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DepEd Form 137-E Republika ng Pilipinas

(Republic of the Philippines)


Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYONG ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)
Rehiyon I
(Region I)
PALAGIANG TALAAN SA MABABANG PAARALAN
(ELEMENTARY SCHOOL PERMANENT RECORD)
LRN: __________________________

I. Pangalan Sangay Paaralan


(Name) Apelyido Unang Pangalan M.I. (Division) (School)

Kasarian Petsa ng Kapanganakan Pook Petsa ng Pagpasok


(Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod

Magulang/Tagapag-alaga
(Parent / Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

Grade I - School Grade II - School


School Year School Year

Periodic Rating Final Periodic Rating Final


Learning Areas Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating
Mother Tongue Mother Tongue
Filipino Filipino
English English
Mathematics Mathematics
Araling Panlipunan Araling Panlipunan
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
MAPEH MAPEH
Music Music
Art Art
Physical Education Physical Education
Health Health
General Average General Average
Eligible for Admission to Grade Eligible for Admission to Grade
Grade III - School Grade IV - School
School Year School Year

Periodic Rating Final Periodic Rating Final


Learning Areas Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating
Mother Tongue Filipino
Filipino English
English Mathematics
Mathematics Science
Science Araling Panlipunan
Araling Panlipunan Edukasyon sa Pagpapakatao

Edukasyon sa Pagpapakatao Edukason Pantahanan at


Pangkabuhayan (EPP)
MAPEH MAPEH
Music Music
Art Art
Physical Education Physical Education
Health Health
General Average General Average
Eligible for Admission to Grade Eligible for Admission to Grade

Grade V - School Grade VI - School


School Year School Year

Periodic Rating Final Periodic Rating Final


Learning Areas Remarks Learning Areas Remarks
1 2 3 4 Rating 1 2 3 4 Rating
Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan Araling Panlipunan
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
Edukason Pantahanan at
Edukason Pantahanan at Pangkabuhayan (EPP)
Pangkabuhayan (EPP) Technology Livelihood
Education (TLE)
MAPEH MAPEH
Music Music
Art Art
Physical Education Physical Education
Health Health
General Average General Average
Eligible for Admission to Grade Eligible for Admission to Grade
III. LEARNER'S OBSERVED VALUES
Gr.___ SY.___________ Gr.___ SY.___________ Gr.___ SY.___________ Gr.___ SY.___________
Core Values Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Express one's spiritual beliefs while
respecting the spiritual beliefs of others
1. Maka-Diyos
Shows adherence to ethical principles by
upholding the truth in all undertakings
Is sensitive to individual, social, and cultural
2. Makatao differences; resists stereotyping people
Demonstrates contributions toward solidarity
Cares for the environment and utilizes
3. Makakalikasan resources wisely, judiciously and
economically
Demonstrates pride in being a Filipino;
exercises the rights and responsibilities of a
Filipino citizen.
4. Makabansa
Demonstrates appropriate behavior in
carrying out activities in the school,
community, and country

Gr.___ SY.___________ Gr.___ SY.___________ Gr.___ SY.___________ Gr.___ SY.___________


Core Values Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
Express one's spiritual beliefs while
respecting the spiritual beliefs of others
1. Maka-Diyos
Shows adherence to ethical principles by
upholding the truth in all undertakings
Is sensitive to individual, social, and cultural
2. Makatao differences; resists stereotyping people
Demonstrates contributions toward solidarity
Cares for the environment and utilizes
3. Makakalikasan resources wisely, judiciously and
economically
Demonstrates pride in being a Filipino;
exercises the rights and responsibilities of a
Filipino citizen.
4. Makabansa
Demonstrates appropriate behavior in
carrying out activities in the school,
community, and country

IV. ATTENDANCE RECORD


No. of
School No. of Times No. of School Days
Grade No. of School Days Cause Cause
Days Tardy Present
I Absent
II
III
IV
V
VI

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 _________________________.

Signature

Designation
Adviser Principal II

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