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Republika ng Pilipinas 
(Republic of the Philippines) 
Kagawaran ng Edukasyon 
(Department of Education) 
KAWANIHAN NG EDUKASYONG ELEMENTARYA 
(BUREAU OF ELEMENTARY EDUCATION) 
Rehiyon IX 
(Region IX) 
LAOY OLINGAN ELEMENTARY SCHOOL 
PALAGIANG TALAAN SA MABABANG PAARALAN 
(ELEMENTARY SCHOOL PERMANENT RECORD) 
LRN:______________________________ 
Pangalan 
Dipolog City Laoy Olingan 
Sangay_______________________Paaralang Elementarya ng ____ _________ 
(Name) Apelyido Unang Pangalan M.I. (Division) 
(School) 
Kasarian______________Petsa ng kapanganakan_______________________________Pook _________________________________________Petsa ng Pagpasok____________ 
(Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod (Date of Entrance) 
(Town/Province/City) 
Magulang/Tagapag-alaga 
Pangalan Tirahan Hanapbuhay 
(Name) (Address) (Occupation) 
PAG-UNLAD SA MABABANG PAARALAN 
(ELEMENTARY SCHOOL PROGRESS) 
Kindergarten-School__________________________ 
School Year___________________ 
Learning Areas Periodic Rating Learning Areas Periodic Rating Learning Areas Periodic Rating 
1 2 3 4 1 2 3 4 1 2 3 4 
I. MENTAL DEVELOPMENT B. NUMBER READINESS SOCIAL DEVELOPMENT 
A. Communication Arts ·Can count, write & recognized 1-20 · Is friendly 
ENGLISH ·Can count by rote to 100 · Speaks in a pleasant 
voice 
· Identifies/reads the letter of the 
alphabet/words 
·Can group objects as directed · Shares with others 
· Can produce phonetical sounds of 
letters/words 
·Has number concept · Can lead his/her peers 
· Can answer questions accurately ·Can identify shapes/colors/sizes/positions · Grows in social 
relationship 
· Can recite, simple rhymes/poems C. MUSIC INTEREST EMOTIONAL DEVELOPMENT 
· Can write his/her name ·Enjoy listening music · Is happy 
· Can trace, copy letters/word forms ·Takes part in Singing/Activities · Reacts appropriately in 
all situations 
· Can follow simple instructions D. ART INTEREST · Tells the truth readily 
FILIPINO ·Can express through art · Shows courteous habits 
· Can recognize/say letters/words ·Can reproduce figures/symbols 
· Can name common objects & 
·Uses crayons properly 
people 
· Can follow simple instructions 
Grade 1 – School ____________________ _________ Grade 2 – School __________ ___________________ 
School Year _________________________________ School Year _________________________________ 
LEARNING AREAS 
PERIODIC RATING 
Final Rating Remarks LEARNING AREAS 
PERIODIC RATING Final Rating Remarks 
1 2 3 4 1 2 3 4 
Mother Tongue Mother Tongue 
Filipino Filipino 
English English 
Mathematics Mathematics 
Araling Panlipunan Araling Panlipunan 
MAPEH MAPEH 
Music Music 
Art Art 
Physical Education Physical Education 
Health Health 
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao 
AVERAGE AVERAGE 
Eligible for Admission to Grade _____________________________________ Eligible for Admission to Grade _____________________________________ 
Grade 3 – School ____________________ _________ Grade 4 – School __________ ___________________ 
School Year _________________________________ School Year _________________________________ 
LEARNING AREAS 
PERIODIC RATING Final Rating Remarks LEARNING AREAS PERIODIC RATING Final Rating Remarks 
1 2 3 4 1 2 3 4 
Mother Tongue Mother Tongue 
Filipino Filipino 
English English 
Mathematics Mathematics 
Science & Health Science & Health 
Araling Panlipunan Araling Panlipunan 
MAPEH MAPEH 
Music Music 
Art Art 
Physical Education Physical Education 
Health Health 
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao 
AVERAGE AVERAGE 
Eligible for Admission to Grade _____________________________________ Eligible for Admission to Grade _____________________________________ 
Grade 5 – School ____________________ _________ Grade 6 – School __________ ___________________ 
School Year _________________________________ School Year _________________________________ 
LEARNING AREAS PERIODIC RATING Final Rating Remarks LEARNING AREAS PERIODIC RATING Final Rating Remarks
1 2 3 4 1 2 3 4 
Mother Tongue Mother Tongue 
Filipino Filipino 
English English 
Mathematics Mathematics 
Science & Health Science & Health 
Araling Panlipunan 
MAPEH 
Araling Panlipunan 
MAPEH 
Music 
Art 
Music 
Art 
Physical Education 
Health 
Physical Education 
Health 
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao 
AVERAGE AVERAGE 
Eligible for Admission to Grade _____________________________________ Eligible for Admission to Grade _____________________________________ 
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. Resourcefulness and 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. Resourcefulness and 
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: 
Kindergarten Periodic Rating Character Building 
O – Outstanding B – Beginning 74% and Below A – Outstanding 95% - 100% 
VS – Very Satisfactory D – Developing 75% - 79% B – Very Satisfactory 84 – 89% 
S – Satisfactory AP – Approaching Proficiency 80 – 84% C – Good 83 – 88% 
NI – Needs Improvement P – Proficient 85 – 89% D – Fair 76 – 82% 
A – Advanced 90 – 100% 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
CERTIFICATION 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/Year ________________________________. 
