DepEd Form IX
SCHOOL
School Address
email/telephone number
STUDENT'S GRADUATION FORM
LRN ____________ Track/Strand: ______________________________________________________
Name: Surname, Given Name Middle Name Date of Birth: Year: _____ Month:_________
Place of Birth: Province: Bulacan Town: _________ Barangay: _____________
Parent/Guardian: _______________________________ Occupation: ________________________
Address of Parent/Guardian: ________________________________________________________________________
Junior High School Completer from: _______________________________________ School Year: _________________
Gen. Ave: ___
SCHOOL: ' SCHOOL:
Classified as: Grade 11 Semester: 1st School Year: 2018-2019 Classified as: Grade 12 Semester: 1st School Year:
SUBJECTS Final Grade Action Taken SUBJECTS Final Grade
Average: 0 Average: 0
Days of School ________________ Days Present____________ Days of School ________________ Days Present___________
SCHOOL_____________________________Summer_________________ SCHOOL______________________________Summer_______________
SUBJECT/S Final Grade Action Taken SUBJECT/S Final Grade
Days of School ________________ Days Present Days of School ________________ Days Present______
SCHOOL: SCHOOL: '
Classified as: Grade 11 Semester: 2nd School Year: 2018-2019 Classified as: Grade 12 Semester: 2nd School Year: 2019-2020
SUBJECTS Final Grade Action Taken SUBJECTS 3rd Quarter
DepEd Form IX
Average: 0 Average:
Days of School ________________ Days Present____________ Days of School ________________ Days Present___________
SCHOOL_____________________________Summer_________________ SCHOOL______________________________Summer_______________
SUBJECT/S Final Grade Action Taken SUBJECT/S Final Grade
Days of School ________________ Days Present Days of School ________________ Days Present__________
DepEd Form IX
__________
Day: ___
_________
__________
____________
____________
2019-2020
Action Taken
sent____________
________________
Action Taken
sent______
Year: 2019-2020
Action Taken
DepEd Form IX
sent____________
________________
Action Taken
esent___________
SUMMARY OF SUBJECTS
Grade 11 Grade 12
Subjects Semester School Year Subjects Semester
CERTIFICATION Checked against original copy:
I certify that this is a true rec _____________________
as per requirement of the Department of Education. He/She is eligi CECILIA S. CUSTODIO, PhD
for graduation in the School Year/S 2019-2020 EPS- In charge of Private Schools
The above-mentioned name met the required no. of 80 hrs during his/her
Work Immersion at PARTNER INDUSTRY, ADDRESS AND DATE. MARCOS M. DELA CRUZ
SGOD Chief
____________________________________________
School Principal/School Head
School Year