School ID
School Name
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
NAME
(Last Name, First Name, Middle Name)
LRN
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
Code
Required Information
AGE as of 1st
Friday June
NAME
(Last Name, First Name, Middle Name)
LRN
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
Transferred Out
T/O
Transferred IN
T/I
Dropped
Late Enrollment
DRP
LE
AGE as of 1st
Friday June
Division
School Year
ADDRESS
MOTHER TONGUE (Grade 1 to
IP
3 Only)
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE (Grade 1 to
IP
3 Only)
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE (Grade 1 to
IP
3 Only)
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE (Grade 1 to
IP
3 Only)
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE (Grade 1 to
IP
3 Only)
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE (Grade 1 to
IP
3 Only)
(Ethnic Group)
Indicator
Code
RELIGION
House #/ Street/
Sitio/
Purok
Required Information
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE (Grade 1 to
IP
3 Only)
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
CCT Recipient
CCT
Balik-Aral
B/A
LWD
Specify
ACL
Learner With
Dissability
Accelarated
Municipality/ City
Province
District
Section
Grade Level
PARENTS
Province
GUARDIAN
(If
not Parent)
Name
Relation-ship
PARENTS
Province
GUARDIAN
(If
not Parent)
Name
Relation-ship
PARENTS
Province
GUARDIAN
(If
not Parent)
Name
Relation-ship
PARENTS
Province
GUARDIAN
(If
not Parent)
Name
Relation-ship
PARENTS
Province
GUARDIAN
(If
not Parent)
Name
Relation-ship
PARENTS
Province
REGISTERED
BoSY
EoSY
Prepared by:
GUARDIAN
(If
not Parent)
Name
Relation-ship
GUARDIAN
PARENTS
Province
(If
not Parent)
Name
MALE
(Signature of Adviser over Printed Name)
FEMALE
TOTAL
BoSY Date:
EoSYDate:
Relation-ship
REMARKS
Contact Number of
Parent or Guardian
REMARKS
Contact Number of
Parent or Guardian
REMARKS
Contact Number of
Parent or Guardian
REMARKS
Contact Number of
Parent or Guardian
REMARKS
Contact Number of
Parent or Guardian
REMARKS
Contact Number of
Parent or Guardian
Certified Correct:
REMARKS
Contact Number of
Parent or Guardian
BoSY Date:
EoSYDate:
School ID
School Year
Name of School
(1st row for date)
LEARNER'S NAME
(Last Name, First Name, Middle Name)
M
TH
TH
TH
LEARNER'S NAME
(Last Name, First Name, Middle Name)
M
TH
TH
TH
LEARNER'S NAME
(Last Name, First Name, Middle Name)
M
TH
TH
TH
1. CODES FO
(blank) - P
x 100
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.
2. REASONS
a. Domestica.1. Had to ta
b. Individual-
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Abu
b.5. Poor aca
LEARNER'S NAME
(Last Name, First Name, Middle Name)
M
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
TH
TH
TH
b.6. Lack of in
b.7. Hunger/M
c. School-Re
c.1. Teacher F
c.2. Physical c
c.3. Peer influ
d. Geographi
d.1. Distance
d.2. Armed co
d.3. Calamitie
e. Financial-R
e.1. Child labo
f. Others (Sp
Section
Total for the Month
)
F
TH
TH
ABSENT
TARDY
)
F
TH
TH
ABSENT
TARDY
)
F
TH
blank) - Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer,
Lower for Cutting Classes)
Early marriage/pregnancy
Parents' attitude toward schooling
Family problems
dividual-Related Factors
Illness
Overage
Death
Drug Abuse
Poor academic performance
TH
Month:
ABSENT
TARDY
Summary
M
TOTAL
)
F
TH
Lack of interest/Distractions
Hunger/Malnutrition
chool-Related Factors
Teacher Factor
Physical condition of classroom
Peer influence
eographic/Environmental
Distance between home and school
Armed conflict (incl. Tribal wars & clanfeuds)
Calamities/Disasters
nancial-Related
Child labor, work
hers (Specify)
TH
School ID
School Year
School Name
NO.