__________________________ 
Name and Signature 
(Date) (Designation)

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Form 137 k to 12

  • 1. Republika ng Pilipinas (Republic of the Philippines) Kagawaran ng Edukasyon (Department of Education) KAWANIHAN NG EDUKASYONG ELEMENTARYA (BUREAU OF ELEMENTARY EDUCATION) Rehiyon IX (Region IX) LAOY OLINGAN ELEMENTARY SCHOOL PALAGIANG TALAAN SA MABABANG PAARALAN (ELEMENTARY SCHOOL PERMANENT RECORD) LRN:______________________________ Pangalan Dipolog City Laoy Olingan Sangay_______________________Paaralang Elementarya ng ____ _________ (Name) Apelyido Unang Pangalan M.I. (Division) (School) Kasarian______________Petsa ng kapanganakan_______________________________Pook _________________________________________Petsa ng Pagpasok____________ (Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod (Date of Entrance) (Town/Province/City) Magulang/Tagapag-alaga Pangalan Tirahan Hanapbuhay (Name) (Address) (Occupation) PAG-UNLAD SA MABABANG PAARALAN (ELEMENTARY SCHOOL PROGRESS) Kindergarten-School__________________________ School Year___________________ Learning Areas Periodic Rating Learning Areas Periodic Rating Learning Areas Periodic Rating 1 2 3 4 1 2 3 4 1 2 3 4 I. MENTAL DEVELOPMENT B. NUMBER READINESS SOCIAL DEVELOPMENT A. Communication Arts ·Can count, write & recognized 1-20 · Is friendly ENGLISH ·Can count by rote to 100 · Speaks in a pleasant voice · Identifies/reads the letter of the alphabet/words ·Can group objects as directed · Shares with others · Can produce phonetical sounds of letters/words ·Has number concept · Can lead his/her peers · Can answer questions accurately ·Can identify shapes/colors/sizes/positions · Grows in social relationship · Can recite, simple rhymes/poems C. MUSIC INTEREST EMOTIONAL DEVELOPMENT · Can write his/her name ·Enjoy listening music · Is happy · Can trace, copy letters/word forms ·Takes part in Singing/Activities · Reacts appropriately in all situations · Can follow simple instructions D. ART INTEREST · Tells the truth readily FILIPINO ·Can express through art · Shows courteous habits · Can recognize/say letters/words ·Can reproduce figures/symbols · Can name common objects & ·Uses crayons properly people · Can follow simple instructions Grade 1 – School ____________________ _________ Grade 2 – School __________ ___________________ School Year _________________________________ School Year _________________________________ LEARNING AREAS PERIODIC RATING Final Rating Remarks LEARNING AREAS PERIODIC RATING Final Rating Remarks 1 2 3 4 1 2 3 4 Mother Tongue Mother Tongue Filipino Filipino English English Mathematics Mathematics Araling Panlipunan Araling Panlipunan MAPEH MAPEH Music Music Art Art Physical Education Physical Education Health Health Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao AVERAGE AVERAGE Eligible for Admission to Grade _____________________________________ Eligible for Admission to Grade _____________________________________ Grade 3 – School ____________________ _________ Grade 4 – School __________ ___________________ School Year _________________________________ School Year _________________________________ LEARNING AREAS PERIODIC RATING Final Rating Remarks LEARNING AREAS PERIODIC RATING Final Rating Remarks 1 2 3 4 1 2 3 4 Mother Tongue Mother Tongue Filipino Filipino English English Mathematics Mathematics Science & Health Science & Health Araling Panlipunan Araling Panlipunan MAPEH MAPEH Music Music Art Art Physical Education Physical Education Health Health Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao AVERAGE AVERAGE Eligible for Admission to Grade _____________________________________ Eligible for Admission to Grade _____________________________________ Grade 5 – School ____________________ _________ Grade 6 – School __________ ___________________ School Year _________________________________ School Year _________________________________ LEARNING AREAS PERIODIC RATING Final Rating Remarks LEARNING AREAS PERIODIC RATING Final Rating Remarks
  • 2. 1 2 3 4 1 2 3 4 Mother Tongue Mother Tongue Filipino Filipino English English Mathematics Mathematics Science & Health Science & Health Araling Panlipunan MAPEH Araling Panlipunan MAPEH Music Art Music Art Physical Education Health Physical Education Health Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao AVERAGE AVERAGE Eligible for Admission to Grade _____________________________________ Eligible for Admission to Grade _____________________________________ 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. Resourcefulness and 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. Resourcefulness and 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: Kindergarten Periodic Rating Character Building O – Outstanding B – Beginning 74% and Below A – Outstanding 95% - 100% VS – Very Satisfactory D – Developing 75% - 79% B – Very Satisfactory 84 – 89% S – Satisfactory AP – Approaching Proficiency 80 – 84% C – Good 83 – 88% NI – Needs Improvement P – Proficient 85 – 89% D – Fair 76 – 82% A – Advanced 90 – 100% 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. CERTIFICATION 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/Year ________________________________. __________________________ Name and Signature (Date) (Designation)