DepEd- Form 137-E (K to 12)

Republika ng Pilipinas
(Republic of the Philippines)
Kagawaran ng Edukasyon
(Department of Education)
KAWANIHAN NG EDUKASYON ELEMENTARYA
(BUREAU OF ELEMENTARY EDUCATION)
Rehiyon V (Bikol)
SANGAY NG MASBATE
(DIVISION OF MASBATE)

PALAGIANG TALAAN SA PAARALANG ELEMENTARYA

(ELEMENTARY SCHOOL PERMANENT RECORD)

I. Pangalan ____________________________________________ Paaralan ____________________________________________________

(Name) Apelyido Unang Pangalan M. Name (School)
(Surname) (First Name)
Kasarian _________ Petsa ng Kapanganakan __________________ Pook ___________________________ Petsa ng Pagpasok ____________________
(Sex) (Date of Birth) (Place of Birth) Bayan Lalawigan Lungsod (Date of Entrance)
(Town Province City)
Magulang/Tagapag-alaga ______________________________________________________________________________________________________
(Parent/Guardian) Pangalan Tirahan Hanapbuhay
(Name) (Address) (Occupation)

II. PAG-UNLAD SA PAARALANG ELEMENTARYA

(ELEMENTARY SCHOOL PROGRESS)
(GRADES I-VI K to 12)

Grade I- School _________________________________________ Grade II- School _______________________________________

School Year __________________________________________ School Year __________________________________________
PERIODIC RATING Final Remarks
PERIODIC RATING Final Remarks
Learning Areas Rating
Learning Areas Rating
1 2 3 4
1 2 3 4
Mother Tongue
Mother Tongue
Filipino Filipino
English English
Mathematics
Mathematics
Araling Panlipunan Araling Panlipunan
MAPEH MAPEH
 Music
 Music
 Arts  Arts
 Physical Education
 Physical Education
 Health  Health
Edukasyon Sa Pagpapakatao (EsP) Edukasyon sa Pagpapakatao (EsP)
Eligible for Admission to Grade ___________ Eligible for Admission to Grade ___________

Grade III- School ______________________________________ Grade IV- School ______________________________________

School Year __________________________________________ School Year __________________________________________
PERIODIC RATING Final Remarks
PERIODIC RATING Final Remarks
Learning Areas Rating
Learning Areas Rating
1 2 3 4
1 2 3 4
Mother Tongue Mother Tongue
Filipino Filipino
English
English
Mathematics Mathematics
Science Science
Araling Panlipunan Araling Panlipunan
MAPEH MAPEH
 Music
 Music
 Arts  Arts
 Physical Education  Physical Education
 Health
 Health
Edukasyon Sa Pagpapakatao (EsP) Edukasyon sa Pagpapakatao (EsP)
Eligible for Admission to Grade ___________ Eligible for Admission to Grade ___________

Grade V- School ______________________________________ Grade VI- School ______________________________________

School Year __________________________________________ School Year __________________________________________
PERIODIC RATING Final Remarks
PERIODIC RATING Final Remarks
Learning Areas Rating
Learning Areas Rating
1 2 3 4
1 2 3 4
Mother Tongue
Mother Tongue
Filipino Filipino
English
English
Mathematics Mathematics
Araling Panlipunan Araling Panlipunan
MAPEH
MAPEH
 Music  Music
 Arts  Arts
 Physical Education
 Physical Education
 Health  Health
Edukasyon Sa Pagpapakatao (EsP)
Edukasyon sa Pagpapakatao (EsP)
Eligible for Admission to Grade ___________ Eligible for Admission to Grade ___________
III. CHARACTER BUILDING
Gr. _____ Sch. Yr. ____________ Gr. _____ Sch. Yr. ____________ Gr. _____ Sch. Yr. ____________
1 2 3 4 FR 1 2 3 4 FR 1 2 3 4 FR
Expresses one’s spiritual beliefs
while respecting the spiritual beliefs
1. Maka- of others
Diyos Shows adherence to ethical
principles by upholding truth

Is sensitive to individual, social, and

cultural differences
2. Makatao
Demonstrates contributions
towards solidarity

3. Maka- Cares for the environment and

utilizes resources wisely,
kalikasan judiciously, and economically

Demonstrates pride in being a

Filipino, exercises the rights and
4. Maka- responsibilities of a Filipino Citizen

bansa Demonstrates appropriate behavior

in carrying out activities in the
school, community and country

Gr. _____ Sch. Yr. ____________ Gr. _____ Sch. Yr. ____________ Gr. _____ Sch. Yr. ____________
1 2 3 4 FR 1 2 3 4 FR 1 2 3 4 FR
Expresses one’s spiritual beliefs while
respecting the spiritual beliefs of
1. Maka- others
Diyos Shows adherence to ethical principles
by upholding truth

Is sensitive to individual, social, and

cultural differences
2. Makatao
Demonstrates contributions towards
solidarity

3. Maka- Cares for the environment and utilizes

resources wisely, judiciously, and
kalikasan economically

Demonstrates pride in being a Filipino,

exercises the rights and responsibilities
4. Maka- of a Filipino Citizen

bansa Demonstrates appropriate behavior in

carrying out activities in the school,
community and country

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

IV. ATTENDANCE RECORD

School Year No. of School Days No. of School

Grade No. of School Days Cause
Absent Days Present

CERTIFICATE OF TRANSFER
TO WHOM IT MAY CONCERN:
T h i s i s t o c e r t i f y t h a t t h i s a t r u e r e c o r d o f t he E l e m e nt a r y Sc ho o l P e r m a n e nt R e c o r d o f
________________________________________. H e / S h e i s e l i g i b l e f o r t r a ns f e r a nd a d m i s s i o n t o G r a d e / Y e a r ____________________.

___________________________
Signature
___________________________
________________________________ Designation
Date