Adoption of School Forms For Kindergarten To Grade 6
Adoption of School Forms For Kindergarten To Grade 6
School ID 104795 Re gion III Divis ion Bulac an Dis trict Bus tos
Gra de
Sc hool Name Tibagan Ele me nta ry School School Yea r 2019 - 2020 Kinder Se c tion ALITAPTAP
Leve l
A G E M O THE G U A R D IA N C o nt a c t
as A D D R ES S P A R EN TS R EM A R KS
R ( if N o t P a re nt ) N umb e r
Sex (M/F)
NAME B IR TH D A TE of TO N G U IP of
R ELIG I M o t he r' s
LR N ( La s t N a me , F irs t N a me , ( mm/ d d / y y y y 1s t E ( Et hni c Ho us e # / F a t he r' s N a me P a re nt
ON M a id e n N a me ( P le a s e re f e r
M id d le N a me ) ) F rid ( G ra d e G ro up ) S t re e t /
B a ra ng a y
M unic i p a l it
P ro v inc e
( La s t N a me ,
N a me
R e la t io ns or
( La s t N a me , t o t he le g e nd
ay 1 to 3 S it io / y/ C it y F irs t N a me , hip G ua rd ia
F irs t N a me , o n la s t p a g e )
J une O nl y ) P uro k M id d l e N a me ) n
M id d l e N a me )
AB LEN, R EM ALLA,J O
AB LEN,R ENZ J OVEN, C hris tia
104795190001 M 05-31-2014 5 Ta ga lo g TIB AGAN B US TOS B ULAC AN R AVEN LEE C ELYN,B OLIM
R EM ALLA nity
C R UZ A,
ANGELES ,J HO
C hris tia
104795190002 ANGELES ,TR IS TAN J OHN, - M 01-16-2014 5 Ta ga lo g
nity
TIB AGAN B US TOS B ULAC AN NA
09157011107
M AE,S ANTOS ,
DE LEON, S TA
C hris tia B ONGA
104795190003 DE LEON,INO, S TA. M AR IA M 08-06-2014 4 Ta ga lo g B US TOS B ULAC AN R ES TYS ONIO M AR IA,M YLIN
nity M AYOR
EVANGELIS TA E,M ALLAR I,
DE LEON,
C hris tia LIWAG,EF RES I
104795190004 DE LEON,M AR K DAVID, LIWAG M 04-06-2014 5 Ta ga lo g TIB AGAN B US TOS B ULAC AN M ILLION
nity LA,B UC O,
F ER NANDEZ
DEL R OS AR IO,
DEL R OS AR IO,J HON ALB ER T, C hris tia VILLEGAS ,VIN
104795190005 M 05-21-2014 5 Ta ga lo g TIB AGAN B US TOS B ULAC AN ALB ER TO
VILLEGAS nity A,C ALIHAN,
ZOLETA
B OQUER O,C R I
C hris tia DOR OJ A, T/I DATE:2019-
104716180001 DOR OJ A,ANDR E, B OQUER O M 10-07-2012 6 Ta ga lo g TIB AGAN B US TOS B ULAC AN S TELYN,ANOL
nity AR IEL OLI 06-03
,
T/ I N a me o f P ub li c ( P ) P ri v a t e ( P R ) S c ho o l B a l ik A ra l B / A N a me o f s c ho o l l a s t a t t e nd e d & Y e a r
Tra ns f e re d In & Ef f e c t iv i t y D a t e
Le a rne r W i t h LW S p e c if y
DR R e a s o n a nd Ef f e c t i v it y D a t e D i s a b il i t y D
D ro p p e d P R e a s o n ( Enro l lme nt b e y o nd 1s t F ri d a y A c c e l e ra t e d S p e c if y Le v e l & Ef f e c t i v i t y D a t a
La t e LE o f J une ) AC
R EG IS TER P re p a re d b y ; C e rt i f i e d C o rre c t :
Bo SY Eo S Y
ED
J OCELYN PRINCIPIO BELTRAN
M A LE 12 12 DOLORES O. GATUZ
CITADEL BITANGCOL BAUTISTA ( S ig na t ure o f S c ho o l He a d o v e r
