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SFRT 2017

School Form 1 School Regi


School Name Bais City National High School School ID 303212
Semester 1st Semester School Year 2019-2020
Section RUBY Course (For TVL Only)

COMPLETE A

Sex (M/F)
NAME BIRTHDATE AGE Religious Affiliation
LRN (Last Name, First Name, Name Extension, Middle
(mm/dd/yyyy) House No./ Street/ Sitio/
Name) Barangay
Purok

Abuyabor, Prince Charls M 10/28/2002 15.5 Born Again Aglipay St. Barangay II
120396080008 Acab, John Mark
120072080078 Buenafe, Jhon Nico Salazar M 9/24/2002 16 Roman Catholic Tavera St.
Barangay II
120396080028 Caducoy, Richem Balderas M 11/19/2002 16 Matambok
Mandalupang
120097080021 Calumpang, Miko Tacalan M 8/20/2002 16 Roman Catholic Mansangaban
Collado, Ariel Matos M 1/2/2001 18 Roman Catholic Basak
120072080137 Diragon, Aaron Al Villanueva M 6/14/2002 16 Juan Luna St. Barangay II
120072120270 Estrada, Carl Angelo Alcanse M
120093080019 Equio, Nelson Jr. Libradilla M Roman Catholic San Jose Barangay I
120072080159 Ferraren, Marc Niño Remolano M Roman Catholic Malucani Tagpo
237504080017 Laraño, Darwin Garcia M Roman Catholic Mabini St. Barangay I
120072080203 Leonor, John Michael Baldozano M IFI/Aglipay Proper Looc
120074080054 Paclauna, Izaac Bhryll Acar M Roman Catholic Tambacan Barangay I
165509080119 Patalita, RV C. M Roman Catholic Highlands Tamisu
120072080252 Paquera, Arnand Bersa M Roman Catholic Zone 3 Cambuilao
120072070275 Sarabia, Marvin Torres M Roman Catholic San Jose Barangay II
120072080063 Viloria, Ace Bantillo M IFI/Aglipay Canibol Okiot

<=== TOTAL MALE


120074080001 Abetong, Cristine Jeanette Beloira F Roman Catholic Proper Panalaan
120181080007 Acibes, Leogine Villo F Roman Catholic Zone II Cambuilao
120072080050 Badoy, Mary Dianne Ferraren F Roman Catholic Proper Looc
120093080010 Bentula, Veronneca Bañez F Roman Catholic Lower Tamisu
120072080093 Cadiente, Xenkey Babe Grace Torres F Roman Catholic Tuong Capiñahan
120072080112 Catacutan, Rica Mae Legaspi F Roman Catholic Proper Lamogong
120106080010 Diano, Recel M. F Roman Catholic Proper Mabunao
120373080033 Eramis, Kitchekym Jabagat F Roman Catholic Cangwala Lonoy
120098080040 Ferolino, Grace Ann Babor F Roman Catholic Proper Camudlas
120387080018 Grapa, Alfie Kate Moreno F IFI/Aglipay Hindungawan Looc
120076080026 Lagare, Jela Mae B. F Roman Catholic Villanueva Talungon
120081080035 Limbaga, Mikaela Kadusale F Jehova's Witness Buntis Bacong
120072080217 Manlucot, Trixia Mae Tragico F Roman Catholic Proper Mansangaban
120106080014 Malalay, Jane Camille Z. F JMCIM Pansalagon Tara
120072080213 Macay, Majorie Balansag F Roman Catholic Cang-uyagit Manlipac
126228121883 Locson, Ivy R. F Roman Catholic San Lorenzo Cambanjao
120072080263 Ragay, Maria Czarena Keith Balauro F Roman Catholic Proper Matangad
120072080269 Romano, Reem Embalsado F March of Faith Mayungcao Bantolinao
120104070034 Talarion, Jyrah F Roman Catholic Candahuyon Cambagahan
120087080049 Timony, Realyn B. F Roman Catholic Proper Capiñahan
120399080067 Tonador, Mary Jun Sarao F Roman Catholic Panambalon Biñohon
117895080134 Tolentino, Gretchen Sarita F IFI/Aglipay Tavera St. Barangay 2
120096080049 Velasco, Emmalyn L. F Roman Catholic Proper Consolacion
SFRT 2017
SFRT 2017
COMPLETE A

