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School Form 1 (SF 1) School Register

(This replace Form 1, Master List & STS Form 2-Family Background and Profile)

School ID Region Division District

School Name School Year Grade Level SECTION

AGE as of
ADDRESS NAME OF PARENTS GUARDIAN (If not Parent)
BIRTH
BIRTH IP
NAME Sex DATE MOTHER
LRN PLACE (Specify RELIGION
(Last Name, First Name, Middle Name) (M/F) (mm/ TONGUE House # /
(nos. of years as ( Province) Ethnic Group) Father (1st name only if family
dd/yy) Street/Sitio/ Barangay Municipality/ City Province Mother (Maiden) Name Relationship
per last birthday) name identical to learner)
Purok
AGE as of
ADDRESS NAME OF PARENTS GUARDIAN (If not Parent)
BIRTH
BIRTH IP
NAME Sex DATE MOTHER
LRN PLACE (Specify RELIGION
(Last Name, First Name, Middle Name) (M/F) (mm/ TONGUE House # /
(nos. of years as ( Province) Ethnic Group) Father (1st name only if family
dd/yy) Street/Sitio/ Barangay Municipality/ City Province Mother (Maiden) Name Relationship
per last birthday) name identical to learner)
Purok

List and code of Indicators under REMARK column


Prepared by:
Indicator Code Required Information Indicator Code Required Information BoSY EoSY
AGE as of
ADDRESS NAME OF PARENTS GUARDIAN (If not Parent)
BIRTH
BIRTH IP
NAME Sex DATE MOTHER
LRN PLACE (Specify RELIGION
(Last Name, First Name, Middle Name) (M/F) (mm/ TONGUE House # /
(nos. of years as ( Province) Ethnic Group) Father (1st name only if family
dd/yy) Street/Sitio/ Barangay Municipality/ City Province Mother (Maiden) Name Relationship
per last birthday) name identical to learner)
Purok

Transferred Out T/O Name of Public (P) Private (PR) School & Effectivity Date CCT Recipient CCT CCT Control/reference number & Effectivity Date MALE

(Signature of Adviser over Printed Name)


Transferred IN T/I Name of Public (P) Private (PR) School & Effectivity Date Balik-Aral B/A Name of school last attended & Year FEMALE

Dropped DRP Reason and Effectivity Date Learner With Dissability LWD Specify
TOTAL
Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) Accelarated ACL Specify Level & Effectivity Data Date:
not Parent) REMARK/S

(Please refer to the legend on last


Contact Number
page)
not Parent) REMARK/S

(Please refer to the legend on last


Contact Number
page)

Certified Correct:
not Parent) REMARK/S

(Please refer to the legend on last


Contact Number
page)

(Signature of School Head over Printed Name)

Date:
School Form 2 (SF2) Daily Attendance Report for learner
(This cancel Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

School ID School Year Month Reporting

Name of School Grade Level Section

*LEARNER'S NAME DATE (1st row for date, 2nd row for Day: M,T,W,TH,F) Total for the
REMARK/S (If DROPPED OUT, state reason,
(Last Month please refer to legend number 2.
Name, First Name, Middle Name) If TRANSFERRED IN/OUT, write the name of
ABSENT TARDY School.)

MALE | TOTAL Per Day


*LEARNER'S NAME DATE (1st row for date, 2nd row for Day: M,T,W,TH,F) Total for the
REMARK/S (If DROPPED OUT, state reason,
(Last Month please refer to legend number 2.
Name, First Name, Middle Name) If TRANSFERRED IN/OUT, write the name of
ABSENT TARDY School.)

