(This replaced Form 1, Master List & STS Form 2-Family Background and Profile)
School ID
School Name
NAME
(Last Name, First Name, Middle Name)
LRN
Region
106450
III
Division
Tarlac Province
BIRTH
Sex
DATE (mm/
(M/F)
dd/yy)
AGE as of
1st Friday
of June
School Year
District
2014-2015
MOTHER
TONGUE
IP
(Specify
Ethnic Group)
Grade Level
ADDRESS
BIRTH
PLACE
(Province)
Gerona North
Section
NAME OF PARENTS
RIZAL
GUARDIAN (If not Parent)
RELIGION
(nos. of years as
per last birthday)
House # /
Street/Sitio/
Purok
Barangay
Municipality/ City
Province
106450100005
AGUSTIN
MARK LAURENCE
VIAJEDOR
11/13/05
1 7/2
Tarlac
Tagalog
Christianity
N/A
Pinasling
Gerona
Tarlac
AGUSTIN,MARVIN
CORPUZ
106451100007
AILES
JAMES
CACAYURAN
05/03/05
9/1
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
AILES, HILARIO N.
REBEXXA CACAYURAN
106450130175
AMANDE
ALEXIS JAY
SABADO
10/23/04
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
106450100015
BAIS
FERDINAND
OCAMPO
05/30/04
1 0/1
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
106450100016
BELTRAN
JOHN RACE
VIADAN
05/11/03
1 1/1
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Pura
Tarlac
106450100018
BENITEZ
TYRON
AMATORIO
02/02/04
10
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
106450100023
BUGAYONG
RUEL
BASILAS
10/01/05
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
106450100025
CALIGAGAN
JOHN LEINARD
GONZAGA
02/24/05
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
CALIGAGAN, IAN
BELANDO
106450100030
CONDE
NEIL LESTER
BERNABE
12/16/04
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
106450100026
CUNANAN
RUSSEL JAMES
DAILEG
04/25/05
9/1
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
CUNANAN JEFREY A
106450100035
FABIAN
RAYMARK
MAMARIL
08/11/03
11
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
FABIAN RIZALDY
MARCELINA MAMARIL
106450100041
FERNANDEZ
JOHN DANIEL
DONATO
03/24/05
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
FERNANDEZ, ROLANDO
JOSIE M. DONATO
S.
106450130176
GARCIA
ROB THOMAS
MIFUEL
07/27/04
1 0/1
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
###
GUANDE
NICO
ANCHETA
03/20/05
Tarlac
Tagalog
Christianity
N/A
Pinasling
Gerona
Tarlac
GUANDE, DOMY D.
MERLY D. ANCETA
106450100044
IGLESIAS
GIAN CARLO
CUPAG
12/17/04
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
IGLESIAS, HERNAN
FACUN
106450100050
MADRIAGA JR,
FREDDIE
JUNIO
05/23/05
9/1
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
ARLENE JUNIO
106450100054
MENDOZA
JOHN MICHAEL
DE GUZMAN
04/23/02
1 1/1
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
CRISTINA DE GUZMAN
106450100055
MILLA
FREDDIE
CAPINDING
02/01/04
10
Tarlac
Tagalog
Christianity
N/A
Poblacion 2
Gerona
Tarlac
MILLA FRANCISCO T.
106450100056
MOLINA
HARMES
BAUTISTA
01/05/04
10
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
MOLINA, ROLLY
ANALIE BAUTISTA
10650100061
PAGRAD
JOMEL
TORALDE
03/19/05
Tarlac
Tagalog
Christianity
N/A
Poblacion 2
Gerona
Tarlac
MELANIE SORIANO
TORALDE
106464100029
PASCUA
RHEY MARC
MARTINEZ
08/12/05
9/1
Tarlac
Tagalog
Christianity
N/A
Bawa
Gerona
Tarlac
106450100063
PEREZ
JOHN GABRIEL
SANTOS
11/01/05
Tarlac
Tagalog
Christianity
N/A
Pinasling
Gerona
Tarlac
106450100067
SALMASAN
APRIL JAY
JUNIO
04/01/05
9/1
Tarlac
Tagalog
Christianity
N/A
Abagon
Gerona
Tarlac
PAGRAD, JOSEPH
SIARES
PASCUA, REYNALDO
SAPUNGAY
PEREZ, JESSIE
AGUSTIN
SALMASAN
REYNOLD E
BAIS, ROLANDO
VALENCIA
BELTRAN, JOHN
ARCIAGA
BENITEZ, ZALDE
DALIA MIFUEL
Name
AGUSTIN,MARVIN
CORPUZ
AILES, HILARIO N.