Sex (M/F)
NAME BIRTHDATE AGE Religious Affiliation
LRN (Last Name, First Name, Name Extension, Middle
(mm/dd/yyyy) House No./ Street/ Sitio/
Name) Barangay
Purok

120132080099 Vicente, Christine F. F IFI/Aglipay Mambagakay Tamisu


120072080310 Villanueva, Cristine Therese Chua F Roman Catholic Burgos St. Barangay 1

26 <=== TOTAL FEMALE


44 <=== COMBINED
Legend: List and Code of Indicators under REMARKS column
Indicator Code Required Information Indicator Code Required Information
Transferred T/O CCT Recipient CCT CCT Control/reference number &
Out Effectivity Date Name of school
Balik Aral B/A last attended & Year
Transferred In
Specify Exceptionality of the
T/I
Name of School, Date of 1st Attendance and Learner With LWE
Learner
Specify Level & Effectivity Date
Date of Last Attendance if Transferred Out Exceptionality
Accelerated ACL

SFRT 2017
SFRT 2017
Register for Senior High School (SF1-SHS)
District NORTH DISTRICT Division BAIS CITY DIVISION
Grade Level GRADE 11 Track and Strand Humaniti

PLETE ADDRESS PARENTS GUARDIAN (if learner is not Living with Parent)

Municipality/ Father's Name Mother's Maiden Name Name


Province (Last Name, First Name, Name Extension, (Last Name, First Name, Name (Last Name, First Name, Name Relationship
City Middle Name) Extension, Middle Name) Extension, Middle Name)

Bais City Negros Oriental Acab, Marilyn Kadusale Acab, Leoncio Kadusale Uncle

Bais City Negros Oriental Buenafe, Dionesio


Buenafe, Dionesio Malinao Salazar, Melanie Pagador Father
Manjuyod Negros Oriental Malinao
Caducoy, Edgar Balansag Balderas, Rizalita Balbuena Caducoy, Rizalita Balderas Mother
Bais City Negros Oriental Calumpang, Roding Tacalan, Teodora Calumpang, Teodora Tacalan Mother
Bais City Negros Oriental Collado, Edgardo Ardenia Matos, Virginia Collado, Virginia Matos Mother
Bais City Negros Oriental Diragon, Jonathan R. Villanueva, Pamela Marie Diragon, Pamela Marie Mother
Mother
Bais City Negros Oriental Mother
Bais City Negros Oriental Sister
Bais City Negros Oriental Mother
Bais City Negros Oriental Mother
Bais City Negros Oriental Mother
Bais City Negros Oriental Father
Bais City Negros Oriental Mother
Bais City Negros Oriental Auntie
Bais City Negros Oriental Mother
Mother

Bais City Negros Oriental Mother


Bais City Negros Oriental Grandmother
Bais City Negros Oriental Uncle
Bais City Negros Oriental Father
Bais City Negros Oriental Mother
Manjuyod Negros Oriental Auntie
Bais City Negros Oriental Mother
Bais City Negros Oriental Mother
Bindoy Negros Oriental Guardian
Bais City Negros Oriental Mother
Bais City Negros Oriental Relative
Dumaguete Negros Oriental Auntie
Manjuyod Negros Oriental Mother
Mabinay Negros Oriental Mother
Bais City Negros Oriental Father
Bais City Negros Oriental Father
Tanjay Negros Oriental Auntie
Manjuyod Negros Oriental Mother
Bais City Negros Oriental Cousin
Bais City Negros Oriental Mother
Manjuyod Negros Oriental Mother
Bais City Negros Oriental Mother
Bais City Negros Oriental Guardian
SFRT 2017
SFRT 2017
PLETE ADDRESS PARENTS GUARDIAN (if learner is not Living with Parent)

