ADDRESS

AGE as of
NAME BIRTH DATE MOTHER IP
LRN Sex (M/F) 1st Friday RELIGION House #/ Street/
(Last Name, First Name, Middle Name) (mm/dd/ yyyy) TONGUE (Ethnic Group) Father's Name (La
June Sitio/ Barangay Municipality/ City Province
First Name, Middle
Purok

List and Code of Indicators under REMARKS column

Indicator Code Required Information Code Required Information REGISTERED BoSY

Transferred T/O Name of Public (P) Private (PR) School & Effectivity Date CCT CCT Control/reference number & Effectivity Date MALE

Transferred T/I Name of Public (P) Private (PR) School & Effectivity Date B/A Name of school last attended & Year FEMALE

Dropped DRP Reason and Effectivity Date LWD Specify

TOTAL
Late Enrollm LE Reason (Enrollment beyond 1st Friday of June) ACL Specify Level & Effectivity Data
 GUARDIAN
PARENTS REMARKS
(If not Parent)
Contact Number of
Mother's Maiden Name Parent or (Please refer to the
r's Name (Last Name, Guardian
(Last Name, First Name Relation-ship legend on last
Name, Middle Name)
Name, Middle Name) page)

Prepared by: Certified Correct:

EoSY

(Signature of Adviser over Printed Name) (Signature of School Head over Printed
Name)

BoSY Date: EoSYDate: BoSY Date: EoSYDate:

 (1st row for date) Total for the
LEARNER'S NAME Month REMARKS (If DROPPED OUT, state reason, please refer
(Last Name, First to legend number 2.
If TRANSFERRED IN/OUT, write the name of School.)
Name, Middle Name) M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F ABSENT TARDY

FEMALE | TOTAL Per Day

Combined TOTAL PER DAY
GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month: No. of Days of Summary
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance. Classes: M F TOTAL
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper
2. Dates shall be written in the columns after Learner's Name. for Late Commer, Lower for Cutting Classes)
* Enrolment as of (1st Friday of June)
3. To compute the following: 2. REASONS/CAUSES FOR DROPPING OUT
Registered Learners as of end of the month a. Domestic-Related Factors Late Enrollment during the month
a. Percentage of Enrolment = x 100
Enrolment as of 1st Friday of the school year a.1. Had to take care of siblings (beyond cut-off)
Total Daily Attendance a.2. Early marriage/pregnancy
b. Average Daily Attendance = Registered Learners as of end of the month
Number of School Days in reporting month a.3. Parents' attitude toward schooling
Average daily attendance a.4. Family problems
c. Percentage of Attendance for the month = x 100 Percentage of Enrolment as of end of the month
Registered Learners as of end of the month b. Individual-Related Factors
b.1. Illness
Average Daily Attendance
4. Every end of the month, the class adviser will submit this form to the office of the principal for recording of summary b.2. Overage
table into School Form 4. Once signed by the principal, this form should be returned to the adviser. b.3. Death
Percentage of Attendance for the month
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent b.4. Drug Abuse
for 5 consecutive days and/or those at risk of dropping out. b.5. Poor academic performance
Number of students absent for 5 consecutive days:
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period. b.6. Lack of interest/Distractions
* Beginning of School Year cut-off report is every 1st Friday of the School Year b.7. Hunger/Malnutrition
Drop out
c. School-Related Factors
c.1. Teacher Factor
Transferred out
c.2. Physical condition of classroom
c.3. Peer influence
Transferred in
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds) I certify that this is a true and correct report.
d.3. Calamities/Disasters
e. Financial-Related
e.1. Child labor, work (Signature of Teacher over Printed Name)
f. Others (Specify)
Attested by:
School Form 2 : Page ___ of ________
(Signature of School Head over Printed Name)
 Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

LEARNER'S NAME REMARKS/ACTION TAKEN

NO. (Last Name, First Name, Middle Name) (Please refer to the
Date Date Date Date Date Date Date Date legend on last page)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

TOTAL FOR FEMALE | TOTAL COPIES

TOTAL LEARNERS | TOTAL COPIES

GUIDELINES: In case of lost/unreturned books, please provide information with the following code: Prepared By:
1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form. A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
3. The Total Number of Copies issued at BoSY shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for (Signature over printed name)
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. code FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian Date BoSY:____________ Date EoSY: ___________
(for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14,
5. All textbooks being used must be included. Additional copies of this form may be used if needed. 2.2012.
School Form 3: Page ___ of ________
 School Form 4 (SF4) Monthly Learner's Movement and Attendance
(This replaces Form 3 & STS Form 4-Absenteeism and Dropout Profile)

School ID Region Division District

School Name School Year Report for the Month of

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN

REGISTERED
GRADE/ LEARNERS (A+B) Cumulative (A+B) Cumulative (A+B)
YEAR SECTION NAME OF ADVISER (As of End of the Daily Average Percentage for (A) Cumulative as (B) For the Month as of End of the (A) Cumulative as (B) For the Month as of End of the (A) Cumulative as (B) For the Month Cumulative as of
LEVEL Month) the Month of Previous Month
Month
of Previous Month
Month
of Previous Month
End of the Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T