( S ig na t ure o f A d v is e r o v e r P ri nt e d P ri nt e d N a me )
F EM A LE 10 10 N a me )
06/03/2019 04/03/2020
B o S Y Dat e : Eo S Y D a t e :
TO TA L 22 22 06/03/2019 04/03/2020
B o S Y D at e : Eo S Y D a t e :
RESTYSONIO E. DE LEON
G e ne ra t e d t hru LIS
SF 2
Daily Attendance Report of Learners
Data in blue circles are School Form 2 (SF2) Daily Attendance Report of Learners
generated from LIS (This re plac e s Form 1, Form 2 & S TS Form 4 - Abse nt e e ism and Dropout P rof ile )
R e gist e re d Le arne rs as of
e nd o f m o nt h
12 10 22
P e rc e nt age of Enrolm e nt as of Registered learners as of end of month
100% 100% 100% x100
e nd o f m o nt h Enrolment as of 1st Friday of June
A v e rage Daily A t t e ndanc e Registered Learners as of end of the month x No. of days - total absences
11.74 9.95 21.68
No. of Days
Dro pp e d o ut 0 0 0
Tr a n s f e r r e d o u t 0 0 0
Tr a n s f e r r e d i n 0 0 0
SF 3
Books Issued and
School Form 3 (SF3) Books Is s ued and Returned
(This re plac e s Form 1 & Inv e nt ory of Te x t book s)
Scho o l Name Tibaga n Eleme ntary School Grad e Level Kinde r Sectio n ALITAPTAP
Mga Kas anayan Para s a S ubje c t Are a & Tit le S ubje c t Are a & S ubje c t Are a & Tit le S ubje c t Are a & S ubje c t Are a & S ubje c t Are a & S ubje c t A re a & Tit le S ubje c t Are a & Tit le S ubje c t Are a &
Tit le Tit le Tit le Tit le Tit le
Kahandaan s a Pagk atuto,
NAME R E MA R KS/ A C T ION
N Mga Pags as anay s a
Araling
T A KE N (P l e a s e r e f e r
( La s t N a m e , F irs t N a m e ,
o.
M id d le N a m e ) Tagalog Filipino English Math Science Panlipunan
EPP MAPEH to the l e ge nd on l a s t
page )
Dat e Dat e Date Date Date Dat e Dat e Dat e Date Dat e
Issue d Re t urne d Issue d Re t urne d Issue d Re t urne d Issue d Re t urne d Issue d Re t urne d Issue d Re t urne d Issue d Re t urne d Issue d Re t urne d Issue d Re t urne d Issue d Re t urne d
AB LEN,R ENZ J OVEN,
1.
R EM ALLA 6/3/2019 4/3/2020
2. ANGELES,TR IS TAN J OHN, -
M ALTO,NATHAN J AC OB ,
10.
C OR TES
S ANTOS ,J AZ EAR L, S AN
11.
P EDR O
S ANTOS ,J OS EP H DAYNE,
12.
B ER NAR DINO
<=== TOTAL F OR M ALE |
12.
TOTAL C OP IES ===> 12 12
AR C EGA,KIM J ANINE,
1.
LOR ITO FM LLTR
B AGS IC ,M IC KA LEI,
2.
M AR QUEZ
B UC O,LEENETH ALIS ON,
3.
GATC HALIAN TDO TLTR
ILAGAN,J HAM ILLE J ADE,
4.
DAQUIZ
R OYOL,S OP HIA C LOEYY,
5.
ANGELES
S ANTOS ,ALES S IA R HIANNA,
6.
DELA C R UZ NEG PTL
S ER ENIO,ALYANNA, NIC A
7.
VER A
S UM ALINOG,J OALLAINE
8.
J ANE, LAC S AM ANA
TIU,J EAN M AR GAR ETTE,
9.
C R UZ
VILLAR AM A,R HIAN LEI,
10.
S ANTOS
<=== TOTAL F OR F EM ALE |
10.
TOTAL C OP IES ===> 10 7
22.