Grade Level
Subject Area & Title
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
Returned
Issued
Returned
Issued
Returned
Issued
NO.
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
Returned
Issued
Returned
Issued
Returned
Issued
NO.
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
Returned
Issued
Returned
Issued
Returned
Issued
NO.
Date
Date
Date
Date
LEARNER'S NAME
(Last Name, First Name, Middle Name)
Issued
GUIDELINES:
1. Title of Books Issued to each learner must be recorded by the class adviser.
2. The Date of Issuance and the Date of Return shall be reflected in the form.
3. The Total Number of Copies issued at BoSY shall be reflected in the form.
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form.
5. All textbooks being used must be included. Additional copies of this form may be used if needed.
Returned
Issued
Returned
Issued
Returned
Issued
Section
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Prepared By:
School ID
Region
Division
School Name
GRADE/
YEAR LEVEL
SECTION
NAME OF ADVISER
REGISTERED
LEARNERS
(As of End of the
Month)
M
ATTENDANCE
Daily Average
M
DROPPED OUT
(A) Cumulative as of
Previous Month
M
ELEMENTARY/SECONDARY:
KINDER
GRADE 1/GRADE 7
GRADE 2/GRADE 8
GRADE 3/GRADE 9
GRADE 4/GRADE 10
GRADE 5/GRADE 11
GRADE 6/GRADE 12
TOTAL FOR NON-GRADED
TOTAL
GUIDELINES:
1. This form shall be accomplished every end of the month using the summary box of SF2 submitted by the teachers/advisers to update figures for the month.
2. Furnish the Division Office with a copy a week after June 30, October 30 & March 31
Page _____ of _____ pages
District
School Year
ED OUT
e Month
T
TRANSFERRED OUT
(A+B) Cumulative as of (A) Cumulative as of
End of the Month
Previous Month
M
TRANSFERRED IN
(A+B) Cumulative as of (A) Cumulative as of
End of the Month
Previous Month
M
(A+B) Cumulative as
of End of the Month
M
Region
Division
School ID
School Year
School Name
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/
column is for K to 12 Curricul
level that are still im
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
TOTAL MALE
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/
column is for K to 12 Curricul
level that are still im
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/
column is for K to 12 Curricul
level that are still im
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
TOTAL FEMALE
COMBINED
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/
column is for K to 12 Curricul
level that are still im
List of Graduates)
District
Curriculum
Grade Level
Section
LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)
MALE
FEMALE
PROMOTED
IRREGULAR
RETAINED
TOTAL
LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)
FEMALE
BEGINNNING
(B: 74% and below)
ADVANCED
(A: 90%
and above)
PREPARED BY:
Class Adviser
(Name and Signature)
TOTAL
LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)
School Head
(Name and Signature)
REVIEWED BY:
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.
LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)
4. Must tally with the total enrollment report as of End of School Year
GESP /GSSP (EBEIS)
5. Protocols of validation & submission is under the discretion of the
Schools Division Superintendent
School Form 5: Page ____ of ________
School ID
Region
School Name
GRADE 1 /GRADE 7
GRADE 2 / GRADE 8
GRADE 3 / GRADE 9
GRADE 4 / GRADE
SUMMARY TABLE
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
PROMOTED
IRREGULAR (Grade 7 onwards only)
RETAINED
LEVEL OF PROFICIENCY (K to 12 Only)
BEGINNNING
DEVELOPING
APPROACHING PROFICIENCY
(AP: 80%-84%)
PROFICIENT
ADVANCED
ADVANCED
DIVISION REPRESENTATIVE
GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the grade level total and school total.
2. This report together with the copy of Report for Promotion submitted by the class adviser shall be forwarded to the Division Office by the end of the school year.