ELEMENTARY/SECONDARY:
KINDER
GRADE 1/GRADE 7
GRADE 2/GRADE 8
GRADE 3/GRADE 9
GRADE 4/GRADE 10
GRADE 5/GRADE 11
GRADE 6/GRADE 12
TOTAL FOR NON-GRADED
TOTAL
GUIDELINES: Prepared and Submitted by:
1. This form shall be accomplished every end of the month using the summary box of SF2 submitted by the teachers/advisers to update figures for the month.
2. Furnish the Division Office with a copy a week after June 30, October 30 & March 31
 (Signature of School Head over Printed Name)
Page _____ of _____ pages
 INCOMPLETE SUBJECT/S
GENERAL
(This column is for K to 12 Curriculum and remaining RBEC in
AVERAGE
ACTION TAKEN: High School. Elementary grades level that are still implementing RBEC
(Numerical Value in 2
LEARNER'S NAME PROMOTED, need not to fill up these columns)
LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
RETAINED From previous school years
honor learners, and
Descriptive Letter) completed as of end of current As of end of current School Year
School Year

PREPARED BY:

Class Adviser

(Name and Signature)

CERTIFIED CORRECT & SUBMITTED:

School Head

(Name and Signature)

REVIEWED BY:

(Name and Signature)

Division Representative

GUIDELINES:

1. For All Grade/Year Levels

2. To be prepared by the Adviser. Final rating per

subject area should be taken from the record of subject
teachers. The class adviser should compute for the
General Average.

3. On the summary table, reflect the total number of

learners promoted, retained and *irregular (*for grade 7
onwards only) and the level of proficiency according to
the individual General Average.

4. Must tally with the total enrollment report as of End of

School Year GESP /GSSP (EBEIS)

5. Protocols of validation & submission is under the

discretion of the Schools Division Superintendent
TOTAL FEMALE
 INCOMPLETE SUBJECT/S
GENERAL
(This column is for K to 12 Curriculum and remaining RBEC in
AVERAGE
ACTION TAKEN: High School. Elementary grades level that are still implementing RBEC
(Numerical Value in 2
LEARNER'S NAME PROMOTED, need not to fill up these columns)
LRN decimal places and 3
(Last Name, First Name, Middle Name) IRREGULAR or
decimal places for
RETAINED From previous school years
honor learners, and
Descriptive Letter) completed as of end of current As of end of current School Year
School Year

COMBINED School Form 5: Page ____ of ________

 School Form 6 (SF6)
Summarized Report on Promotion and Level of Proficiency
(This replaces Form 20)

School ID Region Division

School Name District School Year

GRADE 1 /GRADE 7 GRADE 2 / GRADE 8 GRADE 3 / GRADE 9 GRADE 4 / GRADE 10 GRADE 5 / GRADE 11 GRADE 6 / GRADE 12 TOTAL
SUMMARY TABLE

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL

PROMOTED

IRREGULAR

RETAINED

LEVEL OF PROFICIENCY MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL

BEGINNNING
(B: 74% and below)

DEVELOPING
(D: 75%-79%)

APPROACHING
PROFICIENCY
(AP: 80%-84%)

PROFICIENT
(P: 85% -89%)

ADVANCED
(A: 90% and above)

TOTAL

Prepared and Submitted by: Reviewed & Validated by: Noted by:
SCHOOL HEAD DIVISION REPRESENTATIVE SCHOOLS DIVISION SUPERINTENDENT
GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the grade level total and school total.
2. This report together with the copy of Report for Promotion submitted by the class adviser shall be forwarded to the Division Office by the end of the school year.
3. The Report on Promotion per grade level is reflected in the End of School Year Report of GESP/GSSP.
4. Protocols of validation & submission is under the discretion of the Schools Division Superintendent.
 EDUCATIONAL QUALIFICATION Daily Program (time duration)
Employee Remarks (For
Nature of Subject Taught (include
No. (or Tax Name of School Personnel Fund Position/ Appointment/ Grade & Section),
Detailed Items,
Total Actual Indicate name of
(Arrange by Sex
Identification
Source Designation Employment Degree / Post Major/ Advisory Class & Other DAY From To Teaching school/office, For IP's
Number Position, Descending) Minor (M/T/W/T
-T.I.N.) Status Graduate Specialization Ancillary Assignments (00:00) (00:00) Minutes per
H/F) -Ethnicity)
Week

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

GUIDELINES: Submitted by:

1. This form shall be accomplished at the beginning of the school year by the school head. In case of movement of teachers and other personnel during the school year, an
updated Form 19 must be submitted to the Division Office .
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank down to the lowest. (Signature of School Head over Printed Name)
3. Please reflect subjects being taught and if teacher handling advisory class or Ancillary Assignment. Other administrative duties must also reported.
4. Daily Program Column is for teaching personnel only. Updated as of: ___________________________
 EDUCATIONAL QUALIFICATION Daily Program (time duration)
Employee Remarks (For
Nature of Subject Taught (include
No. (or Tax Name of School Personnel Fund Position/ Appointment/ Grade & Section),
Detailed Items,
Total Actual Indicate name of
(Arrange by Sex
Identification
Source Designation Employment Degree / Post Major/ Advisory Class & Other DAY From To Teaching school/office, For IP's
Number Position, Descending) Minor (M/T/W/T
-T.I.N.) Status Graduate Specialization Ancillary Assignments (00:00) (00:00) Minutes per
H/F) -Ethnicity)
Week

School Form 7, Page ___ of ________