<=== TOTAL LEAR NER S |
TOTAL C OP IES ===> 22 19
In c a s e o f lo s t / u n re t u rn e d b o o k s , p le a s e p ro v id e in f o rm a t io n wit h P re p a re d B y:
G UID E LIN E S :
t h e f o llo win g c o d e :
1. Title o f Bo o ks Is s ued to each learner mus t b e reco rd ed b y the clas s ad vis er. A. In Co lumn Date Returned , co d es are: FM =Fo rce M ajeure, TDO: Trans ferred /Dro p o ut ,
2 . The Date o f Is s uance and t he Dat e o f Ret urn s hall b e reflected in t he fo rm. NEG=Neg lig ence CITADEL BITANGCOL BAUTIS TA
3 . The To tal Numb er o f Co p ies is s ued at Bo SY s hall b e reflected in the fo rm. B. In Co lumn Remark/ Actio n Taken, co d es are: LLTR=Secured Lett er fro m Learner d uly s ig ned b y (Sig nature o f Ad vis er o ver Print ed Name)
4 . The To tal Numb er o f Co p ies o f Bo o ks Ret urned at the Eo SYs hall b e reflected in the fo rm. p arent /g uard ian (fo r co d e FM ), TLTR=Teacher p rep ared letter/rep o rt d uly no ted b y Scho o l
5. All t extb o o ks b eing us ed mus t b e includ ed . Ad d it io nal co p ies o f this fo rm may b e us ed if need ed . Head fo r s ub mis s io n to Scho o l Pro p erty Cus t o d ian (fo r co d e TDO), PTL=Paid b y the Learner
(fo r co d e NEG). References : DO# 2 3 , s .2 0 0 1, DO# 2 5, s .2 0 0 3 , DO# 14 , 2 .2 0 12 . RESTYSONIO E. DE LEON
G e ne ra t e d t hru LIS
Da te o f B o S Y:___/___/_____ Da te o f Eo S Y: ___/___/_____
06/03/2019
04/03/2020
SF 4
Monthly Learners
Movement & Attendance
School Form 4 (SF4) Monthly Learner's Movement and Attendance
(This replaces Form 3 & STS Form 4-Absenteeism and Dropout Profile)
School Name Tibagan Elementary School School Year 2019-2020 Report for the Month of January
MALE G R A D E O N E R EA D Y 14 12 26
3 104795180003 DE LEON,NIO STA MARIA 111 AD GR ADE ONE R EADY LEVEL OF PROFICIENCY
4 104795180004 ESTEBAN,CYRUS PAUL ALEJANDRINO 114 AD GR ADE ONE R EADY D e s c rip t o r &
G ra d in g MALE FEMALE TOTAL
5 104795180005 GARCIA,JAMES GENES IS GRIPON 105 AD GR ADE ONE R EADY S c a le
Sug g es t Hig hly Ad vanced
6 104795180006 MAGNO,JAY VIVEN GRIMALDO 105 AD GR ADE ONE R EADY Develo p ment - SHAD (13 0 0 0 0
and ab o ve)
7 104795180007 MARQUEZ,WAYNE STEPHEN DELA CRUZ 117 AD GR ADE ONE R EADY Sug g es t Slig ht Ad vanced
Develo p ment - SSAD (12 0 - 0 0 0
8 104795180008 PANIGBATAN,JAYLORD FORBES 117 AD GR ADE ONE R EADY 12 9 )
10 104795180010 QUIMSON,JOHN MATTHEW CARPIO 111 AD GR ADE ONE R EADY Sug g es t Slig ht Delay in
Overall Develo p ment - 0 0 0
11 104795180011 RAMOS ,NOAH GAVRIE GUANSING 117 AD GR ADE ONE R EADY SSIDOD (70 -79 )
15 104795180015 AUGUIS,ALLIYA SHANE PADUA 117 AD GR ADE ONE R EADY REVIEWED BY:
16 104795180016 AUSTRIA,PAULA MAY ANZANO 105 AD GR ADE ONE R EADY JAY ARR V. SANGOYO Ph. D.
