FORM 137-E Copy of this record sent to

Republika ng Pilipinas Principal of __________________

(Republic of the Philippines)
School on____________________
Kagawaran ng Edukasyon
(Department of Education) ______________________
KAWANIHAN NG EDUKASYON ELEMENTARYA Principal
(BUREAU OF ELEMENTARY EDUCATION)
Rehiyon: _______

PALAGIANG TALAAN SA MABABANG PAARALAN

(Elementary School Permanent Record)
LRN: _______________________________

Pangalan: ______________________________________________________________ Sangay: __________________Paaralan: _______________________________

(Name) Apelyido UnangPangalan M.I. (Division) (School)

Kasarian: _________ Petsa ng Kapanganakan: _________________Pook: ___________________________________Petsa ng Pagpasok: ____________

(Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod (Date of Entrance)
(Town/Province/City)
Magulang/Tagapag-alaga:____________________________________________________________________________________________________________________
(Parent/Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

PAG-UNLAD SA MABABANG PAARALAN

(Elementary School Progress)

Grade I-School____________________________________________________________________ Grade II-School________________________________________________________________

School Year________________________________________________________________________ School Year__________________________________________________________________
Periodic Rating Periodic Rating
LEARNING AREAS Remarks LEARNING AREAS Remarks
1 2 3 4 1 2 3 4
Mother Tongue Mother Tongue
Filipino Filipino
English English
Mathematics Mathematics
Araling Panlipunan (AP) Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP) Edukasyon sa Pagpapakatao (EsP)
MAPEH MAPEH
Music Music
Art Art
Physical Education (PE) Physical Education (PE)
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 Periodic Rating
LEARNING AREAS Remarks LEARNING AREAS Remarks
1 2 3 4 1 2 3 4
Mother Tongue Filipino
Filipino English
English Mathematics
Mathematics Science
Science Araling Panlipunan (AP)
Araling Panlipunan (AP) Edukasyon sa Pagpapakatao (EsP)
Edukasyon sa Pagpapakatao (EsP) EPP
MAPEH MAPEH
Music Music
Art Art
Physical Education (PE) Physical Education (PE)
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 Periodic Rating
LEARNING AREAS Remarks LEARNING AREAS Remarks
1 2 3 4 1 2 3 4
Filipino Filipino
English English
Mathematics Mathematics
Science Science
Araling Panlipunan (AP) Araling Panlipunan (AP)
Edukasyon sa Pagpapakatao (EsP) Edukasyon sa Pagpapakatao (EsP)
EPP EPP
MAPEH MAPEH
Music Music
Art Art
Physical Education (PE) Physical Education (PE)
Health Health
General Average General Average
Eligible for Admission to Grade______________________________________________ Eligible for Admission to Grade______________________________________________
III. REPORT ON LEARNER’S OBSERVED VALUES
Gr. 1 S.Y. _____________ Gr. 2 S.Y. _____________ Gr. 3 S.Y. _____________
Quarter Quarter Quarter
Core Values Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one’s spiritual beliefs while
respecting the spiritual beliefs of
MAKA- others
DIYOS Shows adherence to ethical principles
by upholding truth
Shows adherence to ethical principles
by upholding truth
MAKATAO Demonstrates contributions toward
solidarity
Cares for the environment and utilizes
MAKA
resources wisely, judiciously, and
KALIKASAN economically
Demonstrates pride in being a Filipino;
exercises the rights and
responsibilities of a Filipino citizen.
MAKABANSA
Demonstrates appropriate behavior in
carrying out activities in the school,
community, and country

Gr. 4 S.Y. _____________ Gr. 5 S.Y. ____________ Gr. 6 S.Y. ____________

Quarter Quarter Quarter
Core Values Behavior Statements
1 2 3 4 1 2 3 4 1 2 3 4
Expresses one’s spiritual beliefs while
respecting the spiritual beliefs of
MAKA- others
DIYOS Shows adherence to ethical principles
by upholding truth
Shows adherence to ethical principles
by upholding truth
MAKATAO Demonstrates contributions toward
solidarity
Cares for the environment and utilizes
MAKA
resources wisely, judiciously, and
KALIKASAN economically
Demonstrates pride in being a Filipino;
exercises the rights and
responsibilities of a Filipino citizen.
MAKABANSA
Demonstrates appropriate behavior in
carrying out activities in the school,
community, and country

MARKING NON-NUMERICAL RATING MARKING NON-NUMERICAL RATING

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

IV. ATTENDANCE RECORD

No. of School No. of School No. of Times No. of School
Grade Cause Cause
Days Days Absent Tardy Days Present

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 of Grade_____________________.

_____________________________________________
Signature
__________________________________________ ____________________________________________
Date Designation