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Republic of the Philippines
Department of Education
Region VII, Central Visayas
DIVISION OF LAPU-LAPU CITY
LRN: ________________
Name: _______________________________________ Date of Birth: __________________________ Sex: ___________
(Surname) (First Name) (M.I.) (Month) (Day) (Year)
Place of Birth: ________________________________ Town City: _________________ Barangay: __________________
Name of Parent or Guardian: ________________________________ Occupation: _______________________________
Address of Parent or Guardian: ________________________________________________________________________
Elementary Course Completed (School): ________________________________ Year: ___________ Gen. Ave.: _______
School: ________________________________ Grade _______ Section ____________ School Year __________________
Learning Areas
Periodic Ratings
Final Rating Remarks Core Values
Periodic Ratings
1st 2nd 3rd 4th 1st 2nd 3rd 4th
Filipino 1. Maka-Diyos
English 2. Makatao
Mathematics 3. Makakalikasan
Science 4. Makabansa
Araling Panlipunan
EdukasyonsaPagpapakatao Legend:
TLE AO - Always Observed
MAPEH SO – Sometimes Observed
Music RO – Rarely Observed
Arts NO – Not Observed
Physical Education
Health To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
General Average Lack Subjects_________________________________
June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL
Days of School
Days Present
School: ________________________________ Grade _______ Section ____________ School Year __________________
Learning Areas
Periodic Ratings
Final Rating Remarks Core Values
Periodic Ratings
1st 2nd 3rd 4th 1st 2nd 3rd 4th
Filipino 1. Maka-Diyos
English 2. Makatao
Mathematics 3. Makakalikasan
Science 4. Makabansa
Araling Panlipunan
EdukasyonsaPagpapakatao Legend:
TLE AO - Always Observed
MAPEH SO – Sometimes Observed
Music RO – Rarely Observed
Arts NO – Not Observed
Physical Education
Health To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
General Average Lack Subjects_________________________________
June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL
Days of School
Days Present
DepEd Form 137-A
______________________________
Class Adviser (Name & Signature)
______________________________
Class Adviser (Name & Signature)
School: ________________________________ Grade _______ Section ____________ School Year __________________
Learning Areas
Periodic Ratings
Final Rating Remarks Core Values
Periodic Ratings
1st 2nd 3rd 4th 1st 2nd 3rd 4th
Filipino 1. Maka-Diyos
English 2. Makatao
Mathematics 3. Makakalikasan
Science 4. Makabansa
Araling Panlipunan
EdukasyonsaPagpapakatao Legend:
TLE AO - Always Observed
MAPEH SO – Sometimes Observed
Music RO – Rarely Observed
Arts NO – Not Observed
Physical Education
Health To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
General Average Lack Subjects_________________________________
June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL
Days of School
Days Present
School: ________________________________ Grade _______ Section ____________ School Year __________________
Learning Areas
Periodic Ratings
Final Rating Remarks Core Values
Periodic Ratings
1st 2nd 3rd 4th 1st 2nd 3rd 4th
Filipino 1. Maka-Diyos
English 2. Makatao
Mathematics 3. Makakalikasan
Science 4. Makabansa
Araling Panlipunan
EdukasyonsaPagpapakatao Legend:
TLE AO - Always Observed
MAPEH SO – Sometimes Observed
Music RO – Rarely Observed
Arts NO – Not Observed
Physical Education
Health To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
General Average Lack Subjects_________________________________
June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL
Days of School
Days Present
School: ________________________________ Grade _______ Section ____________ School Year __________________
Learning Areas
Periodic Ratings
Final Rating Remarks Core Values
Periodic Ratings
1st 2nd 3rd 4th 1st 2nd 3rd 4th
Filipino 1. Maka-Diyos
English 2. Makatao
Mathematics 3. Makakalikasan
Science 4. Makabansa
Araling Panlipunan
EdukasyonsaPagpapakatao Legend:
TLE AO - Always Observed
MAPEH SO – Sometimes Observed
Music RO – Rarely Observed
Arts NO – Not Observed
Physical Education
Health To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
General Average Lack Subjects_________________________________
June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL
Days of School
Days Present
______________________________
Class Adviser (Name & Signature)
______________________________
Class Adviser (Name & Signature)
______________________________
Class Adviser (Name & Signature)
School: ________________________________ Grade _______ Section ____________ School Year __________________
Learning Areas
