School Form 1 School Register for Senior High School (SF1-SHS)

School Name School ID District Division

Semester School Year Grade Level Track and Strand

Section Course (For TVL Only)

COMPLETE ADDRESS PARENTS GUARDIAN

(if learner is not Living with Parent)

Sex (M/F)
NAME BIRTHDATE AGE Religious
LRN (Last Name, First Name, Name (mm/dd/yyyy) Affiliation Mother's Maiden Name Name
Father's Name
Barangay Municipality/
Extension, Middle Name) House No./ (Last Name, First Name, (Last Name, First Name,
Street/ Sitio/
Purok City Province (Last Name, First Name, Name
Name Extension, Middle Name Extension, Middle Relationship
Extension, Middle Name)
Name) Name)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40

<=== TOTAL MALE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33

SFRT 2017
F1-SHS)
Region

Contact REMARKS
Number of (Please refer to the legend)
Parent/
Guardian

SFRT 2017
 COMPLETE ADDRESS PARENTS GUARDIAN
(if learner is not Living with Parent)

Sex (M/F)
NAME BIRTHDATE AGE Religious
LRN (Last Name, First Name, Name (mm/dd/yyyy) Affiliation Mother's Maiden Name Name
Father's Name
Barangay Municipality/
Extension, Middle Name) House No./ (Last Name, First Name, (Last Name, First Name,
Street/ Sitio/
Purok City Province (Last Name, First Name, Name
Name Extension, Middle Name Extension, Middle Relationship
Extension, Middle Name)
Name) Name)
34
35
36
37
38
39
40

<=== TOTAL FEMALE

<=== COMBINED
Legend: List and Code of Indicators under REMARKS column
Beginning of the Prepared By:
Indicator Code Required Information Indicator Code Required Information REGISTERED Semester End of the Semester
Transferred T/O CCT Recipient CCT CCT Control/reference
Out number & Effectivity Date
Balik Aral B/A Name of school last attended MALE
Transferred In & Year
T/I Specify Exceptionality of the
Learner With LWE Learner Signature of Adviser over Printed Name
Name of School, Date of 1st Exceptionality Specify Level & Effectivity
Attendance and Date of Last Accelerated ACL Date FEMALE
Attendance if Transferred Out
Beginning of the Semester Date:
TOTAL

SFRT 2017
 Contact REMARKS
Number of (Please refer to the legend)
Parent/
Guardian

of Adviser over Printed Name

End of the Semester Date:

SFRT 2017
 School Form 2 Daily Attendance Report of Learners for Senior High School (SF2-SHS)

School Name SALAOAGAN NHS School ID 303810 District Dimataling Division ZAMBO. SUR Region 1X
Semester SECOND School Year 2018-2019 Grade Level 11 Track and Strand TVL

Section Topaz Course/s (only for TVL) Agri-Fisheries Month of

REMARKS
1. If No Longer in School
DATE (NLS), state reason, please
NAME Total for the Month refer to legend number. 2. If
No. (Last Name, First Name, Name TRANSFERRED IN/OUT,
write the name of School. 3. If
Extension, Middle Name)
M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F ABSENT TARDY SHIFTING IN/OUT, write the
name of
1 Track/Strand/Program).

2
3
4
5
6
7
<=== MALE | TOTAL Per Day
===>
1
2
3
4
5
6
7
8
9
<=== FEMALE | TOTAL Per Day ===>

Combined TOTAL Per Day

 1X
TVL

MARKS
nger in School
e reason, please
nd number. 2. If
RRED IN/OUT,
e of School. 3. If
N/OUT, write the
me of
and/Program).
 REMARKS
1. If No Longer in School
DATE (NLS), state reason, please
NAME Total for the Month refer to legend number. 2. If
No. (Last Name, First Name, Name TRANSFERRED IN/OUT,
write the name of School. 3. If
Extension, Middle Name)
M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F ABSENT TARDY SHIFTING IN/OUT, write the
name of
Track/Strand/Program).

GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month: No. of Days Summary

of Classes:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance (blank) - Present; (x) - Absent; Tardy (half M F
2. To compute the following: shaded = Upper for Late Comer, Lower for
Cutting Classes) * Enrolment (as of 1st Friday
of the semester)
2. REASONS/CAUSES FOR NO LONGER Late Enrolment during the month (beyond cut-off)
Registered Learners as of end
a. Percentage of Enrolment = Registered Learners as of end of the month x 100 IN SCHOOL (NLS) of the month
Percentage of Enrolment as of
Enrolment as of 1st Friday of the school year a. Domestic-Related Factors end of the month
Total Daily Attendance a.1. Had to take care of siblings Average Daily Attendance
b. Average Daily Attendance = a.2. Early marriage/pregnancy Percentage of Attendance for
Number of School Days in reporting month a.3. Parents' attitude toward schooling the month
a.4. Family problems Number of students absent for
Average daily attendance 5 consecutive days
c. Percentage of Attendance for the month = x 100
Registered Learners as of end of the month
b. Individual-Related Factors
3. Every end of the month, the Class Adviser will submit this form to the Office of the Principal for recording of summary table into b.1. Illness No Longer in School (NLS)
School Form 4. Once signed by the School Head, this form should be returned to the Class Adviser. b.2. Overage
4. The Class Adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent b.4. Drug Abuse
for 5 consecutive days and/or those at risk of dropping out. b.5. Poor Academic Performance Transferred Out
5. Attendance performance of learners will be reflected in the SF9-SHS of every grading period. b.6. Lack of Interest/Distractions
b.7. Hunger/Malnutrition Transferred In

Shifting Out

c. School-Related Factors Shifting In

c.1. Teacher Factor
c.2. Physical Condition of Classroom I certify that this report is true and correct:
c.3. Peer Influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. tribal wars & clan Signature of Class Adviser over Printed Name
feuds)
e. Financial-Related
e.1. Child labor, work Attested By:

f. Others (Specify) Signature of School Head over Printed Name

a. Death
b. Transferred to School Abroad
c. Transferred to International School
d. Transferred to ALS
MARKS
nger in School
e reason, please
nd number. 2. If
RRED IN/OUT,
e of School. 3. If
N/OUT, write the
me of
and/Program).

Summary
TOT
AL

eyond cut-off)

Printed Name

Printed Name
 School Form 3 Books Issued and Returned for Senior High School (SF3-SHS)
School Name School ID District Division

Semester School Year Grade Level Track and Strand

Section Course/s (only for TVL)

Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

No.
NAME
(Last Name, First Name, Name Extension,
Middle Name) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
TOTAL MALE ===>
1
2
3
4
5
6
7
8
9
10
11
12
13
14
3-SHS)
Region

/ ModuleTitle Book / ModuleTitle

REMARKS/ACTION TAKEN
(Please refer to the codes below)
(mm/dd/yy) Date (mm/dd/yy)
Returned Issued Returned
 Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

No.
NAME
(Last Name, First Name, Name Extension,
Middle Name) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
TOTAL FEMALE ===>
COMBINED ===>

GUIDELINES: In case of lost/unreturned books, please provide information with the following code:
Prepared By:
1. Title of Books Issued to each learner must be recorded by the Class Adviser. A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
2. The Date of Issuance and the Date of Return shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code
3. The Total Number of Copies issued shall be reflected in the form. FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian (for code
4. The Total Number of Copies of Books Returned shall be reflected in the form. TDO), PTL=Paid by the Learner (for code NEG). References: DO No.23, s.2001, DO No.25, s.2003, DO No.14, s.2012.
5. All textbooks being used must be included. Additional copies of this form may be used if needed.