(Name and S ignature )
17 104795180017 ESTEBAN,TRIXIE CELINE SANTOS 108 AD GR ADE ONE R EADY Divis ion R e pre s e ntative
18 104795180018 HERNANDEZ,JATHINA LYNELLE SAN ANTONIO 114 AD GR ADE ONE R EADY RESTYSONIO E. DE LEON
G e n e ra t e d t h ru LIS
19 104795180026 LOPEZ,JAMAICA LOPEZ 117 AD GR ADE ONE R EADY
GUIDELINES :
20 104795180019 MANGAHAS,CHARISSA MAEY LIWAG 117 AD GR ADE ONE R EADY
1. 1. Do no t inc lude Dro po uts and T rans fe rre d Out (D.O.4,
2014)
21 104795180020 MAPOY,AYANA LOURIZ GUEVARRA 117 AD GR ADE ONE R EADY
2. 2. T his s ho ud be pre pare d by A dv is e r. P o s t T e s t
S tandard S c o re s ho ud be tak e n fro m the re c o rd s ubm itte d
22 104795180021 PLAMENCO,ROSELYN MAE MARQUEZ 94 AD GR ADE ONE R EADY
to the Div is io n Offic e .
3. 3. T he s um m ary table s ho ud re fle c t the to tal num be r o f
23 104795180022 REYES,GINELLE RAYMUNDO 105 AD GR ADE ONE R EADY le arne rs . Fo r GR A DE ON E R EA DY , S um m ativ e A s s e s m e nt
S tandard S c o re m us t be 80 and abo v e , while N EEDS
24 104795180023 SALAYSAY,JADE NICOLE FAUSTINO 116 AD GR ADE ONE R EADY FUR T HER IN T ER VEN T ION m us t be 79 and be lo w.
4. P ro to c o ls o f v alidatio n & s ubm is s io n is unde r the
25 104795180024 SANTOS,KIARA LEI SERPA JUAN 108 AD GR ADE ONE R EADY dis c re tio n o f the S c ho o ls Div is io n S upe rinte nde nt.
5. T E - T e m po rary Enro lle d
26 104795180025 VALERIO,RALAINE ANNE ESPIRITU 117 AD GR ADE ONE R EADY
26 <=== COMBINED
S c h o o l Fo rm 5 (S F 5) Re po rt o n Pro mo tio n an d Le ve l o f Pro fic ie n c y & Ac h ie ve me n t
(T his re plac e s Fo rm s 18-E1, 18-E2, 18A and Lis t o f G raduate s )
S UMMARY TABLE
Did Not Me e t
ACTION TAKEN: Expe c ta tions of the ff.
LEARNER'S NAME GENERAL
LRN PROMOTED, CONDITIONAL Le a rning Are a /s a s of S TATUS MALE FEMALE TOTAL
(Las t Na m e , Firs t Na m e , Middle Na m e ) AVERAGE
o r RETAINED e nd of c urre nt
S c hool Ye a r
PROMOTED 19 20 39
MALE
C O N D IT IO N A LLY
P R O M O T ED
0 0 0
1 0 47 9 51 2 0 1 9 9 AR IZAP A,AC E J OMEL C R IS TOBAL 8 6 P R OMOTED
3 9 <=== COMBINED
PREPARED BY:
GRADE 1 /GRADE 7 GRADE 2 / GRADE 8 GRADE 3 / GRADE 9 GRADE 4 / GRADE 10 GRADE 5 / GRADE 11 GRADE 6 / GRADE 12 TOTA L
SUMMARY TABLE
MALE FEMALE T OTAL MALE FEMALE T OT AL MALE FEMALE T OT AL MALE FEMALE T OTAL MALE FEMALE T OTAL MALE FEMALE T OT AL MALE FEMALE T OTAL
PROMOTED
CONDITIONAL
RETA INED
L EARNING PROGRESS &
ACHIEVEMENT (based o n MALE FEMALE T OTAL MALE FEMALE T OT AL MALE FEMALE T OT AL MALE FEMALE T OTAL MALE FEMALE T OTAL MALE FEMALE T OT AL MALE FEMALE T OTAL
L earn ers' Gen eral Average)
Fairly Satisfacto ry
( 75-79)
Satisfactory
( 80-84)
Very Satisfactory
( 85-89)
Ou tstand ing
(90-100)
TOTA L
Prepared and Submitted by: Reviewed & Validated by: Noted by:
SCHOOL HEAD DIVISION REPRESENTAT IVE SCHOOLS DIVISION SUPERINT ENDENT
GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the grade level total and school total.