Periodic Ratings
Final Rating Remarks Core Values
Periodic Ratings
1st 2nd 3rd 4th 1st 2nd 3rd 4th
Filipino 1. Maka-Diyos
English 2. Makatao
Mathematics 3. Makakalikasan
Science 4. Makabansa
Araling Panlipunan
EdukasyonsaPagpapakatao Legend:
TLE AO - Always Observed
MAPEH SO – Sometimes Observed
Music RO – Rarely Observed
Arts NO – Not Observed
Physical Education
Health To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
General Average Lack Subjects_________________________________
June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL
Days of School
Days Present
School: ________________________________ Grade _______ Section ____________ School Year __________________
Learning Areas
Periodic Ratings
Final Rating Remarks Core Values
Periodic Ratings
1st 2nd 3rd 4th 1st 2nd 3rd 4th
Filipino 1. Maka-Diyos
English 2. Makatao
Mathematics 3. Makakalikasan
Science 4. Makabansa
Araling Panlipunan
EdukasyonsaPagpapakatao Legend:
TLE AO - Always Observed
MAPEH SO – Sometimes Observed
Music RO – Rarely Observed
Arts NO – Not Observed
Physical Education
Health To be classified as ________________________
Total Number of Years in School to Present _________
Advanced Subjects ____________________________
General Average Lack Subjects_________________________________
June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL
Days of School
Days Present
Descriptors Grading Scale Remarks
Outstanding 90 – 100 Passed
Very Satisfactory 85 – 89 Passed
Satisfactory 80 – 84 Passed
Fairly Satisfactory 75 – 79 Passed
Did Not Meet Expectations Below 75 Failed
C E R T I F I C A T E O F T R A N S F E R
To Whom It May Concern:
I hereby certify that this is the true record of __________________________ issued this ____________ day of
___________________ 20 ______ and he/she is eligible for admission to ________________________ and this student
has no money or property accountability in the school.
_____________________________________
School Head
______________________________
Class Adviser (Name & Signature)
______________________________
Class Adviser (Name & Signature)

More Related Content

Form 137 (k 12)

  • 1. Republic of the Philippines Department of Education Region VII, Central Visayas DIVISION OF LAPU-LAPU CITY LRN: ________________ Name: _______________________________________ Date of Birth: __________________________ Sex: ___________ (Surname) (First Name) (M.I.) (Month) (Day) (Year) Place of Birth: ________________________________ Town City: _________________ Barangay: __________________ Name of Parent or Guardian: ________________________________ Occupation: _______________________________ Address of Parent or Guardian: ________________________________________________________________________ Elementary Course Completed (School): ________________________________ Year: ___________ Gen. Ave.: _______ School: ________________________________ Grade _______ Section ____________ School Year __________________ Learning Areas Periodic Ratings Final Rating Remarks Core Values Periodic Ratings 1st 2nd 3rd 4th 1st 2nd 3rd 4th Filipino 1. Maka-Diyos English 2. Makatao Mathematics 3. Makakalikasan Science 4. Makabansa Araling Panlipunan EdukasyonsaPagpapakatao Legend: TLE AO - Always Observed MAPEH SO – Sometimes Observed Music RO – Rarely Observed Arts NO – Not Observed Physical Education Health To be classified as ________________________ Total Number of Years in School to Present _________ Advanced Subjects ____________________________ General Average Lack Subjects_________________________________ June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL Days of School Days Present School: ________________________________ Grade _______ Section ____________ School Year __________________ Learning Areas Periodic Ratings Final Rating Remarks Core Values Periodic Ratings 1st 2nd 3rd 4th 1st 2nd 3rd 4th Filipino 1. Maka-Diyos English 2. Makatao Mathematics 3. Makakalikasan Science 4. Makabansa Araling Panlipunan EdukasyonsaPagpapakatao Legend: TLE AO - Always Observed MAPEH SO – Sometimes Observed Music RO – Rarely Observed Arts NO – Not Observed Physical Education Health To be classified as ________________________ Total Number of Years in School to Present _________ Advanced Subjects ____________________________ General Average Lack Subjects_________________________________ June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL Days of School Days Present DepEd Form 137-A ______________________________ Class Adviser (Name & Signature) ______________________________ Class Adviser (Name & Signature)
