5/24/2018 Form 137 Kto 12
1/3
REPUBLIKA NG PILIPINAS
(Republic of the Philippines)
KAGAWARAN NG EDUKASYON
(Department of Education)
Rehiyon IIIRegion III
SANGAY NG MGA PAARALANG PANGLUNGSOD
Division of City SchoolsCity of Malolos
DepEd !RM "#$ % E PALAGIANG TALAAN SA MABABANG PAARALAN
&R'
(E&EME'*+R, SC-!!& PERM+'E'* REC!RD)
I. Pangalan Purok Paaralan(Name) Apelyido Unang ngalan M.I.
(District) (School)
Kasarian Petsa ng Kapanganakan Pook Petsa ng Pagpasok
(Sex) (Date of Birth) (Place)Bayan/Lalawigan/Lungsod (Date of
Entrance)
(Town/Province/City)
Magulang/Tagapag-alaga
Pangalan Tirahan Hanapbuhay
(Name) (Address) (cc!"ation)
II. PAG-UNLAD SA MABABANG PAARALAN (E&EME'*+R, SC-!!&
PR!/RESS)
/rade I 0 School /rade II 0 School School ,ear School ,ear
&earning +reasPeriodic Rating FINAL
RATINGREMARKS &earning +reas
Periodic Rating FINALRATING
REMARKS
" 1 # 2 " 1 # 2
Mo!e" Tongue Mo!e" Tongue
Filipino Filipino
Englis! Englis!
Ma!e#ai$s Ma!e#ai$s
A"aling Panlipunan A"aling Panlipunan
EPP/TLE EPP/TLE
MAPE% MAPE%
Musi$ Musi$
A" A"
P!ysi$al Edu$aion P!ysi$al Edu$aion
%eal! %eal!
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
General Average General Average
Eligible for Admission to Grade ____________ Eligible for
Admission to Grade ____________
/rade III 0 School /rade I3 0 School
School ,ear School ,ear
&earning +reasPeriodic Rating FINAL
RATINGREMARKS &earning +reas
Periodic Rating FINALRATING
REMARKS
" 1 # 2 " 1 # 2
Mo!e" Tongue Mo!e" Tongue
Filipino Filipino
Englis! Englis!
Ma!e#ai$s Ma!e#ai$s
S$ien$e S$ien$e
A"aling Panlipunan A"aling Panlipunan
EPP/TLE EPP/TLE
MAPE% MAPE%
Musi$ Musi$
A" A"P!ysi$al Edu$aion P!ysi$al Edu$aion
%eal! %eal!
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
General Average General Average
Eligible for Admission to Grade ____________ Eligible for
Admission to Grade ____________
/rade 3 0 School /rade 3I 0 School School ,ear School ,ear
&earning +reasPeriodic Rating FINAL
RATINGREMARKS &earning +reas
Periodic Rating FINALRATING
REMARKS
" 1 # 2 " 1 # 2
Mo!e" Tongue Mo!e" Tongue
Filipino Filipino
Englis! Englis!
Ma!e#ai$s Ma!e#ai$s
S$ien$e S$ien$e
A"aling Panlipunan A"aling Panlipunan
EPP/TLE EPP/TLE
MAPE% MAPE%
Musi$ Musi$
A" A"
P!ysi$al Edu$aion P!ysi$al Edu$aion
%eal! %eal!
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
General Average General Average
Eligible for Admission to Grade _____________ Eligible for
Admission to Grade _____________
5/24/2018 Form 137 Kto 12
2/3
/rade 3 0 School /rade 3I 0 School
School ,ear School ,ear
&earning +reasPeriodic Rating FINAL
RATINGREMARKS &earning +reas
Periodic Rating FINALRATING
REMARKS
" 1 # 2 " 1 # 2
Mo!e" Tongue Mo!e" Tongue
Filipino Filipino
Englis! Englis!
Ma!e#ai$s Ma!e#ai$s
S$ien$e S$ien$e
A"aling Panlipunan A"aling Panlipunan
EPP/TLE EPP/TLE
MAPE% MAPE%
Musi$ Musi$
A" A"
P!ysi$al Edu$aion P!ysi$al Edu$aion
%eal! %eal!
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
General Average General Average
Eligible for Admission to Grade ________ Eligible for Admission
to Grade _______
Legend&
Beginning 'B( )*+ and a,o-e
e-eloping '( )0)1+
App"oa$!ing P"o2i$ien$y 'AP( 3403* +
P"o2i$ien 'P( 3031 +
Ad-an$e 'A( 14 + and a,o-e
III. CHARACTER BUILDING
T"ais/r. Sch. ,r. /r. Sch. ,r. /r. Sch. ,r.
" 1 # 2 .R. " 1 # 2 .R. " 1 # 2 .R.5. %onesy
6. 7ou"esy
8. %elp2ulness and 7oope"aion
*. Resou"$e2ulness and 7"eai-iy
. 7onside"aion 2o" 9!e"s
:. Spo"s#ans!ip
). 9,edien$e
3. Sel20Relian$e
1. Indus"y
54. 7leanliness and 9"de"liness
55. P"o#pness and pun$ualiy
56. Sense o2 Responsi,iliy
58. Lo-e o2 God
5*. Lo-e o2 7oun"y
T"ais/r. Sch. ,r. /r. Sch. ,r. /r. Sch. ,r.
" 1 # 2 .R. " 1 # 2 .R. " 1 # 2 .R.5. %onesy
6. 7ou"esy
8. %elp2ulness and 7oope"aion
*. Resou"$e2ulness and 7"eai-iy
. 7onside"aion 2o" 9!e"s
:. Spo"s#ans!ip
). 9,edien$e
3. Sel20Relian$e
1. Indus"y
54. 7leanliness and 9"de"liness
55. P"o#pness and pun$ualiy
56. Sense o2 Responsi,iliy
58. Lo-e o2 God
5*. Lo-e o2 7oun"y
Guidelines 2o" Raing
A. Outstanding B. VeryGood
C.Good
D. Fair E. Poor
ATTENDANCE RECORD
GradeNo. ofSchoolDays
No. of SchoolDays Absent
CaseNo. ofT!"esTardy
CaseNo. of School Days
#resent
CERTI$ICATE O$ TRANS$ER
TO WO! "T !A# CO$CE%$&
T'is is to (ertify t'at t'is is a true re(ord of t'e Elementary
)('ool Permanent %e(ord of
_____________________________________________.e*)'e is eligible for
transfer and admission to Grade*#ear ______________________
___________________________________ )ignature
______________________ ____________________________________ Date
Designation