3. The Report on Promotion per grade level is reflected in the End of School Year Report of GESP/GSSP.
4. Protocols of validation & submission is under the discretion of the Schools Division Superintendent.
SF6)
nd Level of Proficiency
Division
District
GRADE 4 / GRADE 10
School Year
GRADE 5 / GRADE 11
GRADE 6 / GRADE 12
TOTAL
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
Noted by:
SCHOOLS DIVISION SUPERINTENDENT
School Form 7 (SF7) School Personnel Assignment List and Basic Profi
(This replaces Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)
School ID
123334
School Name
Region VIII
Division
SAMAR
District
BASEY II
(C
Title of Designation
Number of Incumbent
Number of
Incumbent
428826396
Jennifer R. Llemos
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Permanent
Degree / Post
Graduate
Major/ Specialization
Minor
BEED
GEN. ED
Number -T.I.N.)
National
EGT-I
EDUCATIONAL QUALIFICATION
N/A
EDUCATIONAL QUALIFICATION
Employee No. (or Tax Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
401456132
Cristina P. Layos
EGT-I/TIC
Permanent
294754620
Adrian O. Doble
EGT-I
Fund Source
Nature of
Appointment/
Employment Status
National
Sex
Position/
Designation
National
Number -T.I.N.)
Permanent
Degree / Post
Graduate
Major/ Specialization
Minor
BEED
ENGLISH
N/A
BEED
GEN. ED
EDUCATIONAL QUALIFICATION
N/A
GUIDELINES:
1. This form shall be accomplished at the beginning of the school year by the school head. In case of movement of teachers and other personnel during the school year, an updated Form 19 must be submitted to the Division Office .
2. All school personnel, regardless of position/nature of appointment should be included in this form and should be listed from the highest rank down to the lowest.
3. Please reflect subjects being taught and if teacher handling advisory class or Ancillary Assignment. Other administrative duties must also reported.
4. Daily Program Column is for teaching personnel only.
SAMAR
BASEY II
School Year
2015-2016
Appointment: (Contractual,
Fund Source
Substitute, Volunteer,
(SEF, PTA, NGO's etc.)
others specify)
Number of Incumbent
Teaching
NonTeaching
DAY
(M/T/W/TH/F)
From
(00:00)
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
7:15
7:30
7:50
8:45
9:25
9:45
10:30
10:50
1:00
1:10
1:25
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
15
20
50
20
20
45
20
10
10
15
50
DAY
(M/T/W/TH/F)
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
Filipino I-II
M/T/W/TH/F
MAPEH I-II
M/T/W/TH/F
Science I-II
M/T/W/TH/F
From
(00:00)
2:30
2:45
2:45
3:30
3:30
3:50
3:50
4:00
Ave. Minutes per Day
7:40
8:10
8:10
9:00
9:20
10:10
10:10
11:00
11:00
11:40
1:30
2:20
2:20
3:00
3:00
3:50
Ave. Minutes per Day
15
45
20
10
365
30
50
50
50
40
50
40
50
360
M.T.
English Oral Fluency III-IV
Mathematics III-IV
Araling Panlipunan III-IV
Filipino III-IV
MAPEH III-IV
SCIENCE III-IV
MSEP V-VI
EPP V-VI
e lowest.
DAY
(M/T/W/TH/F)
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
M/T/W/TH/F
From
(00:00)
7:40
8:10
8:10
9:00
9:20
10:10
10:10
11:00
11:00
11:40
1:30
2:20
2:20
3:00
3:00
3:50
Ave. Minutes per Day
7:30
7:50
7:50
9:10
9:10
9:50
10:05
10:55
10:55
11:55
1:30
2:30
2:30
3:10
3:10
3:50
Ave. Minutes per Day
30
50
50
50
40
50
40
50
360
20
80
40
50
60
60
40
40
390
Submitted by:
GRACE ACILDO EPIS
(Signature of School Head over Printed Name)
Updated as of: