Form 137 k 12

1. Republikang Pilipinas
(Republic of the 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, Kasaysayan at 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 It May 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)