Municipality/ Father's Name Mother's Maiden Name Name


Province (Last Name, First Name, Name Extension, (Last Name, First Name, Name (Last Name, First Name, Name Relationship
City Middle Name) Extension, Middle Name) Extension, Middle Name)

Bais City Negros Oriental Mother


Bais City Negros Oriental Mother
Father

REGISTE Beginning of the Prepared By:


End of the Semester
RED Semester
MALE 18 18
FERNANDO C. CADAYONA JR.
Signature of Adviser over Printed Name

FEMALE 26 26

Beginning of the Semester Date: June 5, 2018


TOTAL 44 44

SFRT 2017
SFRT 2017

VISION Region VII


Humanities and Social Sciences

Contact Number of REMARKS


Parent/ (Please refer to the legend)
Guardian

9263743183

9999585664
9553107043
9101087710
Irregular
9360913711

SFRT 2017
SFRT 2017
Contact Number of REMARKS
Parent/ (Please refer to the legend)
Guardian

DAYONA JR.
r Printed Name

End of the Semester Date: October 20, 2018

SFRT 2017
School Form 2 Daily Attendance Report of Learners for Senior High
(SF2-SHS)
School Name BAIS CITY NATIONAL HIGH SCHOOL School ID 343932 District NORTH

Semester FIRST SEMESTER School Year 2018-2019 Grade Level


Section RUBY Course/s (only for TVL)

No. NAME 1 2 4 5 6 7 8 9 11 12 13 14 15 16 18 19 20 21
(Last Name, First Name, Name Extension, Middle Name)
M T W TH F S M T W TH F S M T W TH F S M T W TH
1 Acab, John Mark
2 Baga, Geovanie Bulat-ag
3 Buenafe, Jhon Nico Salazar
4 Caducoy, Richem Balderas
5 Calumpang, Miko Tacalan
6 Collado, Ariel Matos
7 Diragon, Aaron Al Villanueva
8 Estrada, Carl Angelo Alcanse
9 Equio, Nelson Jr. Libradilla
10 Ferraren, Marc Niño Remolano
11 Laraño, Darwin Garcia
12 Leonor, John Michael Baldozano
13 Paclauna, Izaac Bhryll Acar
14 Patalita, RV C.
15 Paquera, Arnand Bersa
16 Sarabia, Marvin Torres
17 Viloria, Ace Bantillo
<=== MALE | TOTAL Per Day ===>
1 Abetong, Cristine Jeanette Beloira
2 Acibes, Leogine Villo
3 Badoy, Mary Dianne Ferraren
4 Bentula, Veronneca Bañez
5 Cadiente, Xenkey Babe Grace Torres
6 Catacutan, Rica Mae Legaspi
7 Diano, Recel M.
8 Eramis, Kitchekym Jabagat
9 Ferolino, Grace Ann Babor
No. NAME 1 2 4 5 6 7 8 9 11 12 13 14 15 16 18 19 20 21
(Last Name, First Name, Name Extension, Middle Name)
M T W TH F S M T W TH F S M T W TH F S M T W TH
10 Grapa, Alfie Kate Moreno
11 Lagare, Jela Mae B.
12 Limbaga, Mikaela Kadusale
13 Manlucot, Trixia Mae Tragico
14 Malalay, Jane Camille Z.
15 Macay, Majorie Balansag
16 Locson, Ivy R.
17 Ragay, Maria Czarena Keith Balauro
18 Romano, Reem Embalsado
19 Talarion, Jyrah
20 Timony, Realyn B.
21 Tonador, Mary Jun Sarao
22 Tolentino, Gretchen Sarita
23 Velasco, Emmalyn L.
24 Vicente, Christine F.
25 Villanueva, Cristine Therese Chua
<=== FEMALE | TOTAL Per Day ===>
Combined TOTAL Per Day
GUIDELINES: 1. CODES FOR CHECKING AT
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance (blank) - Present; (x) - Absent; Tardy
2. To compute the following: Comer, Lower for Cu

