(Name) (School) (Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod (Date of Entrance)
(Name) (School) (Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod (Date of Entrance)
(Name) (School) (Sex) (Date of Birth) (Place) Bayan/Lalawigan/Lungsod (Date of Entrance)
KAGAWARAN NG EDUKASYON
(Department of Education)
Rehiyon IV
Region IV
LRN: ________________________
Pangalan
(Name)
Apelyido
Kasarian
(Sex)
Unang ngalan
M.I.
Petsa ng Kapanganakan
(Date of Birth)
Purok
(District)
Paaralan
(School)
Pook
(Place) Bayan/Lalawigan/Lungsod
(Town/Province/City)
Petsa ng Pagpasok
(Date of Entrance)
Magulang/Tagapag-alaga
Pangalan
(Name)
Tirahan
(Address)
Hanapbuhay
(Occupation)
II.
Learning Areas
Periodic Rating
2
3
4
REMARKS
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
Periodic Rating
2
3
4
REMARKS
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
Learning Areas
Periodic Rating
2
3
4
Health
Edukasyon sa Pagpapakatao
General Average
Learning Areas
Periodic Rating
2
3
4
REMARKS
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
Learning Areas
Periodic Rating
1
2
3
4
FINAL
RATING
Learning Areas
REMARKS
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
Legend:
Beginning (B)
Developing (D)
Approaching Proficiency (AP)
Proficient (P)
Advance (A)
III.
CHARACTER BUILDING
Traits
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Honesty
Courtesy
Helpfulness and Cooperation
Resourcefulness and Creativity
Consideration for Others
Sportsmanship
Obedience
Self-Reliance
Industry
Cleanliness and Orderliness
Promptness and punctuality
Sense of Responsibility
Love of God
Love of Country
Traits
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
Honesty
Courtesy
Helpfulness and Cooperation
Resourcefulness and Creativity
Consideration for Others
Sportsmanship
Obedience
Self-Reliance
Industry
Cleanliness and Orderliness
Promptness and punctuality
Sense of Responsibility
Love of God
Love of Country
A.
Outstanding
Good
B. Very
D.
Fair
E. Poor
.Good
ATTENDANCE RECORD
Grade
No. of
School
Days
No. of School
Days Absent
Cause
No. of
Times
Tardy
Cause
No. of School
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 to Grade/Year ______________________
___________________________________
Signature
______________________
Date
____________________________________
Designation