AMANDE, ELMER
MEJIA
JUVY OCAMPO BAIS
BELTRAN, JOHN
ARCIAGA
BENITEZ, ZALDE R.
REYNAN BUGAYONG
CALIGAGAN, IAN
BELANDO
LUZ BERNABE
CONDE
JEFREY CUNANAN
MARCELINA M.
FABIAN
RONALDO
FERNANDEZ
CHRISTOPHER ROY
GARCIA
DOMY D. GUANDE
HERNAN FACUN
IGLESIAS
FREDDIE
MADRUAGA SR.
JAYMER MENDOZA
FRANCISCO T. MILLA
ROLLY MOLINA
JOSEPH SIARES
PAGRAD
REYNALDO
MARICEL TOMAS MARTINEZ
SAPUNGAY PASCUA
PEREZ JESSIE
SANTOS JOANNE CANO
AGUSTIN
VERONICA JUNIO
VERONICA JUNIO
SALMASAN
NAME
(Last Name, First Name, Middle Name)
LRN
BIRTH
Sex
DATE (mm/
(M/F)
dd/yy)
AGE as of
1st Friday
of June
ADDRESS
BIRTH
PLACE
(Province)
MOTHER
TONGUE
IP
(Specify
Ethnic Group)
NAME OF PARENTS
RELIGION
(nos. of years as
per last birthday)
House # /
Street/Sitio/
Purok
Barangay
Municipality/ City
Province
106450100070
SOLOMON JR.
JONAR
ENERO
02/16/04
10
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
106450100071
SANTA MARIA
MHAR JOSEPH
MARIANO
10/13/05
Tarlac
Tagalog
Christianity
N/A
Carbonel
Gerona
Tarlac
106450100072
SANTA MARINA
ALI JAY
DUMALAG
06/11/05
9/1
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
26
<=====
TOTAL MALE
106450100001
AGBUNAG
LYNDSEY
CORTEZ
07/02/05
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
106450130170
ALIOSADA
MARIA CHRISTINE
FACUN
10/06/05
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
106450100011
ARELLANO
KAYCELENE
RAMOS
08/26/03
11
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
101742100015
CRUZ
MA. KYLA
LOPEZ
05/26/05
11
Tarlac
Tagalog
Christianity
N/A
Pinasling
Gerona
Tarlac
STA.
MARIA
MARLON
PANGILINA
N
AGBUNAG ,
CARLO
MAGNO
FACUN,
CHRISTOPH
ER R.
ARELLANO
ARTURO
SABADO
EMILY ENERO
ROSARIO WAGE
MARIANO
AILEEN DUMALAG
CORTEZ LOVELY
VILLANUEVA
CRISTETA LLABES
RAMOS
JULITA LOPEZ
DESTURA
MARVIN
BERZAL
106450100034
DESTURA
FACUN
02/06/05
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
106457100020
EVANGELISTA
SHANE
CAVERTO
04/01/05
Tarlac
Tagalog
Christianity
N/A
Singat
Gerona
Tarlac
MARILOU CAVERTO
106450100036
FABIAN
ROXANNE
MAMARIL
11/05/04
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
MARCELINA MAMARIL
106450100038
FACUN
JONA
PANIBON
10/12/04
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
FACUN, PEPITO
LUMIBAO JR.
106450100039
FACUN
MAURICE JHADE
GADDANG
09/03/05
Tarlac
Tagalog
Christianity
N/A
Abagon
Gerona
Tarlac
FACUN, HAZEL R.