2. REASONS/CAUSES FOR NO
a. Percentage of Enrolment = x 100 (NLS)

a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
b. Average Daily Attendance =
a.3. Parents' attitude toward schooling
a.4. Family problems

c. Percentage of Attendance for the month = x 100


b. Individual-Related Factors
3. Every end of the month, the Class Adviser will submit this form to the Office of the Principal for recording of summary table into School Form 4. Once signed by the b.1. Illness
School Head, this form should be returned to the Class Adviser. b.2. Overage
4. The Class Adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days and/or b.4. Drug Abuse
b.5. Poor Academic Performance
those at risk of dropping out. b.6. Lack of Interest/Distractions
5. Attendance performance of learners will be reflected in the SF9-SHS of every grading period. b.7. Hunger/Malnutrition

c. School-Related Factors
c.1. Teacher Factor
c.2. Physical Condition of Classroom
c.3. Peer Influence
No. NAME 1 2 4 5 6 7 8 9 11 12 13 14 15 16 18 19 20
c.1. Teacher Factor21
(Last Name, First Name, Name Extension, Middle Name) c.2. Physical Condition of Classroom
M T W TH F S M T W TH F S M T W TH F S c.3.
M PeerTInfluence
W TH

d. Geographic/Environmental
d.1. Distance between home and schoo
d.2. Armed conflict (incl. tribal wars & c
d.3. Calamities/Disasters

e. Financial-Related
e.1. Child labor, work

f. Others (Specify)
a. Death
b. Transferred to School Abroad
c. Transferred to International School
d. Transferred to ALS
or High School

NORTH DISTRICT

XI

22
F
22
F

OR CHECKING ATTENDANCE
ent; (x) - Absent; Tardy (half shaded = Upper for Late
Comer, Lower for Cutting Classes)

S/CAUSES FOR NO LONGER IN SCHOOL

Related Factors
care of siblings
age/pregnancy
tude toward schooling
lems

Related Factors

mic Performance
rest/Distractions
nutrition

lated Factors
ctor
ndition of Classroom
nce
22
F

c/Environmental
tween home and school
ict (incl. tribal wars & clan feuds)
Disasters

Related
work

ecify)

o School Abroad
o International School
School Form 3 Books Issued and Returned for Senior High School (SF3-SHS)
School Name BAIS CITY NATIONAL HIGH SCHOOL School ID 343932 District NORTH Division BAIS CITY Region VII
Semester FIRST SEMESTER School Year 2O18-2019 Grade Level XI Track and Strand HUMSS

Section GRADE 11 - RUBY Course/s (only for TVL)

Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

No. NAME ORAL COMM. PHILOSPHY REMARKS/ACTION TAKEN


(Last Name, First Name, Name Extension, Middle Name) (Please refer to the codes below)
Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

1 AGUILAR, Aran Lot 18-Jun


2 ARAPOC, Ethan Raiel Japin 18-Jun
BERSABAL, Christian Dale
3 18-Jun
Mediavilla
4 CABUGNASON, Christian Dave 18-Jun
5 EREGIL, Nherio Jr. Porgatorio 18-Jun
6 FLORENOSOS, Kemuel Dinglasa 18-Jun
7 GALERA, Janrich Aliñabon 18-Jun
8 GONZAGA, Jim Aliñabo 18-Jun
9 ISO, Arcel John Martir 18-Jun
10 JABILLO, Rufino, Jr. Cabildo 18-Jun
11 LARIOSA, John Nicole Cadavis 18-Jun
12 LIMAN, Jeffersom Kelvin Selpa 18-Jun
MALABOSA, Cyrel Clausvic
13 18-Jun
Abrasaldo
14 MARTINEZ, Junie Balasabas 18-Jun
NADAL, Ren Owen Immanuel
15 18-Jun
Abrasaldo
16 REYES, John Lloyd Aba 18-Jun
17 TUMALE, Gino Marfred Delas Verlas 18-Jun
18 VILAR, Ken Eregil 18-Jun
19 YACO, Limbert Baldomar 18-Jun
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

