Katawan (MSEP) *Edukasyon saPagpapakatao Edukasyon saPagpapakatao AVERAGE AVERAGE Eligible for Admission to Grade _____________________________________ Eligible for Admission to Grade _____________________________________ . LEARNING AREAS Kindergarten Sch. Year: _______________ 1 2 3 4 SOCIALDEVELOPMENT Is friendly Speaks in apleasant voice Shares with others Can lead his/her peers Grows in social relationship EMOTIONALDEVELOPMENT Is happy Reacts appropriately in all situations Tells the truth readily Shows courteous habits Evaluation Code: O – Outstanding VS – Very Satisfactory S – Satisfactory NI – Needs Improvement CHARACTER BUIDING Gr. ___________________ Sch. Yr._______________ Gr. ___________________ Sch. Yr._______________ Gr. ___________________ Sch. Yr._______________ 1 2 3 4 FR 1 2 3 4 FR 1 2 3 4 FR 1. Honesty 2. Courtesy 3. Helpfulness and Cooperation 4. Resourcefulnessand Creativity 5. Consideration for Others 6. Sportsmanship 7. Obedience 8. Self-Reliance 9. Industry 10. Cleanliness &Orderliness 11. Promptness & Punctuality 12. Sense of Responsibility 13. Love of God 14. Patriotism & Love of Country CHARACTER BUIDING Gr. ___________________ Sch. Yr._______________ Gr. ___________________ Sch. Yr._______________ Gr. ___________________ Sch. Yr._______________ 1 2 3 4 FR 1 2 3 4 FR 1 2 3 4 FR 1. Honesty 2. Courtesy 3. Helpfulness and Cooperation 4. Resourcefulnessand Creativity 5. Consideration for Others 6. Sportsmanship 7. Obedience 8. Self-Reliance 9. Industry 10. Cleanliness &Orderliness 11. Promptness & Punctuality 12. Sense of Responsibility 13. Love of God 14. Patriotism & Love of Country CODE: NONE-NUMERICALRATING NUMERICALRATING A – Outstanding 95– 100 B – Very Satisfactory 84 – 89 C – Satisfactory 83 – 88 D – Fair 76 – 82 E – Poor 71 – 75 ATTENDANCE RECORD GRADE No. of School Days No. of School Days Absent Cause No. of Time Tardy Cause No. of School Days Present
- 3. CERTIFICATIONOFTRANSFER To Whom ItMay Concern This is to certify that this is atrue record of theElementary SchoolPermanent Recordof __________________________________________,He/She is eligible for transfer and admission to Grade/Year ________________________________. __________________________ Name and Signature (Date) (Designation)