Republic of the Philippines

Region I
DIVISION OF LA UNION
PUGO CENTRAL SCHOOL
SOCIO / ACADEMIC / ANECDOTAL RECORD
Name: ________________________________________ Residence: __________________________ Pugo
______________ La Union
________________
Birthdate: ______________ Place __________________ (Brgy.) (Town) (Province)
Child Position: of ____ children ____
Father : ________________________________ Educational Attainment: _________________________ Occupation: _________________________________
Mother : ________________________________ Educational Attainment: _________________________ Occupation: _________________________________

State if both parents are living: Yes ____ No ____ Living with parents: Yes ____ No ____
Others: Pls. specify ________ If no, please specify __________________________

Parents’ Monthly Income: __________ Economic Status: very poor ____ poor ____ average ____ high ____

I. Pre-Elementary Education: II. Elementary Education

Entrance Ages: Nursery ____ Kinder ____ Graduated with honors? Yes ____ No ____ (Pls. check)
If yes, specify _____________________________

(To be filled after graduation)

A. Academic Profile I II III IV V VI
1. Reading 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Non-reader ...…………….
Poor ...…………….
Good ..……………..
Excellent ………………..
*Legend : No. 1 above means Non-reader No. 3 above means Good Reader
No. 2 above means Poor Reader No. 4 above means Excellent
Please check appropriate box in each grade applicable opposite Nos. 1,2,3, or 4 as the case maybe .

I II III IV V VI
2. Math
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Addition (+)
Subtraction (-)
Multiplication (x)
Division (/)
Problem Solving
The rating for Math is:
1. W…..level of mastery is very poor. 3. Y …..just enough mastery.
2. X …..some degree of mastery but needs more practice . 4. Z …..manifests excellence.
Above code shall be entered for each of the curriculum year.
 I II III IV V VI
B. Oral Part./Recitation 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Passive …………………..
Poor …...…………….
Active ...………………

C. Any academic honor obtained in:

Grade I _____________ Grade IV _____________
Grade II _____________ Grade V _____________
Grade III _____________ Grade VI _____________
(Pls. specify)
D. Special/Talents/Skills/Winnings I II III IV V VI
1. Singing ………………………………………………………….. 1
2. Dancing/Rhythmics ………………………………………………………….. 2
3. Music Reading ………………………………………………………….. 3
4. Drawing/Painting …………………………………………………………. 4
5. Dramatics ………………………………………………………….. 5
6. Speaking …………………………………………………………..
6.a
a. declamation …………………………………………………………..
b
b. oratorical …………………………………………………………..
7. Athletics ………………………………………………………….. 7
8. Leadership …………………………………………………………. 8

(Please check opposite each item if applicable under any of the four columns)
9. Other (Pls. Specify) __________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
E. Cases of Significant Misdemeanor/s
Date Subject/Situation Brief Description Remarks
____________________________ ________________________________ _______________________________ ________________________
_________________________ _____________________________ ____________________________ _____________________
_________________________ _____________________________ ____________________________ _____________________

Certification is hereby made on the veracity of the above-mentioned entries per item.
Grade : I II III IV V VI
Advisers: _________________ _________________ _________________ _________________ _________________ _________________

Principal/School Heads: _________________ _________________ _________________ _________________ _________________ _________________