Sample of Form 137
Sample of Form 137
Department of Education
Region X - Northern Mindanao
Elementary School Permanent Record
Pangalan ________________________________________________________________________________
Sangay ___________________ Paaralan ________________________________
(Name) Apelyido Unang Pangalan M.I. (Division) (School)
Name: Terresa, Maria Leonora Davao de Oro New Kapatagan Elementary School
Address: P-18 New Kapatagan Casoon Monkayo Davao de Oro (Division) (School)
Female 08/09/1999 P-7 Awao Santa Josefa Agusan del Sur 6/6/2005 6/6/2005
(Sex) (Date of Birth) (Birth of Place). (Date of Entrance)
Magulang/Tagapag-alaga Teresa, Ana Marie L. P-18 New Kapatagan Casoon House wife
(Parent/Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)
Grade One School : New Kapatagan, Elementary School Grade Two School : New, kapatagan Elementary School
School Year : 2005-2006 School Year : 2006-2007
Periodic Rating FINAL Periodic Rating FINAL
Learning Areas REMARKS Learning Areas REMARKS
1 2 3 4 RATING 1 2 3 4 RATING
Mother Tongue 85 89 90 92 89 PASSED Mother Tongue 86 87 88 89 88 PASSED
Filipino 87 89 92 88 89 PASSED Filipino 87 87 89 89 88 PASSED
English 87 87 88 88 88 PASSED English 88 88 88 90 89 PASSED
Mathematics 82 82 85 86 84 PASSED Mathematics 85 86 86 88 86 PASSED
Araling Panlipunan 90 91 93 94 92 PASSED Araling Panlipunan 90 92 91 92 91 PASSED
MAPEH 86 88 88 90 88 PASSED MAPEH 87 88 89 89 88 PASSED
Music 85 86 87 88 87 PASSED Music 85 86 88 87 87 PASSED
Arts 88 87 88 90 88 PASSED Arts 87 87 88 89 88 PASSED
Physical Education 87 86 88 89 88 PASSED Physical Education 88 89 89 90 89 PASSED
Health 90 91 90 92 91 PASSED Health 88 88 89 89 89 PASSED
Edukasyon sa Pagpapakatao 90 90 90 90 90 PASSED Edukasyon sa Pagpapakatao 90 91 91 92 91 PASSED
General Average 87 88 89 90 89 PASSED General Average 88 88 89 90 89 PASSED
Eligible for Admission to Grade II Eligible for Admission to Grade III
Grade Three School: New kapatagan Elementary School Grade Four School : New Kapatagan Elementary School
School Year : 2007-2008 School Year : 2008-2009
Periodic Rating FINAL Periodic Rating FINAL
Learning Areas REMARKS Learning Areas REMARKS
1 2 3 4 RATING 1 2 3 4 RATING
Mother Tongue 88 89 89 90 89 PASSED Filipino 86 88 88 89 88 PASSED
Filipino 85 86 86 89 87 PASSED English 85 84 87 88 86 PASSED
English 84 85 88 89 87 PASSED Mathematics 85 86 87 88 87 PASSED
Mathematics 84 86 85 88 86 PASSED Science 88 88 89 90 89 PASSED
Science and Health 86 88 87 90 88 PASSED Araling Panlipunan 90 91 92 93 92 PASSED
Araling Panlipunan 88 88 90 91 89 PASSED Edukasyon sa Pagpapakatao 90 90 92 93 91 PASSED
Edukasyong Pantahanan at
MAPEH 85 86 88 89 87 PASSED Pangkabuhayan (EPP) 86 87 88 89 88 PASSED
Grade Five School: New kapatagan Elementary School Grade Six School: New kapatagan Elementary School
School Year: 2009-2010 School Year: 2010-2011
Periodic Rating FINAL Periodic Rating FINAL
Learning Areas REMARKS Learning Areas REMARKS
1 2 3 4 RATING 1 2 3 4 RATING
Filipino 85 86 87 90 87 PASSED Filipino 86 87 88 89 87 PASSED
English 84 85 88 89 87 PASSED English 85 85 87 88 86 PASSED
Mathematics 84 85 86 88 86 PASSED Mathematics 85 86 87 88 87 PASSED
Science 88 89 89 90 89 PASSED Science 88 87 89 90 89 PASSED
Araling Panlipunan 88 88 90 91 89 PASSED Araling Panlipunan 88 89 92 92 90 PASSED
Edukasyon sa Pagpapakatao 88 89 91 91 90 PASSED Edukasyon sa Pagpapakatao 90 90 92 93 91 PASSED
Edukasyong Pantahanan at Edukasyong Pantahanan at
Pangkabuhayan (EPP) 83 85 87 89 86 PASSED Pangkabuhayan (EPP) 84 87 88 89 87 PASSED
CERTIFICATE 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 of Grade/Year____________________.
Signature
Date
Designation