No. NAME ORAL COMM. PHILOSPHY REMARKS/ACTION TAKEN


(Last Name, First Name, Name Extension, Middle Name) (Please refer to the codes below)
Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

36
37
38
39
40
TOTAL MALE ===>
1 ALOLINO, Jedael Baldosano 18-Jun 18-Jun
2 AMPARADO, Rica Jane Aba 18-Jun 18-Jun
3 BONCALES, Niña Marie Zamora 18-Jun 18-Jun
4 BUENAGUA, AJ Baquio 18-Jun 18-Jun
5 CABILDO Czykaye Epan 18-Jun 18-Jun
6 CALIDGUID, Marefie Caseres 18-Jun 18-Jun
7 DAHIL, Judilyn Bureros 18-Jun 18-Jun
8 DELA CRUZ, Rowena Solitario 18-Jun 18-Jun
9 DEVELLERES, Rosalina Navares 18-Jun 18-Jun
10 EQUIO, Cindy Libradilla 18-Jun 18-Jun
11 GARTALLA, Jocelyn Serrano 18-Jun 18-Jun
12 HINDANG, Keziahbel Sarno 18-Jun 18-Jun
13 INGCO, Abegail L. 18-Jun 18-Jun
14 LAGUNERO, Mica Cagang 18-Jun 18-Jun
15 LAGUNERO, Micah Decoriña 18-Jun 18-Jun
16 LITERAL, Jeraldyn Tresquio 18-Jun 18-Jun
17 MANOLONG, Maricel Sabanal 18-Jun 18-Jun
18 MAYLAN, Eva Alma Grace Enecerio 18-Jun 18-Jun
19 MEDICO, Rengel Mae Garson 18-Jun 18-Jun
20 PALOMAR, Marife Andicoy 18-Jun 18-Jun
21 PATENIO, Ericka Jane C. 18-Jun 18-Jun
22 PILEO, Ericka L. 18-Jun 18-Jun
23 PLECER, Charia Mae Dinolan 18-Jun 18-Jun
24 RODRIQUEZ, Leah Bayawa 18-Jun 18-Jun
25 TERANO, Aljane Marie H. 18-Jun 18-Jun
26 TORRES, Richielyn Kyla Megio 18-Jun 18-Jun
27
28
29
30
31
32
33
34
35
36
Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle Book / ModuleTitle

No. NAME ORAL COMM. PHILOSPHY REMARKS/ACTION TAKEN


(Last Name, First Name, Name Extension, Middle Name) (Please refer to the codes below)
Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy) Date (mm/dd/yy)
Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

37
38
TOTAL FEMALE ===>
COMBINED ===>

GUIDELINES: In case of lost/unreturned books, please provide information with the following code:
Prepared By:
1. Title of Books Issued to each learner must be recorded by the Class Adviser. A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence
2. The Date of Issuance and the Date of Return shall be reflected in the form. B. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code
3. The Total Number of Copies issued shall be reflected in the form. FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian (for
4. The Total Number of Copies of Books Returned shall be reflected in the form.
5. All textbooks being used must be included. Additional copies of this form may be used if needed.
code TDO), PTL=Paid by the Learner (for code NEG). References: DO No.23, s.2001, DO No.25, s.2003, DO No.14, FERNANDO C. CADAYONA JR.
s.2012.
Signature of Class Adviser over Printed Name
School Form 4 Monthly Learners' Movement and Attendance for Senior High School (SF

School Name District Division Region

School ID Semester School Year For th

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN SHIFTED OU

REGISTERED
LEARNERS (A) (A+B) (A) (A+B) (A) (A+B) (A)
(As of End Cumulative Cumulative Cumulative Cumulative Cumulative Cumulative Cumulative
TRACK STRAND Daily % for the
Number as
(B) Total for
Number as of Number as
(B) Total for
Number as Number as
(B) Total for
Number as of Number as
(B) Total for
of the Month) Average Month the Month the Month the Month the Month
of Previous End of the of Previous of End of of Previous End of the of Previous
Month Month Month the Month Month Month Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F