MARILOU Y. GADDANG
106450130177
GALEON
SHEENA
DIZON
07/28/05
Tarlac
Tagalog
Christianity
N/A
Poblacion 3
Gerona
Tarlac
106450100045
JUNIO
FREDELYN
JUNIO
01/28/03
11
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
106450130171
MILLADO
ANGELICA BEA
IBARRA
03/17/05
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
106450100060
ORPILLA
RENALYN
SOLIVEN
08/13/04
10
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
106477100038
PEREZ
ALONA MAE
ANCHETA
11/09/05
Tarlac
Tagalog
Christianity
N/A
Pinasling
Gerona
Tarlac
106450100066
SABANGAN
AIRA
GUARIN
12/15/03
10
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
106450090077
VINUYA
LIBERTY JOY
FLORES
09/09/03
11
Tarlac
Tagalog
Christianity
N/A
Poblacion 1
Gerona
Tarlac
16
<====
TOTAL FEMALE
42
<====
COMBINED
MILLADO TELESFORO
MALLARI
ORPILLA, RODOLFO
ESPANOLA
Transferred Out
Code
T/O
Required Information
Indicator
CCT Recipient
Code
CCT
Required Information
CCT Control/reference number & Effectivity Date
MALE
BoSY
EoSY
26
26
CARLO MAGGNO
AGBUNAG
CHRISTOPHER
FACUN
CRISTETA RAMOS
ARELLANO
RENATO A. CRUZ SR.
MARVIN BERZAL
DESTURA
MARILOU CAVERTO
EVANGELISTA
RIZALDY FABIAN
PEPITO LUMIBAO
FACUN JR.
HAZEL R. FACUN
MARIO GALEON
TELOSFONO
MILLADO JR.
JULIE SOLIVEN
ORPILLA
ALI D PEREZ
ANGELO SABANGAN
VILMA GUARIN
VIRGINIA FLORES
JONAR SOLOMON
SR.
MARLON P. STA.
MARIA
AILEEN STA. MARINA
ARELENE JUNIO
MADRIAGA FREDDIE
SABANGAN ANGELO
Name
NOEL VINUYA
Prepared by:
NAME
(Last Name, First Name, Middle Name)
LRN
BIRTH
Sex
DATE (mm/
(M/F)
dd/yy)
AGE as of
1st Friday
of June
ADDRESS
BIRTH
PLACE
(Province)
MOTHER
TONGUE
IP
(Specify
Ethnic Group)
(nos. of years as
per last birthday)
Transferred IN
Dropped
Late Enrollment
T/I
DRP
LE
Balik-Aral
Learner With Dissability
Accelarated
B/A
LWD
ACL
NAME OF PARENTS
RELIGION
House # /
Street/Sitio/
Purok
Barangay
Municipality/ City
Province
FEMALE
16
16
TOTAL
42
42
Name
06/02/14
RIZAL
REMARK/S
Contact Number
(Parent
/Guardian)
Relationship
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
REMARK/S
Contact Number
(Parent
/Guardian)
Relationship
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
RELATIVE
Certified Correct:
REMARK/S
Contact Number
(Parent
/Guardian)
Relationship
BoSY Date:
EoSYDate:
School ID
106450
2014 - 2015
School Year
Gabaldon ES
Name of School
JUNE
Grade 4
Grade Level
(1st row for date)
No.
NAME
(Last Name, First Name, Middle Name)
9 10 11 12 13 16 17 18 19 20 23 24 25 26 27 30
TH
TH
TH
TH
RIZAL
Section
TH
ABSENT
TARDY
17
26
26 26 26 26 26 26 26 26
26 26 26 26 26 26 26 26 26 26 26 26
16
16 16 16 16 16 16 16 16
16 16 16 16 16 16 16 16 16 16 16 16
42
42 42 42 42 42 42 42 42
42 42 42 42 42 42 42 42 42 42 42 42
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Month: JUNE
No. of Days of
Classes: 20
Summary
M
TOTAL
26
16
42
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
26
16
42
100%
100%
100%
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
School ID
106450
2014 - 2015
School Year
Gabaldon ES
Name of School
JULY
Grade 4
Grade Level
(1st row for date)
No.
