SF10-ES

Republic of the Philippines

Department of Education
Learner Permanent Record for Elementary School
(Formerly Form 137)

LEARNER'S PERSONAL INFORMATION

LAST NAME: ___________________________________________ FIRST NAME: __________________________________________ N

________________________
Learner Reference Number (LRN): _________________________________ Birthdate (mm/dd/yyyy): _____________________________
ELIGIBILITY FOR ELEMENTARY SCHOOL ENROLMENT

Credential presented for Grade 1: Kinder Progress Report Card ECCD Checklist Kindergarten Certificate of Completion
Name of School: ____________________________________________________ School ID: ______________________ Address of School: ________

Other Credential Presented:

PEPT Passer Rating: ______________________ Date of Examination/Assessment (mm/dd/yyyy): ________________________________
Name and Address of Testing Center: _____________________________________________________________________________________

SCHOLASTIC RECORD
School: _____________________________________________________ School ID: _________________ School: ___________________
District: ___________________________ Division: ______________________ Region: _______________ District: ___________________
Classified as Grade: ____________ Section: ________________________ School Year: ______________ Classified as Grade: _________
Name of Adviser: _______________________________________ Signature: _______________________ Name of Adviser: ___________

Quarterly Rating
LEARNING AREAS Final Rating Remarks Learning Areas
1 2 3 4

English English

Mathematics Mathematics

Science Science

Filipino Health & Wellness

Civics & Culture Filipino

Computer Civics & Culture

MAPEH Computer

Physical Education

Arts

Music

General Average General Average

Remedial Classes Conducted from: _____________________ to: ___________________ Remedial Classes

Recomputed
Learning Areas Final Rating Remedial Class Mark Remarks Learning Areas
Final Grade

School: _____________________________________________________ School ID: _________________ School: ___________________

District: ___________________________ Division: ______________________ Region: _______________ District: ___________________
Classified as Grade: ____________ Section: ________________________ School Year: ______________ Classified as Grade: _________
Name of Adviser: _______________________________________ Signature: _______________________ Name of Adviser: ___________

Quarterly Rating Learning Areas

Learning Areas Final Rating Remarks
1 2 3 4

English English

Mathematics Mathematics

Science Science

Filipino Health & Wellness

Civics & Culture Filipino

Computer History & Geography

MAPEH Computer

Physical Education

Arts

Music

BGB/Bible

General Average General Average

Remedial Classes Conducted from: _____________________ to: ___________________ Remedial Classes

Recomputed
Learning Areas Final Rating Remedial Class Mark Remarks Learning Areas
Final Grade
ppines
ation
mentary School (SF10-ES)

INFORMATION

___________________ NAME EXTN (Jr., I, II) __________ MIDDLE NAME:

___________________________________ Sex: ____________________________

SCHOOL ENROLMENT

en Certificate of Completion
Address of School: _______________________________________________________________

_______________________ Others (Pls. specify): _____________________________________

__________________________ Remark: _____________________________________________

ECORD
hool: _____________________________________________________ School ID: _________________
trict: ___________________________ Division: ______________________ Region: _______________
ssified as Grade: ____________ Section: ________________________ School Year: ______________
me of Adviser: _______________________________________ Signature: _______________________

Quarterly Rating
Learning Areas Final Rating Remarks
1 2 3 4

glish

hematics

ence

alth & Wellness

pino

ics & Culture

mputer

ysical Education

sic

neral Average

Remedial Classes Conducted from: _____________________ to: ___________________

Recomputed
Final Rating Remedial Class Mark Remarks
Final Grade

hool: _____________________________________________________ School ID: _________________

trict: ___________________________ Division: ______________________ Region: _______________
ssified as Grade: ____________ Section: ________________________ School Year: ______________
me of Adviser: _______________________________________ Signature: _______________________

Learning Areas Quarterly Rating

Final Rating Remarks
1 2 3 4

ish

hematics

nce

th & Wellness

ino

ory & Geography

puter

sical Education

ic

/Bible

eral Average

Remedial Classes Conducted from: _____________________ to: ___________________

Recomputed
Final Rating Remedial Class Mark Remarks
Final Grade

SFRT 2017
SF10-ES Page 2 of ________
SCHOLASTIC RECORD
School: _____________________________________________________ School ID: _________________ School: _____________________________________________________ School ID: _________________
District: ___________________________ Division: ______________________ Region: _______________ District: ___________________________ Division: ______________________ Region: _______________
Classified as Grade: ____________ Section: ________________________ School Year: ______________ Classified as Grade: ____________ Section: ________________________ School Year: ______________
Name of Adviser: _______________________________________ Signature: _______________________ Name of Adviser: _______________________________________ Signature: _______________________

Quarterly Rating Quarterly Rating

LEARNING AREAS Final Rating Remarks Learning Areas Final Rating Remarks
1 2 3 4 1 2 3 4

English English

Mathematics Mathematics

Science Science

Health & Wellness Health & Wellness

Filipino Filipino

History & Geography History & Geography

Computer Creative Communication

Physical Education TLE

Arts Computer

Music Physical Education

BGB/Bible Arts

Music

BGB/Bible

General Average General Average

Remedial Classes Conducted from: _____________________ to: ____________________ Remedial Classes Conducted from: _____________________ to: ____________________
Recomputed Recomputed
Learning Areas Final Rating Remedial Class Mark Remarks Learning Areas Final Rating Remedial Class Mark Remarks
Final Grade Final Grade

For Transfer Out /Elementary School Completer Only

CERTIFICATION
I CERTIFY that this is a true record of _______________________________________________________________ with LRN ___________________ and that he/she is eligible for admission to Grade ____________

School Name: ___________________________________________________ School ID ____________________ Division: _____________________________ Last School Year Attended: ______________________

(Affix School Seal here)

CERTIFICATION
I CERTIFY that this is a true record of _______________________________________________________________ with LRN ___________________ and that he/she is eligible for admission to Grade ____________

School Name: ___________________________________________________ School ID ____________________ Division: _____________________________ Last School Year Attended: ______________________

(Affix School Seal here)

CERTIFICATION
I CERTIFY that this is a true record of _______________________________________________________________ with LRN ___________________ and that he/she is eligible for admission to Grade ____________

School Name: ___________________________________________________ School ID ____________________ Division: _____________________________ Last School Year Attended: ______________________

(Affix School Seal here)

May add Certification Box if needed SFRT Revised 2017