REPUBLIC OF THE PHILIPPINES FORM 137-SHS

DEPARTMENT OF EDUCATION

SENIOR HIGH SCHOOL STUDENT PERMANENT RECORD

LEARNER'S INFORMATION
LAST NAME: BALDOZA FIRST NAME: PEMIE MIDDLE NAME: ANOVER
LRN: 136634050100 Date of Birth (MM/DD/YYYY): APRIL 7,2000 Sex: FEMALE Date of SHS Admission (MM/DD/YYYY):

ELIGIBILITY FOR SHS ENROLMENT

High School Completer* Gen. Ave: ⁄ Junior High School Completer Gen. Ave: 77
Date of Graduation/Completion (MM/DD/YYYY): Name of School: CAMARIN HIGH SCHOOL School Address: CADENA DE AMOR 18, AREA B, CAMARIN CALOOCAN CITY

PEPT Passer** Rating: ALS A&E Passer*** Rating: Others (Pls. Specify):
Date of Examination/Assessment (MM/DD/YYYY): Name and Address of Community Learning Center:
*High School Completers are students who graduated from secondary school under the old curriculum ***ALS A&E - Alternative Learning System Accreditation and Equivalency Test for JHS
**PEPT - Philippine Educational Placement Test for JHS
SCHOLASTIC RECORD
SCHOOL: CIEVEROSE COLLEGE INC. SCHOOL ID: 407034 GRADE LEVEL: 11 SY: 2016-2017 SEM: 1ST
TRACK/STRAND: TVL/HOTEL AND RESTAURANT SERVICES SECTION: SHS-11
Indicate if Subject is Quarter SEM FINAL ACTION
CORE, APPLIED, or SUBJECTS
1ST 2ND GRADE TAKEN
SPECIALIZED
Core Oral Communication 83 77 80 PASSED
Core General Mathematics 76 78 77 PASSED
Core Personal Development/Pansariling Kaunlaran 74 76 75 PASSED
Core Physical Education and Health 77 77 77 PASSED
Core Komunikasyon at Pananaliksik sa Wika at Kulturang Pilipino 78 77 78 PASSED
Applied Filipino sa Piling Larang 78 79 79 PASSED
Applied English for Academic and Professional Purposes 78 79 79 PASSED
Specialized Introduction to Hospitality Industry 75 74 75 PASSED
Specialized Principle of Safety,Hygiene and Sanitation 81 80 81 PASSED

General Ave. for the Semester: 78 PASSED

REMARKS:
Prepared by: Certified True and Correct: Date Checked (MM/DD/YYYY):

Signature of Adviser over Printed Name Signature of Authorized Person over Printed Name, Designation

REMEDIAL CLASSES Conducted from (MM/DD/YYYY): to (MM/DD/YYYY): SCHOOL: SCHOOL ID:

Indicate if Subject is REMEDIAL
SEM FINAL RECOMPUTED ACTION
CORE, APPLIED, or SUBJECTS CLASS
GRADE FINAL GRADE TAKEN
SPECIALIZED MARK

Name of Teacher/Adviser: Signature:

SCHOOL: CIEVEROSE COLLEGE INC. SCHOOL ID: 407034 GRADE LEVEL: 11 SY: 2016-2017 SEM: 2ND
TRACK/STRAND: TVL/HOTEL AND RESTAURANT SERVICES SECTION: SHS-11
Indicate if Subject is Quarter SEM FINAL ACTION
CORE, APPLIED, or SUBJECTS
3RD 4TH GRADE TAKEN
SPECIALIZED
Core 21st Century Literature from the Philippines and the World 76 76 76 PASSED
Core Pagbasa at Pagsusuri ng Iba't Ibang Teksto Tungo sa Pananaliksik 86 84 85 PASSED
Core Understanding Culture, Society and Politics 84 77 81 PASSED
Core Physical Education and Health 70 80 75 PASSED
Core Statistics and Probability 71 75 73 FAILED
Core Reading and Writing 84 83 84 PASSED
Applied Practical Research 1 80 75 78 PASSED
Specialized Food selection and Preparation 66 85 76 PASSED
Specialized Bartending 81 83 82 PASSED

General Ave. for the Semester: 79 PASSED

REMARKS:
Prepared by: Certified True and Correct: Date Checked (MM/DD/YYYY):

Signature of Adviser over Printed Name Signature of Authorized Person over Printed Name, Designation

REMEDIAL CLASSES Conducted from (MM/DD/YYYY): to (MM/DD/YYYY): SCHOOL: SCHOOL ID:

Indicate if Subject is REMEDIAL
SEM FINAL RECOMPUTED ACTION
CORE, APPLIED, or SUBJECTS CLASS
GRADE FINAL GRADE TAKEN
SPECIALIZED MARK

Name of Teacher/Adviser: Signature:

 Page 2 BALDOZA, PEMIE ANOVER Form 137-SHS
SCHOOL: CIEVEROSE COLLEGE INC. SCHOOL ID: 407034 GRADE LEVEL: 12 SY: 2017-2018 SEM: 1ST
TRACK/STRAND: TVL/HOTEL AND RESTAURANT SERVICES SECTION: SHS-12