NAME
(Last Name, First Name, Middle Name)
M
9 10 11 14 15 16 17 18 21 22 23 24 25 28 29 30 31
TH
TH
TH
TH
RIZAL
Section
TH
ABSENT
TARDY
X
X
X
X
13
26
26 26 26 26 26 26 26 26 26 24 26 26 25 24 25 26 26 26 25 22
24 26
12
25
X
X
16 16 16 16 16 16 16 16 16 14 16 16 16 12 15 16 14 16 16 14
15 16
42
42 42 42 42 42 42 42 42 42 38 42 42 41 36 40 42 40 42 42 36
39 42
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Month: JULY
No. of Days of
Classes: 22
Summary
TOTAL
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
26
16
42
(beyond cut-off)
Registered Learners as of
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
25.41
15.45
40.91
97.73
96.56
97.40
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
School ID
106450
2014 - 2015
School Year
Gabaldon ES
Name of School
AUGUST
Grade 4
Grade Level
(1st row for date)
No.
NAME
(Last Name, First Name, Middle Name)
M
TH
8 11 12 13 14 15 18 19 20 21 22 25 26 27 28 29
TH
TH
TH
RIZAL
Section
TH
TARDY
17
26
26 26 26 25 25 26 26 26 26 26 26 26 26 26
26
26 26 25 26
X
X
16 16 15 15 16 16 16 16 16 16 16 16 16 16
16
16 15 14 16
42
42 42 41 40 41 42 42 42 42 42 42 42 42 42
42
42 41 39 42
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Month: AUGUST
No. of Days of
Classes: 19
Summary
M
TOTAL
26
16
42
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
25.84
15.74
41.58
99.38
98.38
99
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
School ID
106450
2014 - 2015
School Year
Gabaldon ES
Name of School
SEPTEMBER
Grade 4
Grade Level
(1st row for date)
No.
NAME
(Last Name, First Name, Middle Name)
9 10 11 12 15 16 17 18 19 22 23 24 25 26 29 30
TH
TH
TH
TH
RIZAL
Section
TH
ABSENT
TARDY
17
X
X
X
X
18
26 22 25 25 26 25 26 25 26 26 26 21 21 26 26 26 26 26 26 26 26 26
13
31
X
X
16
16 13 16 16 16 14 15 16 16 16 16 13 12 16 16 16 16 16 16 16 16 16
42
42 35 41 41 42 39 41 41 42 42 42 34 33 42 42 42 42 42 42 42 42 42
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Summary
M
TOTAL
26
16
42
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
25.18
15.41
40.59
96.85
96.31
96.65
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
School ID
106450
2014 - 2015
School Year
Gabaldon ES
Name of School
Grade 4
Grade Level
(1st row for date)
No.
NAME
(Last Name, First Name, Middle Name)
M
9 10 13 14 15 16 17 20 21 22 23 24 27 28 29 30 31
TH
TH
TH
TH
RIZAL
Section
TH
TARDY
26
26 26 26 26 25 24 25 26 26 25 26 26 26 26 26 26 26 26 26 26 26 26 26
15 16 16 16 15 16 16 15 15 16 16 16 16 16 16 16 16 16 16 16 16 16 16
42
41 42 42 42 40 40 41 41 41 41 42 42 42 42 42 42 42 42 42 42 42 42 42
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Month: OCTOBER
No. of Days of
Classes: 23
Summary
M
TOTAL
26
16
42
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
25.78
15.83
41.61
99.16
98.91
99.07
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
School ID
106450
2014 - 2015
School Year
Gabaldon ES
Name of School
NOVEMBER
Grade 4
Grade Level
(1st row for date)
No.