2. T his report together with the copy of Report for Promotion submitted by the class adviser shall be forwarded to the Division Office by the end of the school year.
3. T he Report on Promotion per grade level is reflected in the End of School Year Report of GESP/GSSP.
4. Protocols of validation & submission is under the discretion of the Schools Division Superintendent.
Sc ho o l Fo rm 6 (SF6)
Summarize d Re port o n Pro mo tion and Le arning Pro g re s s & Ac hie ve me nt
S chool ID 104795 Re gion III Divis ion Bula ca n
S chool Na m e Tiba ga n Ele m e nta ry S chool Dis trict Bus tos S chool Ye a r 2019-2020
2018-2019
P ROMOTED 60 58 118 63 54 117 76 58 134 82 59 137 72 59 141 72 73 145 78 60 138 503 421 924
CONDITIONAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
RETAINED 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
S a t isfa c t ory
60 58 118 53 43 96 70 44 114 74 47 121 39 42 81 52 43 58 35 406 312 443
(80%-84%)
Out st a nding
0 0 0 4 3 7 3 0 3 4 4 8 2 1 3 5 2 4 7 22 17 40
(90%-100%)
DOLORES
DOORES O.
O. GATUZ
GATUZ JAY ARR V. SANGOYO Ph. D. GERMILINA H. PASCUAL,
ZENIA G. MOSTOLES CESO
Ed. D., CESO V V RESTYSONIO
RES TYS ONIO E.E.DE
DELEON
LEON
(S igna ture o f S c ho o l He a d o ve r P rinte d Na m e ) DIVIS ION R EP R ES ENTATIVE S C HOOL DIVIS ION S UP ER INTENDENT Ge ne ra te d thru LIS
SF 7
School Personnel
Assignment List and
Basic Profile
School Form 7 (SF7) School Personnel Assignment List and Basic Profile
(This replaced Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)
School Name Tibagan Elementary School District Bustos School Year 2019-2020
Department of Education
School Form 8 Learner's Basic Health and Nutrition Report (SF8)
(For All Grade Levels)
15.13
Date of Weighing Name of Class Adviser Name of School Head District Nutrition Coordinator
Reminders for SF 8:
1. Data to be filled out should be written properly EXCEPT for SECTION
2. LRN, Learner’s Name, and Birthdate must be copied from SF 1
3. You may adjust the size of columns or rows if needed
How to download
forms from LIS
Select form to be
downloaded
for other forms
Select form to be
downloaded
LEARNER’S PROGRESS
REPORT CARD
( SF-9 ES )
SF9 Guidelines
The Progress Report Card was renamed to
Learner’s Progress Report Card or SF9
(DO 58 s. 2017)
The format and content as prescribed in
DO 8 s. 2015 will still be adopted
Beginning SY 2018-2019 , the arrangement of
learner’s name must follow the format in SF5
( DO 11 s. 2018 )
PROPER
FORMAT
MALE
ALL
CAPS
NAME OF
TEACHER
NAME OF ( ALL CAPS )
SCHOOL
HEAD
PASSED 1. grades in the
PASSED different subject
PASSED areas should be
PASSED placed at the center
PASSED
PASSED
(all caps)
In case of
PA
SSE
P
A
SS
P
A
S
S
PASSE
D
dropped
D E
PA E
PAS
PA
D
SSE D
SE PASSED
SS
D ED D
PA
SSE
D
Dropped
PASSED PASSED PASSED
PA
SSE
(Reason)
PASSED PASSED PASSED
D
(Date)
PA
PASSED PASSED
SSE PASSED
D
PA PAS
PA
SS PAS SED
SSE
E SED
D
D
PA PA PASSE PASSE
SSE SS D D
D ED
PA PA PASSE
SSE SS D
D ED
PA PA
SSE PASSE
SS D
D ED
PA PA PASSE
SSE SS
P D
D ED
PA A
PASS
SSE S PASSED
P ED
D S
A
PA E PA
S PASSED
SSE D SSE
S
D D
E PA
D SSE PASSED
D
Other Reminders for SF9
*The ES where the learner completed elementary level shall keep the original
copy of SF10-ES
*Any erasures or alterations on the document should be validated and bear the signature
of the School Head in ink.