FEMALE | DAILY TOTAL


Combined TOTAL PER DAY
* Automatic Generation thru LIS
Summary for the
GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month: No. of Days of Month
Classes:
1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance. blank- Present; (x)- Absent; Tardy (half M F TOTAL
2. Dates shall be written in the preceding columns beside Learner's Name. shaded= Upper for Late Commer, Lower for
Cutting Classes) * Enrolment as of (1st Friday of June)
3. To compute the following:
Registered Learner as of End of the Month 2. REASONS/CAUSES OF DROP-OUTS
a. Percentage of Enrolment = x 100 Late Enrollment (beyond cut-off)
Enrolment as of 1st Friday of June a. Domestic-Related Factors
Total Daily Attendance a.1. Had to take care of siblings
b. Average Daily Attendance = Registered Learner as of end of the month
Number of School Days in reporting month a.2. Early marriage/pregnancy
Average daily attendance a.3. Parents' attitude toward schooling Percentage of Enrolment as of end of the
c. Percentage of Attendance for the month = x 100 month
Registered Learner as of End of the month a.4. Family problems

b. Individual-Related Factors Average Daily Attendance


4. Every End of the month, the teacher/adviser submit this form to the office of the principal for recording of b.1. Illness
summary table into the Form 3. Once signed by the principal, this form should be returned to the adviser. Percentage of Attendance for the month
b.2. Overage
5. Attendance performance of learner is expected to reflect in Form 137 and Form 138 every grading period b.3. Death Number of students with 5 consecutive days of
* Beginning of School Year cut-off report is every 1st Friday of School Calendar Days b.4. Drug Abuse absences:
b.5. Poor academic performance
Drop out
b.6. Lack of interest/Distractions
b.7. Hunger/Malnutrition
Transferred out
c. School-Related Factors
c.1. Teacher Factor
Transferred in
c.2. Physical condition of classroom
c.3. Peer influence
d. Geographic/Environmental I certify that this is a true and correct report.
*LEARNER'S NAME DATE (1st row for date, 2nd row for Day: M,T,W,TH,F) Total for the
REMARK/S (If DROPPED OUT, state reason,
(Last Month please refer to legend number 2.
Name, First Name, Middle Name) If TRANSFERRED IN/OUT, write the name of
ABSENT TARDY School.)
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clan
feuds) (Signature of Teacher over Printed Name)
d.3. Calamities/Disasters
e. Financial-Related Attested by:
e.1. Child labor, work
School Form 2: Page 2 of ________ f. Others (Signature of School Head over Printed Name)
School Form 3 (SF3) Books Issued and Returned
(This replace Form 1 & Inventory of Text Book)

School ID School Year


School Name Grade Level Section
Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

*LEARNER'S NAME
NO.
(Last Name, First Name, Middle Name)

Date Date Date Date Date Date Date Date Date


Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

TOTAL FOR MALE | TOTAL COPIES


Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title

*LEARNER'S NAME
NO.
(Last Name, First Name, Middle Name)

Date Date Date Date Date Date Date Date Date


Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned Issued Returned

TOTAL FOR FEMALE | TOTAL COPIES

TOTAL LEARNERS | TOTAL COPIES


* Automatic Generation thru LIS
GUIDELINES: Prepared By:
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. (Signature over printed name)
4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. School Form 3: Page 2 of ________
Region: Division: District

School Form 4 (SF4) Monthly Learner's Movement and Attendance


(This replace Form 3 & STS Form 4-Absenteeism and Dropout Profile)

Region Division District

School ID

School Name School Year Month Reporting

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN


REGISTERED
GRADE/ LEARNER (A+B)
NAME OF ADVISER YEAR SECTION (As of End of the (A+B) Cumulative (A+B) Cumulative
(A) Cumulative as (A) Cumulative as (A) Cumulative as Cumulative as of
LEVEL Month) Average Percentage
of Previous Month
(B) For the Month as of End of the
of Previous Month
(B) For the Month as of End of the
of Previous Month
(B) For the Month
End of the
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

1 0 1 1 0 1

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

# Need home visitation as per DECS Service Manual (page, section) Prepared and Submitted by:
GUIDELINES:
1. This forms shall be accomplished every end of the month using the summary box of Form 1 submitted by the teachers/advisers to update figures for the month.
Columns for "Cumulative as of Previous Month" require the figures in "cumulative total reported from previous month".
2. Furnish copy to Division Office: a week after July 31, October 30 & March 31 (Signature of School Head over Printed Name)
3. Teachers who are handling advisory class shall be reported.
4. Small school that has one section per grade/year level are 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.
School Form 5 (SF 5) Report on Promotion & Level of Proficiency
(This replace Forms 18-E1, 18-E2, 18A)