NAME
(Last Name, First Name, Middle Name)
7 10 11 12 13 14 17 18 19 20 21 24 25 26 27 28
TH
TH
TH
TH
RIZAL
Section
TH
ABSENT
TARDY
17
X
X
26
26 26 26 26 26 26 26 26 26 25 25 25 25 26 26 26 26 26 26 26
X
X
10
16
16 16 16 16 14 15 16 15 14 16 16 16 16 16 16 16 16 16 16 16
42
42 42 42 42 40 41 42 41 40 41 41 41 41 42 42 42 42 42 42 42
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Month: NOVEMBER
No. of Days of
Classes: 20
Summary
M
TOTAL
26
16
42
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
25.8
15.7
41.5
99.23
98.13
98.81
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
School ID
106450
2014 - 2015
School Year
Gabaldon ES
Name of School
DECEMBER
Grade 4
Grade Level
(1st row for date)
No.
NAME
(Last Name, First Name, Middle Name)
9 10 11 12 15 16 17 18 19 22 23 24 25 26 29 30 31
TH
TH
TH
TH
RIZAL
Section
ABSENT
TARDY
17
X
X
14
26
23 24 22 26 26 26 26 26 26 26 21 26 26 26 26
21
13 16 14 16 16 16 16 16 16 16 14 16 16 16 16
42
36 40 36 42 42 42 42 42 42 42 35 42 42 42 42
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Month: DECEMBER
No. of Days of
Classes: 15
Summary
M
TOTAL
26
16
42
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
25.07
15.53
40.6
96.41
97.08
96.67
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
School ID
106450
2014 - 2015
School Year
Gabaldon ES
Name of School
JANUARY
Grade 4
Grade Level
(1st row for date)
No.
NAME
(Last Name, First Name, Middle Name)
M
TH
9 12 13 14 15 16 19 20 21 22 23 26 27 28 29 30
TH
TH
TH
RIZAL
Section
TH
TARDY
11
26 26 26 26 26 26 26 26 26 26 25 26 25 25 23 21 26 26 26 26
18
29
X
X
X
X
X
X
16
16 16 16 16 16 16 15 15 14 16 16 14 14 15 15 12 16 14 15 15
42
42 42 42 42 42 42 41 41 40 42 41 40 39 40 38 33 42 40 41 41
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Month: JANUARY
No. of Days of
Classes: 20
Summary
M
TOTAL
26
16
42
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
25.45
15.1
40.55
97.88
94.38
96.55
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
School ID
106450
2014 - 2015
School Year
Gabaldon ES
Name of School
Grade 4
Grade Level
(1st row for date)
No.
NAME
(Last Name, First Name, Middle Name)
9 10 11 12 13 16 17 18 19 20 23 24 25 26 27
TH
TH
TH
TH
RIZAL
Section
TH
ABSENT
TARDY
X
X
26
26 26 26 26 26 26 26 26 26 26 23 25 26 26 26 25 26 26 25 24
17
25
X
X
X
X
X
X
X
X
X
X
X
X
16
16 16 15 13 16 16 15 14 13 16 14 15 16 15 16 15 16 16 15 15
42
42 42 41 39 42 42 41 40 39 42 37 40 42 41 42 40 42 42 40 39
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Month: FEBRUARY
No. of Days of
Classes: 20
Summary
M
TOTAL
26
16
42
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
25.6
15.15
40.75
98.46
94.69
97.02
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
School ID
106450
2014 - 2015
School Year
MARCH
Grade Level
Grade 4
Gabaldon ES
Name of School
NAME
(Last Name, First Name, Middle Name)
9 10 11 12 13 16 17 18 19 20 23 24 25 26 27
TH
TH
TH
TH
RIZAL
Section
TH
ABSENT
TARDY
8
9
19
26 24 24 24 21 21 26 23 26 26 26 26 26 26 26 26 26 26 26 26
X
15
34
X
X
X
X
X
X
X
16
15 13 14 15 12 12 16 16 16 16 16 16 16 16 16 16 16 16 16 16
42
41 37 38 39 33 33 42 39 42 42 42 42 42 42 42 42 42 42 42 42
GUIDELINES:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.
