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Principal of
__________________
School
on____________________

REPUBLIC OF THE PHILIPPINES


DEPARTMENT OF EDUCATION
Region X
Schools Division Office of DEPED TAMBAYAN

FORM 137-A

ELEMENTARY SCHOOL PERMANENT RECORD

LRN: ________________

Name: ___________________________________________________________ Date of Birth: Year _____________ Month___________


Day_________
Place
of
Birth:
Province
__________________________________
Town_________________________________
Barrio__________________________
Parent
or
Guardian:
_____________________________________________________________
Occupation
____________________________________
Address
of
Parent
or
Guardian:
__________________________________________________________________________________________________
ELEMENTARY SCHOOL PROGRESS
Grade ___ School _________________________________________________
School Year _________________

Learning Areas

Periodic Rating
2
3
4

FINAL
RATING

REMARKS

Grade ___ School _________________________________________________


School Year _________________

Learning Areas

Mother Tongue

Mother Tongue

Filipino

Filipino

English

English

Mathematics

Mathematics

Araling Panlipunan

Araling Panlipunan

EPP/TLE

EPP/TLE

MAPEH

MAPEH

Music

Music

Art

Art

Physical Education

Physical Education

Health
Edukasyon sa Pagpapakatao

FINAL
RATING

REMARKS

General Average

Eligible for Admission to Grade ____________

Eligible for Admission to Grade ____________

Grade ___ School _________________________________________________


School Year _________________

Periodic Rating
2
3
4

FINAL
RATING

REMARKS

Grade ___ School _________________________________________________


School Year _________________

Learning Areas

Mother Tongue

Mother Tongue

Filipino

Filipino

English

English

Mathematics

Mathematics

Science

Science

Araling Panlipunan

Araling Panlipunan

EPP/TLE

EPP/TLE

MAPEH

MAPEH

Music

Music

Art

Art

Physical Education

Physical Education

Health
Edukasyon sa Pagpapakatao

Periodic Rating
2
3
4

FINAL
RATING

REMARKS

Health
Edukasyon sa Pagpapakatao

General Average

General Average

Eligible for Admission to Grade ____________

Eligible for Admission to Grade ____________

Grade ___ School _________________________________________________


School Year _________________

Learning Areas

Periodic Rating
2
3
4

Health
Edukasyon sa Pagpapakatao

General Average

Learning Areas

Periodic Rating
2
3
4

FINAL
RATING

REMARKS

Grade ___ School _________________________________________________


School Year _________________

Learning Areas

Mother Tongue

Mother Tongue

Filipino

Filipino

English

English

Mathematics

Mathematics

Science

Science

Araling Panlipunan

Araling Panlipunan

EPP/TLE

EPP/TLE

MAPEH

MAPEH

Music

Music

Art

Art

Physical Education

Physical Education

Health
Edukasyon sa Pagpapakatao
General Average
Eligible for Admission to Grade _____________

Periodic Rating
2
3
4

FINAL
RATING

Health
Edukasyon sa Pagpapakatao
General Average
Eligible for Admission to Grade _____________

REMARKS

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