TOTAL FOR GRADE 11


TOTAL FOR GRADE 12
GRAND TOTAL

Prepared and Submitted By:

Signature of School Head over Printed Name


l (SF4-SHS)

Region

For the Month of

TED OUT SHIFTED IN

(A+B) (A) (A+B)


Cumulative Cumulative Cumulative
Total for (B) Total for
Number as of Number as Number as
Month the Month
End of the of Previous of End of the
Month Month Month

T M F T M F T M F T M F T
School Form 5A End of Semester and School Year Status of

School Name Bais City National High School School ID

Semester School Year

Track and Strand

BACK SUBJECT
LEARNER'S NAME
No. LRN List down subjects where learner
(Last Name, First Name, Name Extension, Middle Name)
below 75%)

MALE
1
2
3
4
5
6
7
8
9
10

FEMALE
BACK SUBJECT
LEARNER'S NAME
No. LRN List down subjects where learner
(Last Name, First Name, Name Extension, Middle Name)
below 75%)

GUIDELINES:

This form shall be accomplished after each semester in a school year, leaving the End of School Year Status Column and Summary Table for End of
be filled up only after the 2nd semester or at the end of the School Year.

INDICATORS:
End of Semester Status
Complete - number of learners who completed/satisfied the requirements in all subject areas (with grade of at least 75%)
Incomplete - number of learners who did not meet expectations in one or more subject areas, regardless of number of subjects failed (with gr
Note: Do not include learners who are No Longer in School (NLS)

End of School Year Status


Regular - number of learners who completed/satisfied requirements in all subject areas both in the 1st and 2nd semester
Irregular - number of learners who were not able to satisfy/complete requirements in one or both semesters
Status of Learners for Senior High School (SF5A-SHS)

343932 Region

Grade Level Section


Course/s (only for TVL)

BACK SUBJECT/S END OF


END OF SCHOOL
jects where learner obtained a rating SEMESTER
YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)

SUMMARY TABLE 1ST SEM

STATUS MALE FEMALE TOTAL


COMPLETE

INCOMPLETE

TOTAL

SUMMARY TABLE 2ND SEM

STATUS MALE FEMALE TOTAL

COMPLETE

INCOMPLETE

TOTAL

SUMMARY TABLE (End of the School Year Only)

STATUS MALE FEMALE TOTAL

REGULAR

IRREGULAR

TOTAL

Prepared By:

Signature of Class Adviser over Printed Name


BACK SUBJECT/S END OF
END OF SCHOOL
jects where learner obtained a rating SEMESTER
YEAR STATUS
below 75%) STATUS (Regular/ Irregular)
(Complete/ Incomplete)

Certified Correct By:

Signature of School Head over Printed Name

Reviewed By:

Signature of Division Representative over Printed Name

y Table for End of School Year Status blank/unfilled at the end of the 1st Semester. These data elements shall

ects failed (with grade less than 75%)


School Form 5B List of Learners with Complete SHS Requirements (SF5B-SHS)
School Name School ID District Division Region
Semester School Year Section
Track and Strand Course/s (only for TVL)

Completed SHS
in 2 SYs? (Y/N)
National
LEARNER'S FULL NAME(Last Name, First Name, Name Extension, Middle Certification
No. LRN
Name) Level Attained
(only if applicable)

MALE

SUMMARY TABLE A
STATUS MALE FEMALE TOTAL

Learners who
completed SHS
Program within 2
SYs or 4
semesters

Learners who
completed SHS
Program in more
than 2 SYs or 4
semesters

TOTAL

SUMMARY TABLE B
STATUS MALE FEMALE TOTAL
NC III
NC II
NC I
TOTAL

Note: NCs are recorded here for documentation but is not a requirement for
graduation.
Completed SHS
in 2 SYs? (Y/N)
National
LEARNER'S FULL NAME(Last Name, First Name, Name Extension, Middle Certification
No. LRN
Name) Level Attained
(only if applicable)
Note: NCs are recorded here for documentation but is not a requirement for
graduation.