2. Dates shall be written in the columns after Learner's Name.
3. To compute the following:
(blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)
a. Percentage of Enrolment =
b. Average Daily Attendance =
Month: MARCH
501
305
806
No. of Days of
Classes: 20
Summary
M
TOTAL
26
16
42
26
16
42
x 100
a. Domestic-Related Factors
a.1. Had to take care of siblings
a.2. Early marriage/pregnancy
a.3. Parents' attitude toward schooling
a.4. Family problems
x 100
4. 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 principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5
consecutive days and/or those at risk of dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
*Beginning of School Year cut-off report is every 1st Friday of the School Year
26
16
42
100%
100%
100%
25.05
15.25
40.3
96.35
95.31
95.95
end of month
Percentage of Enrolment as of
end of month
b. Individual-Related Factors
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abuse
b.5. Poor academic performance
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
c. School-Related Factors
c.1. Teacher Factor
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
Dropped out
Transferred out
Transferred in
e. Financial-Related
f. Others (Specify)
Attested by:
Region
Region III
School ID
Division
106450
Tarlac
School Year
School Name
District
2014 - 2015
Gabaldon ES
Grade Level
INCOMPLETE SUBJECT
GENERAL AVERAGE
LRN
LEARNER'S NAME
(Last Name, First Name, Middle Name)
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
MALE
106450100005
81.30
PROMOTED
106451100007
81.60
PROMOTED
106450130175
79.30
PROMOTED
106450100015
79.10
PROMOTED
106450100016
79.30
PROMOTED
106450100018
80.60
PROMOTED
106450100023
83.15
PROMOTED
106450100025
81.10
PROMOTED
106450100030
80.15
PROMOTED
106450100026
79.55
PROMOTED
106450100035
80.00
PROMOTED
106450100041
81.65
PROMOTED
106450130176
79.45
PROMOTED
106477100028
81.55
PROMOTED
106450100044
81.00
PROMOTED
106450100050
79.50
PROMOTED
106450100054
81.75
PROMOTED
106450100055
80.00
PROMOTED
Page 37
Curriculum
80.55
PROMOTED
106450100061
79.65
PROMOTED
106464100029
82.85
PROMOTED
106450100063
81.50
PROMOTED
106450100067
79.45
PROMOTED
106450100070
81.80
PROMOTED
106450100071
79.95
PROMOTED
106450100072
81.50
PROMOTED
79.85
PROMOTED
106450130170
82.50
PROMOTED
106450100011
78.60
PROMOTED
101742100015
81.60
PROMOTED
106450100034
82.55
PROMOTED
106457100020
83.55
PROMOTED
106450100036
80.75
PROMOTED
106450100038
81.10
PROMOTED
106450100039
82.40
PROMOTED
106450130177
82.15
PROMOTED
106450100045
80.65
PROMOTED
106450130171
85.10
PROMOTED
106450100060
81.30
PROMOTED
106477100038
81.70
PROMOTED
106450100066
81.30
PROMOTED
106450090077
81.00
PROMOTED
Page 38
Gerona North
BEC
Grade 4
Section
RIZAL
INCOMPLETE SUBJECT/S
SUMMARY TABLE
STATUS
MALE
FEMALE
TOTAL
PROMOTED
26
16
42
IRREGULAR
RETAINED
MALE
FEMALE
TOTAL
BEGINNING
(B: 74% and below)
DEVELOPING
(75%-79%)
APPROACHING
PROFICIENCY
(AP: 80%-84%)
PROFICIENT
(P: 85%-89%)
ADVANCED
(A: 90% and above)
PREPARED BY:
Page 39
REVIEWED:
AUGUSTO L. BALLESTEROS
EDUCATION PROGRAM SUPERVISOR MATHEMATICS
RECOMMENDING APPROVAL:
APPROVED:
GUIDELINES:
1. For All Grade/Year Levels.
2. To be prepared by the Adviser. Final rating per subject area should be taken
from the record of subject teachers. The class Adviser should compute for the
General Average.
3. On the summary table, reflect the total number of learners promoted,
retained and *irregular (*for grade 7 onwards only) and the level of proficiency
according to the individual General Average.
4. Must tally with the total enrollment report as of End of School Year GESP
/GSSP (EBEIS).
5. Protocols of validation and submission is under the
Page 40