REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF EDUCATION

SENIOR HIGH SCHOOL STUDENT PERMA

LEARNER'S INFORMATION
LAST NAME: FIRST NAME:
LRN: Date of Birth (MM/DD/YYYY): Sex:

ELIGIBILITY FOR SHS ENROLMENT

High School Completer* Gen. Ave: ⁄ Junior High School Completer Gen. Ave:
Date of Graduation/Completion (MM/DD/YYYY): Name of School:
PEPT Passer** Rating: ALS A&E Passer*** Rating: Others (Pls. Spec
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 Lea
**PEPT - Philippine Educational Placement Test for JHS
SCHOLASTIC RECORD
SCHOOL: FELIX BALGOS NATIONAL HIGH SCHOOL SCHOOL ID: 343654
TRACK/STRAND:GENERAL ACADEMIC STRAND
Indicate if Subject is
CORE, APPLIED, or SUBJECTS
SPECIALIZED
Core Komunikasyon at Pananaliksik sa Wika at Kulturang Pilipino
Core Oral Communication
Core General Mathematics
Core Earth and Life Science*
Core Understanding Culture, Society and Politics
Core Physical Education and Health
Applied English for Academic and Professional Purposes
Applied Empowerment Technologies
Specialized Introduction to the World Religions and Beliefs System

REMARKS:
Prepared by: Certified True and Correct:

MARY CHARMINE GRACE O. BANIAGO MYRTHYL L. COCHING, Principal

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

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

Indicate if Subject is
CORE, APPLIED, or SUBJECTS
SPECIALIZED

Name of Teacher/Adviser:

SCHOOL: FELIX BALGOS NATIONAL HIGH SCHOOL SCHOOL ID: 343654

TRACK/STRAND:GENERAL ACADEMIC STRAND
Indicate if Subject is
 Indicate if Subject is
CORE, APPLIED, or SUBJECTS
SPECIALIZED
Core Pagbasa at Pagsusuri ng Iba't Ibang Teksto Tungo sa Pananaliksik
Core Reading and Writing
Core 21st Century Literature from the Philippines and the World
Core Statistics and Probability
Core Personal Development/Pansariling Kaunlaran
Core Physical Education and Health
Applied Practical Research 1
Specialized Philippine Politics and Governance
Specialized Humanities I- Trends, Networks and Critical Thinking in the 21st Century Culture

REMARKS:
Prepared by: Certified True and Correct:

MARY CHARMINE GRACE O. BANIAGO MYRTHYL L. COCHING, Principal

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

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

Indicate if Subject is
CORE, APPLIED, or SUBJECTS
SPECIALIZED

Name of Teacher/Adviser:
 PPINES FORM 137-SHS
CATION

PERMANENT RECORD

MIDDLE NAME:
Sex: Date of SHS Admission (MM/DD/YYYY):

NT

School Address:
Pls. Specify):
Center:
rnative Learning System Accreditation and Equivalency Test for JHS

GRADE LEVEL: 11 SY: 2018-2019 SEM: 1ST

SECTION: AMETHYST
Quarter SEM FINAL ACTION
1ST 2ND GRADE TAKEN

General Ave. for the Semester:

Date Checked (MM/DD/YYYY):

Principal III
nted Name, Designation

SCHOOL ID:
REMEDIAL
SEM FINAL RECOMPUTED ACTION
CLASS
GRADE FINAL GRADE TAKEN
MARK

Signature:

GRADE LEVEL: 11 SY: 2018-2019 SEM: 2ND

SECTION: AMETHYST
Quarter SEM FINAL ACTION
 SEM FINAL ACTION
3RD 4TH GRADE TAKEN

General Ave. for the Semester:

Date Checked (MM/DD/YYYY):

Principal III
nted Name, Designation

SCHOOL ID:
REMEDIAL
SEM FINAL RECOMPUTED ACTION
CLASS
GRADE FINAL GRADE TAKEN
MARK

Signature:
 Page 2
SCHOOL: SCHOOL ID: GRADE
TRACK/STRAND:

Indicate if Subject is CORE,

SUBJECTS
APPLIED, or SPECIALIZED

REMARKS:
Prepared by: Certified True and Correct:

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

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

Indicate if Subject is CORE,

SUBJECTS
APPLIED, or SPECIALIZED

Name of Teacher/Adviser:

SCHOOL: SCHOOL ID: GRADE

TRACK/STRAND:

Indicate if Subject is CORE,

SUBJECTS
APPLIED, or SPECIALIZED
REMARKS:
Prepared by: Certified True and Correct:

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

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

Indicate if Subject is CORE,

SUBJECTS
APPLIED, or SPECIALIZED

Name of Teacher/Adviser:

Track/Strand Accomplished:
Awards/Honors Received:
Certified by: Place School Sea

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):

 Form 137-SHS
GRADE LEVEL: SY: SEM: 1ST
SECTION:
Quarter SEM FINAL ACTION
1ST 2ND GRADE TAKEN

General Ave. for the Semester:

Date Checked (MM/DD/YYYY):

ed Name, Designation

SCHOOL ID:
REMEDIAL
SEM FINAL RECOMPUTED ACTION
CLASS
GRADE FINAL GRADE TAKEN
MARK

Signature:

GRADE LEVEL: SY: SEM:

SECTION:
Quarter SEM FINAL ACTION
GRADE TAKEN
 General Ave. for the Semester:

Date Checked (MM/DD/YYYY):

ed Name, Designation

SCHOOL ID:
REMEDIAL
SEM FINAL RECOMPUTED ACTION
CLASS
GRADE FINAL GRADE TAKEN
MARK

Signature:

SHS General Average:

Date of SHS Graduation (MM/DD/YYYY):
chool Seal Here:
 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)

Trends, Networks and Critical Thinking in the 21st Century Culture
Disciplines and Ideas in the Social Sciences
Introduction to the World Religions and Beliefs System
Philippine Politics and Governance
Humanities I- Trends, Networks and Critical Thinking in the 21st Century Culture

OTHER SUBJECTS (Please write the list of subjects below)