*The SF10-ES shall be printed using ordinary legal size bond paper (8.5x13)
HOW TO FILL OUT
SF10- ES
SF10-ES Republic of the Philippines
Department of Education
Learner's Permanent Academic Record for Elementary School
(SF10-ES)
LEARNER'S PERSONAL INFORMATION
LAST NAME: FERNANDEZ FIRST NAME: JAMIE ELISHA NAME EXTN. (Jr,I,II) MIDDLE NAME: LOPEZ
Mathematics 81 80 82 83 82 PASSED
Science
Araling Panlipunan 82 84 86 88 85 PASSED
EPP / TLE
MAPEH 80 81 82 84 82 PASSED
Music 80 81 82 83 82 PASSED
Arts 80 81 83 85 82 PASSED
Health 80 81 84 85 83 PASSED
*Arabic Language
*Islamic Values Education
General Average 83 83 84 85 84 PASSED
School: Tibagan Elementary School School ID: 104795 School: San Pedro Elementary School School ID: 104793
In District: Bustos Division: Bulacan Region: III District: Bustos Division: Bulacan Region: III
cases Classified as Grade: 2 Section: Charity School Year: 2018-2019 Classified as Grade: 2 Section: Matapat School Year: 2018-2019
of Name of Adviser/Teacher: Gloria V. Raya Signature: Name of Adviser/Teacher: Sheila F. Mendoza Signature:
Quarterly Rating Final Quarterly Rating
transfer Learning Areas
1 2 3 4 Rating
Remarks Learning Areas
1 2 3 4
Final
Rating
Remarks
Mother Tongue 83
Mother Tongue 83 85 86 87 85 PASSED
Filipino 85
Filipino 85 86 87 88 87 PASSED
English 82
PASSED
English 82 84 85 86 84
Mathematics 85
PASSED
Transferred Out Mathematics 85 87 88 88 87
Science TRANSFERRED OUT
Masagana ES Science
85 August 30, 2018
Araling Panlipunan 104785 Araling Panlipunan 85 85 86 87 86 PASSED
Music 81 PASSED
Music 81 83 84 85
Arts 82 PASSED
Arts 82 82 84 86
Physical Education 84 PASSED
Physical Education 84 84 86 87
Health 85 PASSED
Health 85 86 87 88
Eduk. sa Pagpapakatao 88 90 PASSED
Eduk. sa Pagpapakatao 88 89 90 92
*Arabic Language *Arabic Language
*Islamic Values Education *Islamic Values Education
General Average 84 General Average 84 86 87 88 86 PASSED
For Transfer Out /Elementary School Completer Only
CERTIFICATION
I CERTIFY that this is a true record of Jamie Elisha L. Fernandez with LRN 104795201274 and that he/she is eligible for admission to Grade ____2____.
School Name: Tibagan Elementary School School ID 104795 Division: _Bulacan__________ Last School Year Attended: __2018-2019_______________
Date Name of Principal/School Head over Printed Name (Affix School Seal here)
important
For form 137 indicate the honors received
at the top part of the DepEd seal
WITH HONORS
(MAY KARANGALAN)
Thank you!
09334917272 Dr. Jay-Arr
09754311464 ™ Dr. JAY ARR
09550892410 Joan
How to Compute Age
Age = date of weighing – child’s date of birth
(YYYY/MM/DD) (YYYY/MM/DD)
Example: Example: 12
12 + 30
2017 2017 +
+ 1
2018 02 23 2018 02 23
2012 05 08 2011 10 27
5 9 15 6 3 26
DONE
DONE
DONE