REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF EDUCATION
FORM 137-A Region X
Schools Division Office of DEPED TAMBAYAN

ELEMENTARY SCHOOL PERMANENT RECORD LRN: ________________

Name: ___________________________________________________________ Date of Birth: Year _____________ Month___________ Day_________

Place of Birth: Province __________________________________ Town_________________________________ Barrio__________________________
Parent or Guardian: _____________________________________________________________ Occupation ____________________________________
Address of Parent or Guardian: __________________________________________________________________________________________________

ELEMENTARY SCHOOL PROGRESS

Grade ___ – School _________________________________________________ Grade ___ – School _________________________________________________

School Year _________________ School Year _________________

Periodic Rating FINAL Periodic Rating FINAL

Learning Areas RATING
REMARKS Learning Areas RATING
REMARKS
1 2 3 4 1 2 3 4
Mother Tongue Mother Tongue
Filipino Filipino
English English
Mathematics Mathematics
Araling Panlipunan Araling Panlipunan
EPP/TLE EPP/TLE
MAPEH MAPEH
Music Music
Art Art
Physical Education Physical Education
Health Health
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
General Average General Average

Eligible for Admission to Grade ____________ Eligible for Admission to Grade ____________

Grade ___ – School _________________________________________________ Grade ___ – School _________________________________________________

School Year _________________ School Year _________________

Periodic Rating FINAL Periodic Rating FINAL

Learning Areas RATING
REMARKS Learning Areas RATING
REMARKS
1 2 3 4 1 2 3 4
Mother Tongue Mother Tongue
Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan Araling Panlipunan
EPP/TLE EPP/TLE
MAPEH MAPEH
Music Music
Art Art
Physical Education Physical Education
Health Health
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
General Average General Average

Eligible for Admission to Grade ____________ Eligible for Admission to Grade ____________

Grade ___ – School _________________________________________________ Grade ___ – School _________________________________________________

School Year _________________ School Year _________________

Periodic Rating FINAL Periodic Rating FINAL

Learning Areas RATING
REMARKS Learning Areas RATING
REMARKS
1 2 3 4 1 2 3 4
Mother Tongue Mother Tongue
Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan Araling Panlipunan
EPP/TLE EPP/TLE
MAPEH MAPEH
Music Music
Art Art
Physical Education Physical Education
Health Health
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
General Average General Average

Eligible for Admission to Grade _____________ Eligible for Admission to Grade _____________