  • 2. School: ________________________________ Grade _______ Section ____________ School Year __________________ Learning Areas Periodic Ratings Final Rating Remarks Core Values Periodic Ratings 1st 2nd 3rd 4th 1st 2nd 3rd 4th Filipino 1. Maka-Diyos English 2. Makatao Mathematics 3. Makakalikasan Science 4. Makabansa Araling Panlipunan EdukasyonsaPagpapakatao Legend: TLE AO - Always Observed MAPEH SO – Sometimes Observed Music RO – Rarely Observed Arts NO – Not Observed Physical Education Health To be classified as ________________________ Total Number of Years in School to Present _________ Advanced Subjects ____________________________ General Average Lack Subjects_________________________________ June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL Days of School Days Present School: ________________________________ Grade _______ Section ____________ School Year __________________ Learning Areas Periodic Ratings Final Rating Remarks Core Values Periodic Ratings 1st 2nd 3rd 4th 1st 2nd 3rd 4th Filipino 1. Maka-Diyos English 2. Makatao Mathematics 3. Makakalikasan Science 4. Makabansa Araling Panlipunan EdukasyonsaPagpapakatao Legend: TLE AO - Always Observed MAPEH SO – Sometimes Observed Music RO – Rarely Observed Arts NO – Not Observed Physical Education Health To be classified as ________________________ Total Number of Years in School to Present _________ Advanced Subjects ____________________________ General Average Lack Subjects_________________________________ June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL Days of School Days Present School: ________________________________ Grade _______ Section ____________ School Year __________________ Learning Areas Periodic Ratings Final Rating Remarks Core Values Periodic Ratings 1st 2nd 3rd 4th 1st 2nd 3rd 4th Filipino 1. Maka-Diyos English 2. Makatao Mathematics 3. Makakalikasan Science 4. Makabansa Araling Panlipunan EdukasyonsaPagpapakatao Legend: TLE AO - Always Observed MAPEH SO – Sometimes Observed Music RO – Rarely Observed Arts NO – Not Observed Physical Education Health To be classified as ________________________ Total Number of Years in School to Present _________ Advanced Subjects ____________________________ General Average Lack Subjects_________________________________ June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL Days of School Days Present ______________________________ Class Adviser (Name & Signature) ______________________________ Class Adviser (Name & Signature) ______________________________ Class Adviser (Name & Signature)
  • 3. School: ________________________________ Grade _______ Section ____________ School Year __________________ Learning Areas Periodic Ratings Final Rating Remarks Core Values Periodic Ratings 1st 2nd 3rd 4th 1st 2nd 3rd 4th Filipino 1. Maka-Diyos English 2. Makatao Mathematics 3. Makakalikasan Science 4. Makabansa Araling Panlipunan EdukasyonsaPagpapakatao Legend: TLE AO - Always Observed MAPEH SO – Sometimes Observed Music RO – Rarely Observed Arts NO – Not Observed Physical Education Health To be classified as ________________________ Total Number of Years in School to Present _________ Advanced Subjects ____________________________ General Average Lack Subjects_________________________________ June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL Days of School Days Present School: ________________________________ Grade _______ Section ____________ School Year __________________ Learning Areas Periodic Ratings Final Rating Remarks Core Values Periodic Ratings 1st 2nd 3rd 4th 1st 2nd 3rd 4th Filipino 1. Maka-Diyos English 2. Makatao Mathematics 3. Makakalikasan Science 4. Makabansa Araling Panlipunan EdukasyonsaPagpapakatao Legend: TLE AO - Always Observed MAPEH SO – Sometimes Observed Music RO – Rarely Observed Arts NO – Not Observed Physical Education Health To be classified as ________________________ Total Number of Years in School to Present _________ Advanced Subjects ____________________________ General Average Lack Subjects_________________________________ June July Aug. Sept. Oct. Nov. Dec. Jan. Feb. March April TOTAL Days of School Days Present Descriptors Grading Scale Remarks Outstanding 90 – 100 Passed Very Satisfactory 85 – 89 Passed Satisfactory 80 – 84 Passed Fairly Satisfactory 75 – 79 Passed Did Not Meet Expectations Below 75 Failed C E R T I F I C A T E O F T R A N S F E R To Whom It May Concern: I hereby certify that this is the true record of __________________________ issued this ____________ day of ___________________ 20 ______ and he/she is eligible for admission to ________________________ and this student has no money or property accountability in the school. _____________________________________ School Head ______________________________ Class Adviser (Name & Signature) ______________________________ Class Adviser (Name & Signature)