Indicate if Subject is CORE, Quarter SEM FINAL ACTION

SUBJECTS
APPLIED, or SPECIALIZED 1ST 2ND GRADE TAKEN

Core Earth Science 85

Core Introduction to the Philosophy of the Human Person/Pambungad sa Pilosopiya ng Tao 78 78 78 PASSED
Core Contemporary Philippine Arts from the Regions 75
Core Media and Information Literacy 84 85 85 PASSED
Core Physical Education and Health 81
Specialized Front Office Procedures and Services 83 80 82 PASSED
Specialized Meal Management 82 80 81 PASSED
Applied Practical Research 2

General Ave. for the Semester: 82 PASSED

REMARKS:
Prepared by: Certified True and Correct: Date Checked (MM/DD/YYYY):

Signature of Adviser over Printed Name Signature of Authorized Person over Printed Name, Designation

REMEDIAL CLASSES Conducted from (MM/DD/YYYY): to (MM/DD/YYYY): SCHOOL: SCHOOL ID:

REMEDIAL
Indicate if Subject is CORE, SEM FINAL RECOMPUTED ACTION
SUBJECTS CLASS
APPLIED, or SPECIALIZED GRADE FINAL GRADE TAKEN
MARK

Name of Teacher/Adviser: Signature:

SCHOOL: CIEVEROSE COLLEGE INC. SCHOOL ID: 407034 GRADE LEVEL: 12 SY: 2017-2018 SEM: 2ND
TRACK/STRAND: TVL/HOTEL AND RESTAURANT SERVICES SECTION: SHS-12

Indicate if Subject is CORE, Quarter SEM FINAL ACTION

SUBJECTS
APPLIED, or SPECIALIZED 3RD 4TH GRADE TAKEN

Core Physical Education and Health

Core Physical Science*
Applied Empowerment Technologies
Applied Entrepreneurship
Applied Inquiries, Investigations and Immersion

General Ave. for the Semester:

REMARKS:
Prepared by: Certified True and Correct: Date Checked (MM/DD/YYYY):

Signature of Adviser over Printed Name Signature of Authorized Person over Printed Name, Designation

REMEDIAL CLASSES Conducted from (MM/DD/YYYY): to (MM/DD/YYYY): SCHOOL: SCHOOL ID:

REMEDIAL
Indicate if Subject is CORE, SEM FINAL RECOMPUTED ACTION
SUBJECTS CLASS
APPLIED, or SPECIALIZED GRADE FINAL GRADE TAKEN
MARK

Name of Teacher/Adviser: Signature:

Track/Strand Accomplished: SHS General Average:

Awards/Honors Received: Date of SHS Graduation (MM/DD/YYYY):
Certified by: Place School Seal Here:

Signature of School Head over Printed Name Date

NOTE:
This permanent record or a photocopy of this permanent record that bears the seal of the school and the original
signature in ink of the School Head shall be considered valid for all legal purposes. Any erasure or alteration
made on this copy should be validated by the School Head.
If the student transfers to another school, the originating school should produce one (1) certified true copy of this
permanent record for safekeeping. The receiving school shall continue filling up the original form.
Upon graduation, the school from which the student graduated should keep the original form and produce one (1)
certified true copy for the Division Office.

REMARKS: (Please indicate the purpose for which this permanent record will be used)

Date Issued (MM/DD/YYYY):

BALDOZA, PEMIE ANOVER Form 137-SHS
ANNEX: LIST OF SUBJECTS TAKEN
Please check the subjects passed by the student
CORE SUBJECTS
∕ Oral Communication
∕ Reading and Writing
∕ Komunikasyon at Pananaliksik sa Wika at Kulturang Pilipino
∕ Pagbasa at Pagsusuri ng Iba't Ibang Teksto Tungo sa Pananaliksik
∕ 21st Century Literature from the Philippines and the World
Contemporary Philippine Arts from the Regions
∕ Media and Information Literacy
∕ General Mathematics
Statistics and Probability
Earth and Life Science*
Physical Science*
∕ Personal Development/Pansariling Kaunlaran
∕ Understanding Culture, Society and Politics
∕ Introduction to the Philosophy of the Human Person/Pambungad sa Pilosopiya ng Tao
Physical Education and Health (spread out in 4 semesters)
*STEM students will take these instead:
Earth Science
Disaster Readiness and Risk Reduction
Subject substitutions, if any:

APPLIED SUBJECTS
∕ English for Academic and Professional Purposes
∕ Practical Research 1
Practical Research 2
∕ Filipino sa Piling Larang
Empowerment Technologies
Entrepreneurship
Inquiries, Investigations and Immersion

SPECIALIZED SUBJECTS (Please write the list of subjects below)

∕ Introduction to Hospitality Industry
∕ Principle of Safety,Hygiene and Sanitation
∕ Food selection and Preparation
∕ Front Office Procedures and Services
∕ Meal Management
∕ Bartending

OTHER SUBJECTS (Please write the list of subjects below)