GUIDELINES:
1. This form should be accomplished by the Class Adviser at End of School
Year.
2. It should be compiled and checked by the School Head and
passed to the Division Office before graduation.

FEMALE
Reviewed By:

Signature of Class Adviser over Printed Name

Certified Correct & Submitted By:

Signature of School Head over Printed Name

Reviewed By:

Signature of Division Representative over Printed Name


Completed SHS
in 2 SYs? (Y/N)
National
LEARNER'S FULL NAME(Last Name, First Name, Name Extension, Middle Certification
No. LRN
Name) Level Attained
(only if applicable)
School Form 6 Summarized Report of Learner Status as of End of Semester and School Year for Senior High School (SF6-SH

School Name School ID District Division

Semester School Year

END OF SCHOOL YEAR


END OF SEMESTER STATUS
(Fill up only at the end of the second seme

GRADE LEVEL
COMPLETE INCOMPLETE TOTAL REGULAR IRREGULAR

MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE

GRADE 11
TRACK/STRAND/COURSE

SUB TOTAL
GRADE 12
TRACK/STRAND/COURSE
SUB TOTAL
TOTAL

Prepared and Submitted By: Reviewed & Validated By: Noted By:
Signature of School Head over Printed Name Signature of Division Representative over Printed Name Signature of Division S
GUIDELINES:
1. After receiving and validating the report on Status of Learners submitted by the Class Adviser, the School Head shall compute the grade level total per track/strand/course and school
2. This report shall be forwarded to the Division Office by the end of the semester.
3. Column for End of School Year shall be accomplished at the end of SY or every after the 2nd semester
4. Protocols of validation & submission are under the discretion of the Schools Division Superintendent.
ol (SF6-SHS)

Region

OOL YEAR
he second semester.)

ULAR TOTAL

TOTAL MALE FEMALE TOTAL


ture of Division Superintendent over Printed Name

urse and school total.


School Form 7 School Personnel Basic Profile and Assignment for Senior High School (SF
School Name School ID District Division
Semester School Year
(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non-Teaching Items (C ) Other Appointments and

Appointment:
Title of Designation
Title of Plantilla Position Title of Plantilla Position (Contractual,
Number of Number of (as it appears in the contract/document:
(as it appears in the appointment (as it appears in the appointment Substitute,
Incumbent Incumbent Teacher, Clerk, Security Guard, Driver etc.)
document/PSIPOP) document/PSIPOP) Volunteer, Othe
specify)

EDUCATIONAL QUALIFICATION Daily Prog


Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Class & Other Ancillary (Enumerate DAY
Source Designation Degree/ Specialization/
Number Position, Descending) (Regular/ Minor Assignments sections (M/T/W/
-T.I.N.) Probationary/ Postgraduate Specialized taught)
TH/F)
Part Time) Training Attended

First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave.
First Semester:
EDUCATIONAL QUALIFICATION Daily Prog
Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Class & Other Ancillary (Enumerate DAY
Source Designation Degree/ Specialization/
Number Position, Descending) (Regular/ Minor Assignments sections (M/T/W/
-T.I.N.) Probationary/ Postgraduate Specialized taught)
TH/F)
Part Time) Training Attended

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave.
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave.
First Semester:

Second Semester:
EDUCATIONAL QUALIFICATION Daily Prog
Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Class & Other Ancillary (Enumerate DAY
Source Designation Degree/ Specialization/
Number Position, Descending) (Regular/ Minor Assignments sections (M/T/W/
-T.I.N.) Probationary/ Postgraduate Specialized taught)
TH/F)
Part Time) Training Attended

Advisory:
Ancillary Assignment/s:
Ave.
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave.
First Semester:

Second Semester:

Advisory:
Ancillary Assignment/s:
Ave.

