FORM 137-E

Republika ng Pilipinas
(Republic of the Philippines)
Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYON ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)
Rehiyon: _3______
(Region)
PALAGIANG TALAAN SA MABABANG PAARALAN
(Elementary School Permanent Record) LRN:_105424150055__

Pangalan: _Delos Reyes_______Kris Ann____ C______ Sangay: _Tarlac Province Paaralan: _Masalasa Elem.School________
(Name) Apelyido Unang Pangalan M.I. (Division) (School)

Kasarian: _Babae Petsa ng Kapanganakan: _11/ 13/2009_Pook: __Victoria,Tarlac_ Petsa ng Pagpasok: _06/01/2015______
(Sex) (Date of Birth) (Place) Bayan/lalawigan/Lungsod (Date of Entrance)
(Town/Province/City)
Magulang/Tagapag-alaga:___________ Romeo__________________ Masalasa,Victoria,Tarlac_____Housekeeper__________
(Parent/Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

PAG-UNLAD SA MABABANG PAARALAN

(Elementary School Progress)

Eligible for Admission to Grade______________________________________________

Grade I-School_________________________________________________________________
School Year__________________________________________________________________ Grade II-School________________________________________________________________
Periodic Rating School Year__________________________________________________________________
LEARNING AREAS Remarks
1 2 3 4 Periodic Rating
Mother Tongue LEARNING AREAS Remarks
1 2 3 4
Filipino Mother Tongue
English Filipino
Mathematics English
Araling Panlipunan (AP) Mathematics
MAPEH Araling Panlipunan (AP)
Music MAPEH
Art Music
Physical Education (PE) Art
Health Physical Education (PE)
Edukasyon sa Pagpapakatao (EsP) Health
General Average Edukasyon sa Pagpapakatao (EsP)
Eligible for Admission to Grade______________________________________________ General Average
Eligible for Admission to Grade______________________________________________
Grade III-School______________________________________________________________
School Year__________________________________________________________________
Grade IV-School_______________________________________________________________
Periodic Rating School Year__________________________________________________________________
LEARNING AREAS Remarks
1 2 3 4 Periodic Rating
Mother Tongue LEARNING AREAS Remarks
1 2 3 4
Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan (AP) Araling Panlipunan (AP)
MAPEH Edukasyon sa Pagpapakatao (EsP)
Music Edukasyong Pantahanan at
Art Pangkabuhayan (EPP)
Physical Education (PE) MAPEH
Health Music
Edukasyon sa Pagpapakatao (EsP) Art
General Average Physical Education (PE)
Eligible for Admission to Grade______________________________________________ Health
General Average
Grade V-School_______________________________________________________________ Eligible for Admission to Grade______________________________________________
School Year__________________________________________________________________
Periodic Rating Grade VI-School_______________________________________________________________
LEARNING AREAS Remarks School Year__________________________________________________________________
1 2 3 4
Filipino Periodic Rating
English LEARNING AREAS Remarks
1 2 3 4
Mathematics Filipino
Science and Health English
MAKABAYAN Mathematics
Heograpiya/Kasaysayan/Sibika Science and Health
(HKS) MAKABAYAN
Edukasyong Pantahanan at Heograpiya/Kasaysayan/Sibika
Pangkabuhayan (EPP) (HKS)
Musika, Sining at Edukasyon sa Edukasyong Pantahanan at
Pagpapalakas ng Katawan (MSEP) Pangkabuhayan (EPP)
Character Education Musika, Sining at Edukasyon sa
Pagpapalakas ng Katawan (MSEP)
General Average Character Education
Eligible for admission to Grade _________________________________
 General Average
Eligible for admission to Grade ________________________________
III. REPORT ON LEARNER’S OBSERVED VALUES

Gr. 1 S.Y. _____________ Gr. 2 S.Y. _____________ Gr. 3 S.Y. _____________

Quarter Quarter Quarter
Core Values Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one’s spiritual beliefs while
respecting the spiritual beliefs of
1. Maka- others
Diyos Shows adherence to ethical principles
by upholding truth
Shows adherence to ethical principles
by upholding truth
2. Makatao Demonstrates contributions toward
solidarity
3. Maka- Cares for the environment and utilizes
resources wisely, judiciously, and
kalikasan economically
Demonstrates pride in being a Filipino;
exercises the rights and
4.Makabansa responsibilities of a Filipino citizen.
Demonstrates appropriate behavior in
carrying out activities in the school,
community, and country

Gr. 4 S.Y. _____________ Gr. 5 S.Y. ____________ Gr. 6 S.Y. ____________

Quarter Quarter Quarter
Core Values Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one’s spiritual beliefs while
respecting the spiritual beliefs of
1. Maka- others
Diyos Shows adherence to ethical principles
by upholding truth
Shows adherence to ethical principles
by upholding truth
2. Makatao
Demonstrates contributions toward
solidarity
Cares for the environment and utilizes
3. Maka-
resources wisely, judiciously, and
kalikasan economically
Demonstrates pride in being a Filipino;
exercises the rights and
4.Makabansa responsibilities of a Filipino citizen.
Demonstrates appropriate behavior in
carrying out activities in the school,
community, and country

AO – Always Observed SO – Sometimes Observed RO – Rarely Observed NO – Not Observed

IV. ATTENDANCE RECORD

No. of School No. of School No. of Times No. of School
Grade Cause Cause
Days Days Absent Tardy Days Present

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