FORM 137-A Sample
FORM 137-A Sample
LRN: 129
Rehiyon IX
Region IX
DIVISION OF DAVAO CITY
I.
Pangalan
BACOLOD,
(Name)
(Surname) Apelyido
Kasarian:
ADRIAN PAUL
A.
12/6/2007
Petsa ng Kapanganakan:
(Sex)
DAVAO CITY
(Division)
Pook:
(Date of Birth)
(Place)
Magulang/Tagapag-alaga
(Parent / Guardian)
Sangay:
M.I.
(School)
DAVAO CITY
Petsa ng Pagpasok:
6/2/201
Bayan/Lalawigan/Lungsod
HOUSEKEEPER
Pangalan
(Name)
Tirahan
(Address)
Hanapbuhay
(Occupation)
Learning Areas
Learning Areas
Mother Tongue
79.75
Filipino
AP 80 AP 82 AP 81.00
English
Mother Tongue
79 AP 81 AP 83 P
Filipino
78 D
85 AP 82.00
79 AP 80 AP 82 D
English
Grade II - School
School Year
Mathematics
77 D
78 D
79 AP 82 D
79.00
Mathematics
Araling Panlipunan
76 D
78 AP 80 AP 82 D
79.00
Araling Panlipunan
MAPEH
MAPEH
D
D
AP
D
AP
Eduk. sa Pagpapakatao D
General Average
D
Eligible for Admission to Grade
*Music
* Art
* Physical Education
* Health
80
79
80
79
80
79
78
AP
AP
AP
AP
AP
AP
D
82
81
82
81
82
81
80
AP
AP
AP
AP
AP
AP
AP
83
82
83
82
84
82
81
AP
AP
P
AP
P
AP
AP
84
81
85
83
85
84
83
AP
AP
AP
AP
AP
AP
AP
81.81
80.75
82.50
81.25
82.75
81.50
80.580
E
D
TWO
Final Rating
Eduk. sa Pagpapakatao
General Average
Grade IV - School
School Year
Periodic Rating
Learning Areas
Filipino
English
Science
Mathematics
Araling Panlipunan
EPP
MAPEH
*Music
* Art
* Physical Education
* Health
*Music
* Art
* Physical Education
* Health
Periodic Rating
Eduk. sa Pagpapakatao
General Average
Eduk. sa Pagpapakatao
General Average
Grade V - School
School Year
Filipino
English
Science
Mathematics
Araling Panlipunan
*Music
* Art
* Physical Education
* Health
Mother Tongue
Filipino
English
Science
Mathematics
Araling Panlipunan
MAPEH
Learning Areas
Periodic Rating
Final Rating
Grade VI - School
School Year
Periodic Rating
Learning Areas
Filipino
English
Science
Mathematics
Araling Panlipunan
Periodic Rating
Final Rating
EPP
MAPEH
*Music
* Art
* Physical Education
* Health
EPP
MAPEH
*Music
* Art
* Physical Education
* Health
Eduk. sa Pagpapakatao
General Average
Eduk. sa Pagpapakatao
General Average
LRN: 129647130103
MENTARYA
ATION)
Y SCHOOL
PAARALAN
RECORD)
MATINA APLAYA ELEMENTARY SCHOOL
6/2/2014
HOUSEKEEPER
Hanapbuhay
(Occupation)
PAARALAN
RESS)
B
D
AP
P
A
0
75
80
85
90
F.R.
F.R.
B
C
B
B
B
B
B
A
A
A
A
A
A
A
B
A
Gr. ______ Sch. Yr. ____________ Gr. ______ Sch. Yr. ____________
1
A
A
A
B
B
A
A
B
C
B
B
Cleanliness and
Orderliness
10
9 Industry
8 Self-Reliance
F.R.
Resourcefulness and
Creativeness
6 Sportsmanship
4 Obedience
D
C
Helpfulness and
Cooperation
2 Courtesy
1
1 Honesty
F.R.
F.R.
F.R.
1 Honesty
2 Courtesy
3
Helpfulness and
Cooperation
4 Obedience
5 Consideration for Others
6 Sportsmanship
7
Resourcefulness and
Creativeness
8 Self-Reliance
9 Industry
10
Cleanliness and
Orderliness
A - Outstanding
B - Very Satisfactory / Very Good
C - Satisfactory
D - Needs Improvement / Fair
E - Poor
No. of
School
Days
No. of School
Days Absent
Cause
No. of Times
Tardy
Cause
No. of School
Days Present
One
201
Sick
192
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 to
Grade/Year
.
Signature
Date
Designation