DepEd Form 137-E

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
DIVISION OF ZAMBOANGA DEL NORTE
SINDANGAN NORTH 1 DISTRICT
UPPER NIPAAN ELEMENTARY SCHOOL
ELEMENTARY SCHOOL PERMANENT RECORD
LRN:

ELEMENTARY SCHOOL PERMNANENT RECORD

(PALAGIANG TALAAN SA MABABANG PAARALAN)

Name: ______________________________________________________Sex:_____ School: UPPER NIPAAN ELEMENTARY SCHOOL

Family Name First Name M.I.
Date of Birth: _______________ Place of Birth: ____________________________________ Date of Entrance :________________
Parent/Guardian __________________________________ ___________________________ _________________________
Name Address Occupation

Grade I - School: Grade II - School ____________________________

School Year _________________ School Year _________________
Peridocic Rating Peridocic Rating
Learning Areas Final Rating Learning Areas Final Rating
1 2 3 4 1 2 3 4
Filipino Filipino
English English
Mathematics Mathematics
Araling Panlipunan Araling Panlipunan
MAPEH MAPEH
* Music * Music
*Art *Art
* Physical Education * Physical Education
* Health * Health
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
Mother Tongue Mother Tongue
Average Average

Eligible for Admission to Grade _______________________ Eligible for Admission to Grade _______________________

Grade III - School __________________ Grade IV - School __________________

School Year _________________ School Year _________________
Peridocic Rating Peridocic Rating
Learning Areas Final Rating Learning Areas Final Rating
1 2 3 4 1 2 3 4
Filipino Filipino
Science Science
English English
Mathematics Mathematics
Araling Panlipunan Araling Panlipunan
MAPEH EPP
* Music MAPEH
*Art * Music
* Physical Education * Art
* Health * Physical Education
Edukasyon sa Pagpapakatao * Health
Mother Tongue Edukasyon sa Pagpapakatao
Average Average

Eligible for Admission to Grade _______________________ Eligible for Admission to Grade _______________________

Grade V - School ___________________________ Grade VI - School __________________________

School Year _________________ School Year _________________
Peridocic Rating Peridocic Rating
Learning Areas Final Rating Learning Areas Final Rating
1 2 3 4 1 2 3 4
Filipino Filipino
Science Science
English English
Mathematics Mathematics
Araling Panlipunan Araling Panlipunan
EPP EPP
MAPEH MAPEH
* Music * Music
* Art * Art
* Physical Education * Physical Education
* Health * Health
Edukasyon sa Pagpapakatao Edukasyon sa Pagpapakatao
Average Average

Eligible for Admission to Grade _______________________ Eligible for Admission to Grade _______________________
 CORE VALUES BEHAVIOR STATEMENTS Gr. ___ Sch. Yr. ____ Gr. ___ Sch. Yr. _____ Gr. ___ Sch. Yr. _____
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one's spiritual beliefs while
respecting the spiritual beliefs of others.
1. MAKA-DIYOS
Shows adherence to ethical principles by
upholding truth.
In sentitive to individual,social and cultural
differnces.
2. MAKA-TAO
Demonstrates contributions towards solidarity.

Cares for the environment and utilizes

3. MAKA-KALIKASAN resources, wisely, judiciosly and
economically.

Demonstrates pride in being a Filipino;

exercises the rights and responsibilities of a
Filipino Citizen.
4. MAKA-BANSA
Demonstrates appropriate behavior in carrying
out activities in the school, community, and
country.

CORE VALUES BEHAVIOR STATEMENTS Gr. ___ Sch. Yr. ____ Gr. ___ Sch. Yr. _____ Gr. ___ Sch. Yr. _____
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one's spiritual beliefs while
respecting the spiritual beliefs of others.
1. MAKA-DIYOS
Shows adherence to ethical principles by
upholding truth.
In sentitive to individual,social and cultural
differnces.
2. MAKA-TAO
Demonstrates contributions towards solidarity.

Cares for the environment and utilizes

3. MAKA-KALIKASAN resources, wisely, judiciosly and
economically.

Demonstrates pride in being a Filipino;

exercises the rights and responsibilities of a
Filipino Citizen.
4. MAKA-BANSA
Demonstrates appropriate behavior in carrying
out activities in the school, community, and
country.

Marking Non-Numerical Rating

AO - Always Observed
SO Sometimes Observed
RO - Rarely Observed
NO N Not Observed

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

CERTIFICATE OF TRANSFER

TO WHOM IT MAY CONCERN:

This is to certify that this is a true copy of the Elementary School Permanent Record of
_________________________________________________. He/She is eligible for transfer and admission
to Grade/Year ____________________________________.

Signature

Date Designation