Region Division District

School ID School Year Curriculum

School Name Grade Level Section

INCOMPLETE SUBJECT/S
GENERAL (This column is for K to 12 Curriculum and
AVERAGE
(Numerical Value in
ACTION TAKEN: remaining RBEC in High School. Elementary grades level that
LEARNER'S NAME PROMOTED, still implementing RBEC need not to fill up this column)
LRN 3 decimal places for
(Last Name, First Name, Middle Name) honor learner,2 for
IRREGULAR or
RETAINED SUMMARY TABLE
non-honor & Completed as of end of current
Descriptive Letter) as of End of the current SY
SY
MALE FEMALE

PROMOTED

IRREGULAR

RETAINED

LEVEL OF PROFICIENCY

MALE FEMALE

BEGINNNING
(B: 74% and
below)

DEVELOPING
(D: 75%-79%)

APPROACHING
PROFICIENCY

(AP: 80%-84%)

PROFICIENT
(P: 85% -89%)

ADVANCED
(A: 90% and
above)
INCOMPLETE SUBJECT/S
GENERAL (This column is for K to 12 Curriculum and
AVERAGE
(Numerical Value in
ACTION TAKEN: remaining RBEC in High School. Elementary grades level that
LEARNER'S NAME PROMOTED, still implementing RBEC need not to fill up this column)
LRN 3 decimal places for
(Last Name, First Name, Middle Name) honor learner,2 for
IRREGULAR or
RETAINED SUMMARY TABLE
non-honor & Completed as of end of current
Descriptive Letter) as of End of the current SY
SY ADVANCED
(A: 90% and MALE FEMALE
above)

TOTAL MALE

PREPARED BY:

Class Adviser

(Name and Signature)

CERTIFIED CORRECT & SUBMITTED:

School Head

(Name and Signature)

GUIDELINES:

1. For All Grades Level

2. To be prepared by the Adviser. Final rating


per subject area should be taken from the
record of subject teacher. The class adviser
should make the computation of General
Average.

2. On the summary table, reflect the total


number of learners promoted, retained and
irreular and the level of proficiency
according to the individual general average
INCOMPLETE SUBJECT/S
GENERAL (This column is for K to 12 Curriculum and
AVERAGE
(Numerical Value in
ACTION TAKEN: remaining RBEC in High School. Elementary grades level that
LEARNER'S NAME PROMOTED, still implementing RBEC need not to fill up this column)
LRN 3 decimal places for
(Last Name, First Name, Middle Name) honor learner,2 for
IRREGULAR or
RETAINED SUMMARY TABLE
non-honor & Completed as of end of current
Descriptive Letter) as of End of the current SY
SY
MALE FEMALE
TOTAL FEMALE 3. Must tallied with the total enrollment
report as of End of School Year GESP /GSSP
COMBINED (BEIS)

School Form 5: Page 2 of ________


TOTAL

CY

TOTAL
TOTAL

e)

TED:

e)

Final rating
from the
ass adviser
General

the total
etained and
ncy
ral average
TOTAL
ollment
ESP /GSSP

e 2 of ________
School Form 6 (SF6) Summarized Report on Promotion
and Level of Proficiency
(This cancel Form 20)

School ID Region Division

School Name District School Year

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
SUMMARY TABLE

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

Nos. of BEGINNNING
(B: 74% and below)
Nos. of DEVELOPING
(D: 75%-79%)

Nos. of APPROACHING
PROFICIENCY
(AP: 80%-84%)

Nos. of PROFICIENT
(P: 85% -89%)

Nos. of ADVANCED
(A: 90% and above)

TOTAL

Prepared and Submitted by: Reviewed & Validated by: Noted by:
SCHOOL HEAD DPO/EPS SCHOOLS DIVISION SUPERINTENDENT

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
School Form 7 (SF7) School Personnel Assignment List and Basic Profile
(This replace Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)

School ID Region Division


School Name District School Year
(A) Nationally-Funded Teaching Related Items (B) Nationally-Funded Non Teaching Items (C ) Other Appointments and Funding Sources