Signature of Class A
/ ModuleTitle Book / ModuleTitle

REMARKS/ACTION TAKEN
(Please refer to the codes below)
(mm/dd/yy) Date (mm/dd/yy)
Returned Issued Returned

ature of Class Adviser over Printed Name

 School Form 4 Monthly Learners' Movement and Attendance for Senior High School (SF4

School Name District Division Region

School ID Semester School Year

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN SHIFTED O

REGISTERED
LEARNERS (A) (A+B) (A) (A+B) (A) (A+B) (A)
TRACK STRAND (As of End Daily % for the Cumulative (B) Total for Cumulative Cumulative (B) Total for Cumulative Cumulative (B) Total for Cumulative Cumulative (B) Total fo
of the Month) Average Month Number as the Month Number as of Number as the Month Number as Number as the Month Number as of Number as the Month
of Previous End of the of Previous of End of the of Previous End of the of Previous
Month Month Month Month Month Month Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M

TOTAL FOR GRADE 11

TOTAL FOR GRADE 12

GRAND TOTAL

Prepared and Submitted By:

Signature of School Head over Printed Name

ol (SF4-SHS)

Region

For the Month of

SHIFTED OUT SHIFTED IN

(A+B) (A) (A+B)

Cumulative Cumulative (B) Total for Cumulative
(B) Total for Number
the Month as of Number as Number as of
End of the of Previous the Month End of the
Month Month Month

F T M F T M F T M F T M F T
 School Form 5A End of Semester and School Year Status of Learners for Senior High School (SF5A-SH

School Name School ID District

Semester School Year Grade Level

Track and Strand Course/s (only for TVL)

BACK SUBJECT/S END OF END OF SCHOOL

No. LRN LEARNER'S NAME List down subjects where learner obtained a rating SEMESTER
(Last Name, First Name, Name Extension, Middle Name) STATUS YEAR STATUS
below 75%) (Complete/ Incomplete)
(Regular/ Irregular)

MALE

FEMALE

Prepared By:

Certified Correct By:

 BACK SUBJECT/S END OF END OF SCHOOL
No. LRN LEARNER'S NAME List down subjects where learner obtained a rating SEMESTER
(Last Name, First Name, Name Extension, Middle Name) STATUS YEAR STATUS
below 75%) (Complete/ Incomplete)
(Regular/ Irregular)

Reviewed By:

GUIDELINES:

This form shall be accomplished after each semester in a school year, leaving the End of School Year Status Column and Summary Table for End of School Year Status blank/unfilled at the end of the 1st Semeste
data elements shall be filled up only after the 2nd semester or at the end of the School Year.

INDICATORS:
End of Semester Status
Complete - number of learners who completed/satisfied the requirements in all subject areas (with grade of at least 75%)
Incomplete - number of learners who did not meet expectations in one or more subject areas, regardless of number of subjects failed (with grade less than 75%)
Note: Do not include learners who are No Longer in School (NLS)

End of School Year Status

Regular - number of learners who completed/satisfied requirements in all subject areas both in the 1st and 2nd semester
Irregular - number of learners who were not able to satisfy/complete requirements in one or both semesters
chool (SF5A-SHS)

Division Region

Section

SUMMARY TABLE 1ST SEM

STATUS MALE FEMALE TOTAL

COMPLETE

INCOMPLETE

TOTAL

SUMMARY TABLE 2ND SEM

STATUS MALE FEMALE TOTAL

COMPLETE

INCOMPLETE

TOTAL

SUMMARY TABLE (End of the School Year Only)

STATUS MALE FEMALE TOTAL

REGULAR

IRREGULAR

TOTAL

repared By:

Signature of Class Adviser over Printed Name

Certified Correct By:

Signature of School Head over Printed Name

Reviewed By:

Signature of Division Representative over Printed Name

he end of the 1st Semester. These

 School Form 5B List of Learners with Complete SHS Requirements (SF5B-SHS)
School Name School ID District Division Region
Semester School Year Section
Track and Strand Course/s (only for TVL)

Completed SHS in
2 SYs? (Y/N)
National
LRN LEARNER'S FULL NAME Certification Level
No. (Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)

MALE

SUMMARY TABLE A
STATUS MALE FEMALE TOTAL

Learners who
completed SHS
Program within 2
SYs or 4
semesters

Learners who
completed SHS
Program in more
than 2 SYs or 4
semesters

TOTAL

SUMMARY TABLE B
STATUS MALE FEMALE TOTAL
NC III
NC II
NC I
TOTAL

Note: NCs are recorded here for documentation but is not a requirement for
graduation.
 Completed SHS in
2 SYs? (Y/N)
National
LRN LEARNER'S FULL NAME Certification Level
No. (Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)

Note: NCs are recorded here for documentation but is not a requirement for
graduation.

