School ID
School Name
AGE as of 1st
Friday of June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/ dd/yy)
(nos. of years
as per last
birthday)
BIRTH PLACE
(Province)
AGE as of 1st
Friday of June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/ dd/yy)
(nos. of years
as per last
birthday)
BIRTH PLACE
(Province)
AGE as of 1st
Friday of June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/ dd/yy)
(nos. of years
as per last
birthday)
BIRTH PLACE
(Province)
AGE as of 1st
Friday of June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/ dd/yy)
(nos. of years
as per last
birthday)
BIRTH PLACE
(Province)
AGE as of 1st
Friday of June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/ dd/yy)
(nos. of years
as per last
birthday)
BIRTH PLACE
(Province)
AGE as of 1st
Friday of June
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/ dd/yy)
(nos. of years
as per last
birthday)
BIRTH PLACE
(Province)
AGE as of 1st
Friday of June
NAME
(Last Name, First Name, Middle Name)
LRN
Sex (M/F)
BIRTH DATE
(mm/ dd/yy)
(nos. of years
as per last
birthday)
BIRTH PLACE
(Province)
Code
Required Information
Indicator
Transferred Out
T/O
CCT Recipient
Transferred IN
Dropped
Late Enrollment
T/I
DRP
LE
Balik-Aral
Learner With Dissability
Accelarated
Division
School Year
ADDRESS
MOTHER
TONGUE
IP
(Specify Ethnic
Group)
RELIGION
House # / Street/Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER
TONGUE
IP
(Specify Ethnic
Group)
RELIGION
House # / Street/Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER
TONGUE
IP
(Specify Ethnic
Group)
RELIGION
House # / Street/Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER
TONGUE
IP
(Specify Ethnic
Group)
RELIGION
House # / Street/Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER
TONGUE
IP
(Specify Ethnic
Group)
RELIGION
House # / Street/Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER
TONGUE
IP
(Specify Ethnic
Group)
RELIGION
House # / Street/Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER
TONGUE
ith Dissability
IP
(Specify Ethnic
Group)
Code
RELIGION
House # / Street/Sitio/
Purok
Barangay
Municipality/ City
Province
Required Information
CCT
MALE
B/A
LWD
ACL
FEMALE
TOTAL
District
Section
Grade Level
NAME OF PARENTS
Name
Relationship
NAME OF PARENTS
Name
Relationship
NAME OF PARENTS
Name
Relationship
NAME OF PARENTS
Name
Relationship
NAME OF PARENTS
Name
Relationship
NAME OF PARENTS
Name
Relationship
NAME OF PARENTS
BoSY
EoSY
Name
Prepared by:
Certified Correct:
BoSY Date:
Relationship
EoSYDate:
BoSY Date:
Eo
REMARK/S
REMARK/S
REMARK/S
REMARK/S
REMARK/S
REMARK/S
REMARK/S
ect:
EoSYDate:
School ID
School Year
Name of School
LEARNER'S NAME
(Last Name, First Name, Middle Name)
LEARNER'S NAME
(Last Name, First Name, Middle Name)
LEARNER'S NAME
(Last Name, First Name, Middle Name)
1. CODES F
blank- Prese
Commer, Lo
x 100
x 100
2. REASON
a. Domestic
a.1. Had to t
a.2. Early m
a.3. Parents
a.4. Family p
b. Individua
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 the School Form 4. Once signed by the principal, this form should be returned to the adviser.
b.1. Illness
LEARNER'S NAME
(Last Name, First Name, Middle Name)
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 the School Form 4. Once signed by the principal, this form should be returned to the adviser.
5. The adviser will extend neccessary intervention including but not limited to home visitation to learner/s that committed 5 consecutive days of absences or those with
potentials of dropping out
6. Attendance performance of learner is expected to reflect in Form 137 and Form 138 every grading period
* Beginning of School Year cut-off report is every 1st Friday of School Calendar Days
b.2. Overage
b.3. Death
b.4. Drug Ab
b.5. Poor ac
b.6. Lack of
b.7. Hunger/
c. School-R
c.1. Teacher
c.2. Physica
c.3. Peer inf
d. Geograph
d.1. Distance
d.2. Armed c
d.3. Calamit
e. Financial
e.1. Child lab
f. Others
ay: M,T,W,TH,F)
Grade Level
Section
Total for the Month
ABSENT
TARDY
ay: M,T,W,TH,F)
ABSENT
TARDY
ay: M,T,W,TH,F)
EASONS/CAUSES OF DROP-OUTS
omestic-Related Factors
ABSENT
Month:
TARDY
Family problems
dividual-Related Factors
Illness
TOTAL
ay: M,T,W,TH,F)
Overage
Death
Drug Abuse
Poor academic performance
Lack of interest/Distractions
Hunger/Malnutrition
chool-Related Factors
Teacher Factor
Physical condition of classroom
Peer influence
eographic/Environmental
Distance between home and school
Calamities/Disasters
nancial-Related
Child labor, work
hers
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
Returned
Issued
Returned
Issued
Returned
Issued
Section
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARK/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
Prepared By:
Region
Division
School ID
School Name
ATTENDANCE
NAME OF ADVISER
GRADE/
YEAR
LEVEL
SECTION
REGISTERED
LEARNER
(As
of End of the Month)
Daily Average
M
DROPPED OUT
(A) Cumulative as of
Previous Month
M
(A+B) Cumulative as of
End of the 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 forms 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 copy to Division Office: a week after June 30, October 30 & March 31
3. Only teachers who are handling advisory class shall be reported. May use additional copy/ies of this form if needed.
4. Small school that has one section per grade/year level is not required to fill the columns "Name of Adviser, Grade/Year Level & Section". Instead, they will only accomplish the summary column per grade/year level.
nd Dropout Profile)
District
School Year
TRANSFERRED IN
(A+B) Cumulative as
of End of the Month
M
ear level.
