DepEd Form 137-A
Republic of the Philippines
Department of Education
Region VII, Central Visayas
DIVISION OF LAPU-LAPU CITY
LRN: ________________
Name: _______________________________________ Date of Birth: __________________________ Sex: ___________
(Surname)
(First Name)
(M.I.)
(Month)
(Day)
(Year)
Place of Birth: ________________________________ Town City: _________________ Barangay: __________________
Name of Parent or Guardian: ________________________________ Occupation: _______________________________
Address of Parent or Guardian: ________________________________________________________________________
Elementary Course Completed (School): ________________________________ Year: ___________ Gen. Ave.: _______
School: ________________________________ Grade _______ Section ____________ School Year __________________
Periodic Ratings
1st 2nd 3rd 4th
Learning Areas
Final Rating
Remarks
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao
TLE
MAPEH
Music
Arts
Physical Education
Health
July
1st
Periodic Ratings
2nd 3rd
4th
1. Maka-Diyos
2. Makatao
3. Makakalikasan
4. Makabansa
Legend:
AO - Always Observed
SO Sometimes Observed
RO Rarely Observed
NO Not Observed
To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
General Average
June
Core Values
Lack Subjects_________________________________
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb.
March
April
TOTAL
Days of School
Days Present
______________________________
Class Adviser (Name & Signature)
School: ________________________________ Grade _______ Section ____________ School Year __________________
Periodic Ratings
1st 2nd 3rd 4th
Learning Areas
Final Rating
Remarks
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao
TLE
MAPEH
Music
Arts
Physical Education
Health
June
Days Present
July
1st
Periodic Ratings
2nd 3rd
4th
1. Maka-Diyos
2. Makatao
3. Makakalikasan
4. Makabansa
Legend:
AO - Always Observed
SO Sometimes Observed
RO Rarely Observed
NO Not Observed
To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
General Average
Days of School
Core Values
Lack Subjects_________________________________
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb.
March
April
TOTAL
______________________________
Class Adviser (Name & Signature)
School: ________________________________ Grade _______ Section ____________ School Year __________________
Periodic Ratings
2nd 3rd 4th
Learning Areas
Final Rating
1st
Remarks
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao
TLE
MAPEH
Music
Arts
Physical Education
Health
July
1st
Periodic Ratings
2nd 3rd
4th
1. Maka-Diyos
2. Makatao
3. Makakalikasan
4. Makabansa
Legend:
AO - Always Observed
SO Sometimes Observed
RO Rarely Observed
NO Not Observed
To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
Lack Subjects_________________________________
General Average
June
Core Values
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb.
March
April
TOTAL
Days of School
Days Present
______________________________
Class Adviser (Name & Signature)
School: ________________________________ Grade _______ Section ____________ School Year __________________
Periodic Ratings
2nd 3rd 4th
Learning Areas
Final Rating
1st
Remarks
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao
TLE
MAPEH
Music
Arts
Physical Education
Health
July
1st
Periodic Ratings
2nd 3rd
4th
1. Maka-Diyos
2. Makatao
3. Makakalikasan
4. Makabansa
Legend:
AO - Always Observed
SO Sometimes Observed
RO Rarely Observed
NO Not Observed
To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
Lack Subjects_________________________________
General Average
June
Core Values
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb.
March
April
TOTAL
Days of School
Days Present
______________________________
Class Adviser (Name & Signature)
School: ________________________________ Grade _______ Section ____________ School Year __________________
Periodic Ratings
1st 2nd 3rd 4th
Learning Areas
Final Rating
Remarks
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao
TLE
MAPEH
Music
Arts
Physical Education
Health
June
July
1st
Periodic Ratings
2nd 3rd
4th
1. Maka-Diyos
2. Makatao
3. Makakalikasan
4. Makabansa
Legend:
AO - Always Observed
SO Sometimes Observed
RO Rarely Observed
NO Not Observed
To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
Lack Subjects_________________________________
General Average
Days of School
Days Present
Core Values
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb.
March
April
TOTAL
______________________________
Class Adviser (Name & Signature)
School: ________________________________ Grade _______ Section ____________ School Year __________________
Periodic Ratings
2nd 3rd 4th
Learning Areas
Final Rating
1st
Remarks
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao
TLE
MAPEH
Music
Arts
Physical Education
Health
July
1st
Periodic Ratings
2nd 3rd
4th
1. Maka-Diyos
2. Makatao
3. Makakalikasan
4. Makabansa
Legend:
AO - Always Observed
SO Sometimes Observed
RO Rarely Observed
NO Not Observed
To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
Lack Subjects_________________________________
General Average
June
Core Values
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb.
March
April
TOTAL
______________________________
Class Adviser (Name & Signature)
Days of School
Days Present
School: ________________________________ Grade _______ Section ____________ School Year __________________
Periodic Ratings
2nd 3rd 4th
Learning Areas
Final Rating
1st
Remarks
Filipino
English
Mathematics
Science
Araling Panlipunan
Edukasyon sa Pagpapakatao
TLE
MAPEH
Music
Arts
Physical Education
Health
July
1st
Periodic Ratings
2nd 3rd
4th
1. Maka-Diyos
2. Makatao
3. Makakalikasan
4. Makabansa
Legend:
AO - Always Observed
SO Sometimes Observed
RO Rarely Observed
NO Not Observed
To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
Lack Subjects_________________________________
General Average
June
Core Values
Aug.
Sept.
Oct.
Nov.
Dec.
Jan.
Feb.
March
April
______________________________
Class Adviser (Name & Signature)
TOTAL
Days of School
Days Present
Descriptors
Grading Scale
Remarks
Outstanding
90 100
Passed
Very Satisfactory
85 89
Passed
Satisfactory
80 84
Passed
Fairly Satisfactory
75 79
Passed
Did Not Meet Expectations
Below 75
Failed
CERTIFICATE OF TRANSFER
To Whom It May Concern:
I hereby certify that this is the true record of __________________________ issued this ____________ day of
___________________ 20 ______ and he/she is eligible for admission to ________________________ and this student
has no money or property accountability in the school.
_____________________________________
School Head