GUIDELINES:

1. This form should be accomplished by the Class Adviser at End of School

Year.
2. It should be compiled and checked by the School Head and
passed to the Division Office before graduation.

FEMALE
Reviewed By:

Signature of Class Adviser over Printed Name

Certified Correct & Submitted By:

Signature of School Head over Printed Name

Reviewed By:

Signature of Division Representative over Printed Name

 Completed SHS in
2 SYs? (Y/N)
National
LRN LEARNER'S FULL NAME Certification Level
No. (Last Name, First Name, Name Extension, Middle Name) Attained
(only if applicable)
 School Form 6 Summarized Report of Learner Status as of End of Semester and School Year for Senior High School (SF6-SHS

School Name School ID District Division

Semester School Year

END OF SEMESTER STATUS END OF SCHOOL YEAR

(Fill up only at the end of the second se

GRADE LEVEL
COMPLETE INCOMPLETE TOTAL REGULAR IRREGULAR

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE

GRADE 11
TRACK/STRAND/COURSE

SUB TOTAL
GRADE 12
TRACK/STRAND/COURSE

SUB TOTAL
TOTAL

Prepared and Submitted By: Reviewed & Validated By: Noted By:
Signature of School Head over Printed Name Signature of Division Representative over Printed Name Signature of Divisio
GUIDELINES:
1. After receiving and validating the report on Status of Learners submitted by the Class Adviser, the School Head shall compute the grade level total per track/strand/course and school t
2. This report shall be forwarded to the Division Office by the end of the semester.
3. Column for End of School Year shall be accomplished at the end of SY or every after the 2nd semester
4. Protocols of validation & submission are under the discretion of the Schools Division Superintendent.
(SF6-SHS)

Region

OOL YEAR
the second semester.)

ULAR TOTAL

TOTAL MALE FEMALE TOTAL

ature of Division Superintendent over Printed Name

e and school total.

 School Form 7 School Personnel Basic Profile and Assignment for Senior High School (SF7-SHS)
School Name School ID District Division
Semester School Year
(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non-Teaching Items (C ) Other Appointments and Funding

Title of Designation Appointment:

Title of Plantilla Position Number of Title of Plantilla Position Number of (as it appears in the contract/document: (Contractual,
(as it appears in the appointment Incumbent (as it appears in the appointment Incumbent Teacher, Clerk, Security Guard, Driver etc.) Substitute,
document/PSIPOP) document/PSIPOP) Volunteer, Others
specify)

EDUCATIONAL QUALIFICATION Daily Program (time

Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/ Employment Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Major/ Class & Other Ancillary (Enumerate DAY
Number - Position, Descending) Source Designation (Regular/ Degree/ Specialization/ Assignments sections From
T.I.N.) Postgraduate Specialized Minor taught) (M/T/W/T (00:00)
Probationary/ H/F)
Part Time) Training Attended

First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Da
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Da
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Da
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Da
First Semester:
 EDUCATIONAL QUALIFICATION Daily Program (time
Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/ Employment Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Major/ Class & Other Ancillary (Enumerate DAY
Number - Position, Descending) Source Designation (Regular/ Degree/ Specialization/ Assignments sections From
T.I.N.) Postgraduate Specialized Minor taught) (M/T/W/T (00:00)
Probationary/ H/F)
Part Time) Training Attended

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Da
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave. Minutes per Da