Region
III
School ID
Division
106030
School Name
LRN
PAMPANGA
School Year
District
2013 - 2014
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
Curriculum
Grade Level
GENERAL AVERAGE
(Numerical Value in 3
decimal places for honor
learner, 2 for non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/S
(This column is for K to 12 Curriculum and remaining RBE
Elementary grades level that still implementing RBEC nee
column)
Completed as of end of current SY
106030120002
80.43
PROMOTED
106030120004
80.46
PROMOTED
106030120008
78.05
PROMOTED
106030120030
80.39
PROMOTED
106030120011
76.23
PROMOTED
106030120013
83.08
PROMOTED
106030120014
80.1
PROMOTED
106030120022
80.17
PROMOTED
106030120017
76.29
PROMOTED
106030120019
80.67
PROMOTED
106030120021
82.96
PROMOTED
106030120017
76.58
PROMOTED
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
GENERAL AVERAGE
(Numerical Value in 3
decimal places for honor
learner, 2 for non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/S
(This column is for K to 12 Curriculum and remaining RBE
Elementary grades level that still implementing RBEC nee
column)
Completed as of end of current SY
106030120021
80.07
PROMOTED
106030120023
76.39
PROMOTED
TOTAL MALE
106030120018
76.42
PROMOTED
106030120029
82.64
PROMOTED
106030120031
77.39
PROMOTED
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
GENERAL AVERAGE
(Numerical Value in 3
decimal places for honor
learner, 2 for non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/S
(This column is for K to 12 Curriculum and remaining RBE
Elementary grades level that still implementing RBEC nee
column)
Completed as of end of current SY
106030120032
82.11
PROMOTED
106030130019
80.05
PROMOTED
106030120035
84.86
PROMOTED
106030120036
80.05
PROMOTED
106030120037
82.4
PROMOTED
106030120039
84.36
PROMOTED
106030120042
75.99
PROMOTED
106030120040
85.64
PROMOTED
106030120041
85.75
PROMOTED
106030130020
77.27
PROMOTED
LRN
LEARNER'S NAME
(Last Name,
First Name, Middle Name)
TOTAL FEMALE
COMBINED
GENERAL AVERAGE
(Numerical Value in 3
decimal places for honor
learner, 2 for non-honor &
Descriptive Letter)
ACTION TAKEN:
PROMOTED,
*IRREGULAR or
RETAINED
INCOMPLETE SUBJECT/S
(This column is for K to 12 Curriculum and remaining RBE
Elementary grades level that still implementing RBEC nee
column)
Completed as of end of current SY
Proficiency
LUBAO EAST
K to 12 RBEC
ONE
Section
MALE
FEMALE
14
PROMOTED
13
TOTAL
27
*IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
MALE
BEGINNNING
(B: 74% and below)
FEMALE
TOTAL
APPROACHING
PROFICIENCY
(AP: 80%-84%)
15
PROFICIENT
(P:
85% -89%)
ADVANCED
(A: 90%
and above)
PREPARED BY:
DIVINA G. CALING
REVIEWED BY:
4. Must tallied with the total enrollment report as of End of School Year
GESP /GSSP (BEIS)
5. Protocols of validation & submission will remain under the discretion
of the Schools Division Superintendent
School Form 5: Page 2 of ________
School ID
Region
Division
School Name
District
GRADE 1 /GRADE 7
GRADE 2 / GRADE 8
GRADE 3 / GRADE 9
GRADE 4 / GRADE 10
SUMMARY TABLE
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
Nos. of BEGINNNING
74% and below)
Nos. of DEVELOPING
75%-79%)
(B:
(D:
Nos. of APPROACHING
PROFICIENCY
(AP: 80%-84%)
Nos. of PROFICIENT
85% -89%)
(P:
Nos. of ADVANCED
90% and above)
(A:
TOTAL
Noted by:
DIVISION REPRESENTATIVE
GUIDELINES:
1. After receiving and validating the Report for Promotion submitted by the class adviser, the School Head shall compute the Total for Grade Level in order to reflect the result in each data field.
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 will remain under the discretion of the Schools Division Superintendent
Promotion
School Year
GRADE 5 / GRADE 11
GRADE 6 / GRADE 12
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
d.
School ID
Region
Division
School Name
District
Number of Incumbent
Number of
Incumbent
Title of Designation
(Designation as ap
contract/document: Teacher, C
Guard, Driver etc.)
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
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 SY, updated Form 19 must submit 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. This form shall also serve as inventory list of
personnel.
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.
ent List,
s)
School Year
(C ) Other Appointments and Funding Sources
ation
(Designation as appeared in the
cument: Teacher, Clerk, Security
Driver etc.)
Appointment:
Fund Source
(Contractual, Substitute,
(SEF, PTA, NGO's etc.)
Volunteer, others specify)
Number of Incumbent
Teaching
NonTeaching
DAY
(M/T/W/TH/
F)
From
(00:00)
DAY
(M/T/W/TH/
F)
From
(00:00)
DAY
(M/T/W/TH/
F)
From
(00:00)