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DepEd Form 137E Republic of the Philippines LRN:_______________

Department of Education
Region VII, Central Visayas
DIVISION OF CEBU CITY

Name: Division: School:


(Last Name) (First Name) (MI)
Sex: Date of Birth: Place (Town/Province):
Date of Entrance: Parent/Guardian:
(Name) (Address)

ELEMENTARY SCHOOL PROGRESS


Grade I School: Grade II School:
School Year: School Year:
Date Enrolled: Date Enrolled:

Periodic Rating Periodic Rating


LEARNING AREAS FR Remarks LEARNING AREAS
1 2 3 4 1 2
ENGLISH ENGLISH
MATHEMATICS MATHEMATICS
SCIENCE SCIENCE
FILIPINO FILIPINO
MAKABAYAN MAKABAYAN
SIBIKA AT KULTURA SIBIKA AT KULTURA
EKAWP EKAWP
General Average: General Average:
Eligible for admission to Grade Eligible for admission to Grade
Teacher: Teacher:
Principal: Principal:
Grade III School: Grade IV School:
School Year: School Year:
Date Enrolled: Date Enrolled:

Periodic Rating Periodic Rating


LEARNING AREAS FR Remarks LEARNING AREAS
1 2 3 4 1 2
ENGLISH ENGLISH
MATHEMATICS MATHEMATICS
SCIENCE SCIENCE
FILIPINO FILIPINO
SIBIKA AT KULTURA SIBIKA AT KULTURA
EPP EPP
MSEP MSEP
EKAWP EKAWP
General Average: General Average:
Eligible for admission to Grade Eligible for admission to Grade
Teacher Teacher
Principal: Principal:

Grade V School: Grade VI School:


School Year: School Year:
Date Enrolled: Date Enrolled:

Periodic Rating Periodic Rating


LEARNING AREAS FR Remarks LEARNING AREAS
1 2 3 4 1 2
ENGLISH ENGLISH
MATHEMATICS MATHEMATICS
SCIENCE SCIENCE
FILIPINO FILIPINO
MAKABAYAN MAKABAYAN
SIBIKA AT KULTURA SIBIKA AT KULTURA
EPP EPP
MSEP MSEP
EKAWP EKAWP
General Average: General Average:
Eligible for admission to Grade Eligible for admission to Grade
Teacher Teacher
Principal: Principal:
LRN:_______________________________

(Occupation)

Periodic Rating
FR Remarks
3 4

Periodic Rating
FR Remarks
3 4

Periodic Rating
FR Remarks
3 4
Grade SY Grade SY Grade SY
TRAIT
1 2 3 4 FR 1 2 3 4 FR 1 2 3

1 Physically clean in body, mind and language


2 Ready to work/cooperate in class activities
3 Honest in word and thought
4 Concerned about preserving he environment
5 Thrifty in using resources of time and money
6 Peace-loving; avoids conflicts and quarrels
7 Trustworthy; can be trusted or depended upon
8 Truthful; seldom tells lies
9 Dependable to complete tasks given to him/her
10 Is able to discipline himself/herself
11 Has faith in God
12 Respects persons in authority
13 Values Filipino culture/arts
14 Behaves in a manner appropriate for his/her age

Grade SY Grade SY Grade SY


TRAIT
1 2 3 4 FR 1 2 3 4 FR 1 2 3

1 Physically clean in body, mind and language


2 Ready to work/cooperate in class activities
3 Honest in word and thought
4 Concerned about preserving he environment
5 Thrifty in using resources of time and money
6 Peace-loving; avoids conflicts and quarrels
7 Trustworthy; can be trusted or depended upon
8 Truthful; seldom tells lies
9 Dependable to complete tasks given to him/her
10 Is able to discipline himself/herself
11 Has faith in God
12 Respects persons in authority
13 Values Filipino culture/arts
14 Behaves in a manner appropriate for his/her age

BELOW AVERAGE AVERAGE ABOVE AV


X XX XXX

* ** ***
B A AA
1 2 3

ATTENDANCE RECORD
CERTIFICATE OF TRANSFER
TO WHOM IT MAY CONCERN,

This is to certify that this is a record/Elementary School Permanent Record of ______________________________. He/She is
transfer and admission to Grade / Year _______________________________________.

Signature

Date Designation
Grade SY

4 FR 1 2 3 4 FR

Grade SY

4 FR 1 2 3 4 FR

ABOVE AVERAGE
XXX

***
AA
3
___________. He/She is eligible for

Signature

Designation

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