GUIDELINES:
1. This form shall be accomplished at the beginning of each semester by the School Head and is submitted to the Division Office. In case of movement of teachers and other
personnel during the semester, an updated SHSF-7 must be submitted to the Division Office at the end of the semester.
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank to the lowest. Sig
3. Please reflect subjects being taught including advisory class or ancillary assignment (if any). Other administrative duties must also be reported.
4. Daily Program Column is for teaching personnel only. Updated as of:
F7-SHS)
Region

nd Funding Sources

Number of Incumbent
Fund Source
(SEF, PTA,
NGO's etc.)
Teaching Non-Teaching

Remarks:
ogram (time duration) *For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
*For additional loads from
Total Actual JHS- please indicate the number
To Teaching of teaching minutes per week)
(00:00) Minutes per
Week

e. Minutes per Day

e. Minutes per Day

e. Minutes per Day

e. Minutes per Day

 Remarks:
ogram (time duration) *For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
*For additional loads from
Total Actual JHS- please indicate the number
To Teaching of teaching minutes per week)
(00:00) Minutes per
Week

e. Minutes per Day

e. Minutes per Day

Signature of School Head over Printed Name

ated as of:

School Form 7, Page ___ of ________

SF 8
Department of Education
School Form 8 Learner's Basic Health and Nutrition Report for Senior High School (SF8-SHS)
(For All Grade Levels)
School Name SALOAGAN NHS District DIMATALING DivisionZAMBOANGA DEL SUR Region IX

School ID 303810 Grade Section TOPAZ Track/Strand (SHS)AGRI-FISHERY ARTSchool Year 2018-2019
Nutritional Status
Learner's Name Birthdate Height for
No. LRN (Last Name, First (MM/DD/ Age Weight Height Height² Age Remarks
Name, Name Extension, (kg) (m) (m²) BMI BMI
Middle Name) YYYY) (kg/m²) Category (HFA)

MALE
1 124942060003 Biala, Jimboy A. 30-Nov-99 19 3 79 1.79 3.2041 24.60 Normal Adult
2 124949070015 Datuoto, Jaynor P. 7/18/2001 17 7 59 1.68 2.8224 20.90 Normal Normal
3 124942070010 Gaya, Narding A. 7-Dec-97 21 2 56 1.7 2.8900 19.30 Normal Adult
4 125689070014 Husin, Norhadin L. 21-Jul-00 18 7 55 1.62 2.6244 20.90 Normal Normal
5 124949070033 Mayad, Jimboy A. 25-Mar-01 17 11 45 1.6 2.5600 17.50 Normal Stunted
6 124949070039 Musa, Benladin M. 12-Dec-01 17 2 60 1.76 3.0976 19.30 Normal Normal
7 303810100037 Tuwawa, Niekieven A. 11-Oct-97 21 4 51 1.65 2.7225 18.70 Normal

FEMALE
1 124949070008 Bantas, Amsia M. 15-Oct-98 20 4 43 1.48 2.1904 19.60 Normal Adult
2 124949070009 Bantas, AsmaM. 15-Aug-01 17 6 42 1.48 2.1904 19.10 Normal Stunted
3 124949070013 Culasito, Jhensen P. 19-Jan-02 17 1 48 1.6 2.5600 18.70 Normal Normal
4 124949070041 Musa, Norronisa K. 5-Mar-01 17 11 58 1.67 2.7889 20.70 Normal Normal
5 124949050041 Paalisbo, Jeceil Ann G. 16-Nov-99 19 3 49 1.54 2.3716 20.60 Normal Adult
6 124949070045 Pangulima, Salasia D. 5-Dec-00 18 2 43 1.48 2.1904 19.60 Normal Stunted
7 124949070048 Salupan, Chelame C. 24-Nov-01 17 3 42 1.45 2.1025 19.90 Normal Stunted

SUMMARY TABLE

Nutritional Status Height for Age (HFA)

Summary Table Severel Summary Table
SEX Severely
Wasted Wasted Normal Overweight Obese TOTAL y Stunted Normal Tall Total
Stunted
MALE 0 0 7 0 0 0 7 0 1 6 0 7
FEMALE 0 0 7 0 0 0 7 0 3 4 0 7
TOTAL 0 0 14 0 0 0 14 0 4 10 0 14

Date of Assessment: Conducted/Assessed By: Certified Correct By: Reviewed By:

SFRT 2017

SFRT 2017