DepEd Form 137

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DepEd Form 137-A

Republic of the
Philippines
DEPARTMENT
OF EDUCATION
Region II
___________
___________
__ ______ __
___
School ________
______________
_____________
Municipality
SECONDARY
STUDENTS
PERMANENT
RECORD
____________
_____________
_____________
______
Date of Birth:
Year
_____
Month
__________
___
Day
____
Sex
_______
(Surname) (Given
Name)
Place of Birth:
Province_______
____________
Town
______________
_________ Barrio
______________
________ Parent
of
Guardian:______
______________
______________
______________
______________
______________
_
(Name) (Address) (
Occupation)
Elementary course
completed _______
______ School
________________
________ Year
__________ Gen.
Ave.____________
RECORD OF
STANDARD
INTELLIGENCE
AND
ACHIEVEMENT
TEST
Name and Form of
Test ScoreReceived
PercentileRankNam
e & From of Test Sc
oreReceivedPercen
tileRankSchool
________________
________________
______________
Year
________________
_______ Section
________________
_ Total number of
years in school to
date
________________
________________
__________ School
Year 20 _____ -
20_______
SUBJECTPERIODI
CAL
RATINGAveraging/
CumulativeFinalRa
tingActionTakenU
nitsEarnedExtra-
curricular Activitie
s1 2
3 4
June JulyAugSe
pt Oct
NovDec Jan
Feb Mar April
May
TOTAL
Days of SchoolDays
Present
Has Advance Units
in
________________
________________
________________
________________
________________
_______ Lacks
Units in
________________
________________
________________
________________
________________
_____________ To
be Classified as
________________
________________
___ Total number of
years in School to
date
________________
_____
(Cur. Year)
School
________________
________________
_____________
School Year
20____ - 20
_______ Section
________________
__
SUBJECTPERIODI
CAL
RATINGAveraging/
CumulativeFinalRa
tingActionTakenU
nitsEarnedExtra-
curricular Activitie
s1 2
3 4
June JulyAugSe
pt Oct
NovDec Jan
Feb Mar April
May
TOTAL
Days of SchoolDays
Present
Has Advance Units
in
________________
________________
________________
________________
________________
_______ Lacks
Units in
________________
________________
________________
________________
________________
_____________ To
be Classified as
________________
________________
___ Total number of
years in School to
date
________________
_____
(Cur. Year)
NAME
________________
________________
________________
________________
________________
________________
___
(Surname) (First N
ame)
School
________________
________________
_____________
School Year
20____ - 20
_______ Section
________________
__
SUBJECTPERIODI
CAL
RATINGAveraging/
CumulativeFinalRa
tingActionTakenU
nitsEarnedExtra-
curricular Activitie
s1 2
3 4

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