GUIDELINES:
1. This form shall be accomplished at the beginning of each semester by the School Head and is submitted to the Division Office. In case of movement of teachers and other
personnel during the semester, an updated SHSF-7 must be submitted to the Division Office at the end of the semester.
EDUCATIONAL QUALIFICATION Daily Prog
Nature of
Employee Appointment/ Grade and
No. (or Tax Name of School Personnel Fund Position/
Employment
Major/
Subjects Taught, Advisory Sections
Identification (Arrange by Sex Status Class & Other Ancillary (Enumerate DAY
Source Designation Degree/ Specialization/
Number Position, Descending) (Regular/ Minor Assignments sections (M/T/W/
-T.I.N.) Probationary/ Postgraduate Specialized taught)
TH/F)
Part Time) Training Attended

1. This form shall be accomplished at the beginning of each semester by the School Head and is submitted to the Division Office. In case of movement of teachers and other
personnel during the semester, an updated SHSF-7 must be submitted to the Division Office at the end of the semester.
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank to the lowest.
3. Please reflect subjects being taught including advisory class or ancillary assignment (if any). Other administrative duties must also be reported.
4. Daily Program Column is for teaching personnel only.
ool (SF7-SHS)
Region

ments and Funding Sources

pointment: Number of Incumbent


ontractual, Fund Source
ubstitute, (SEF, PTA,
nteer, Others NGO's etc.) Teaching Non-Teaching
specify)

Remarks:
Daily Program (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
From To Teaching JHS- please indicate the number
(00:00) (00:00) Minutes per of teaching minutes per week)
Week

Ave. Minutes per Day


Remarks:
Daily Program (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
From To Teaching JHS- please indicate the number
(00:00) (00:00) Minutes per of teaching minutes per week)
Week

Ave. Minutes per Day

Ave. Minutes per Day


Remarks:
Daily Program (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
From To Teaching JHS- please indicate the number
(00:00) (00:00) Minutes per of teaching minutes per week)
Week

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day


Remarks:
Daily Program (time duration)
*For Detailed Items, Indicate
name of school/office,
*For IP - Ethnicity)
Total Actual *For additional loads from
From To Teaching JHS- please indicate the number
(00:00) (00:00) Minutes per of teaching minutes per week)
Week

Signature of School Head over Printed Name

Updated as of:

School Form 7, Page ___ of ________


SF 8 SFRT 2017

Department of Education
School Form 8 Learner's Basic Health and Nutrition Report for Senior High Sc
(For All Grade Levels)

School Name District Division

School ID Grade Section Track/Strand (SHS)

Learner's Name Nutritional St


Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age BMI
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name) (kg/m²)
MALE

SFRT 2017
SFRT 2017 St
Nutritional
Learner's Name
Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age BMI
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name) (kg/m²)

FEMALE

SFRT 2017
SFRT 2017 St
Nutritional
Learner's Name
Birthdate Weight Height Height²
No. LRN (Last Name, First Name, Age BMI
(MM/DD/YYYY) (kg) (m) (m²)
Name Extension, Middle Name) (kg/m²)

SUMMARY TABLE
Nutritional Status He
Summary Table
SEX Severely Severely
Wasted Normal Overweight Obese TOTAL Stunted Normal
Wasted Stunted
MALE
FEMALE
TOTAL

Date of Assessment: Conducted/Assessed By: Certified Correct By:

SFRT 2017
SFRT 2017

High School (SF8-SHS)

Region

School Year

itional Status
Height for
BMI Remarks
Age (HFA)
Category

SFRT 2017
itional Status SFRT 2017
Height for
BMI Remarks
Age (HFA)
Category

SFRT 2017
itional Status SFRT 2017
Height for
BMI Remarks
Age (HFA)
Category

Height for Age (HFA)


Summary Table
Tall Total

Reviewed By:

SFRT 2017

SFRT 2017

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