Title of Plantilla Position Nature of Appointment and Designation Funded by Number of Incumbent
Number of Title of Plantilla Position Number of
(as appeared in the appointment (Contractual , Substitute, (SEF, PTA, NGO's
Incumbent (as appeared in the appointment document) Incumbent Non-
document) Volunteer & others) etc.) Teaching
Teaching

EDUCATIONAL QUALIFICATION * Daily Program (time duration)


Subject Taught (include
Actual Remark/s (For Detailed
Name of School Personnel Grade & Section) &
Fund Position/ Nature of Teaching/ Items, Indicate name of
No. (Arrange by Sex Other Ancillary DAY
Source Designation Appointment Degree / Post Major/ school/office, For IP's
Position, Descending) Minor Assignment (Please (M/T/W/ From To Service
Graduate Specialization (00:00) (00:00) Render -Ethnicity)
Specify) TH/F)
(Mins/Day)

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day


EDUCATIONAL QUALIFICATION * Daily Program (time duration)
Subject Taught (include
Actual Remark/s (For Detailed
Name of School Personnel Grade & Section) &
Fund Position/ Nature of Teaching/ Items, Indicate name of
No. (Arrange by Sex Other Ancillary DAY
Source Designation Appointment Degree / Post Major/ school/office, For IP's
Position, Descending) Minor Assignment (Please (M/T/W/ From To Service
Graduate Specialization (00:00) (00:00) Render -Ethnicity)
Specify) TH/F)
(Mins/Day)

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day


EDUCATIONAL QUALIFICATION * Daily Program (time duration)
Subject Taught (include
Actual Remark/s (For Detailed
Name of School Personnel Grade & Section) &
Fund Position/ Nature of Teaching/ Items, Indicate name of
No. (Arrange by Sex Other Ancillary DAY
Source Designation Appointment Degree / Post Major/ school/office, For IP's
Position, Descending) Minor Assignment (Please (M/T/W/ From To Service
Graduate Specialization (00:00) (00:00) Render -Ethnicity)
Specify) TH/F)
(Mins/Day)
GUIDELINES: Submitted by:
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 (Signature of School Head over Printed Name)
to the lowest. This form shall also serve as inventory list of school personnel.
3. Subject Taught/Ancillary Assignment. Reflect all assignment per personnel such as ancillary/administrative duties. School Form 7, Page 2 of ________
4. * Daily Program Column is for teaching personnel only.
Republic of the Philippines
Department of Education
Region: _____________________________
Division : ____________________________
School: _______________________________

LEARNER DATA SHEET


Pls. Check:
( ) Transferee ( ) Balik-Aral
( ) Private ( ) Public
Name of Previous School: _________________________________________________________
Division: ______________________________ Province/Region : ______________________________

A. PERSONAL DATA (to be accomplished by the parent/pupil during enrolment)


Name of Learner: ______________________________________ LRN: __________________
Date of Birth : _________________________________ Place of Birth : ____________________
Sex: ___________ Current Address/Residence:
SY House #/Street Barangay
SY
SY
SY
SY
SY
Nationality: __________________________ Religion: ______________
Name of Father: _______________________________ Occupation : ___________________
Highest Educational Attainment of Father: ______________________________
Name of Mother: _______________________________ Occupation : ______________________
Highest Educational Attainment of Mother: ______________________________
Name of Guardian (if Guardian is not the parent): ______________________________________
Relationship to Guardian: ________________________________
Contact Number of Parents/Guardian: _________________________________
Currently living with at least one of the parents : ( ) yes ( ) no
Dialect use to communicate within the family: ______________________
Recipient of 4P's* : Yes/ No SY SY
*Programang Pantawid ng SY SY
Pamilyang Pilipino SY SY

B. MEDICAL / HEALTH RECORD (annual updating by the health officer/teacher)


b.1 Nutritional Status
SY_____ SY_____ SY_____ SY_____ SY_____
Weight (kg)
Height (m)
Body Mass Index (BMI)
Nutritional Status
(e.g.Normal,Below Normal,Above Normal,Severely Wasted)
b.2 Learner's record of ailments: (pls. check) (to be examined by the nurse)
SY_____ SY_____ SY_____ SY_____ SY_____
( ) Pediculosis
( ) Tinea Flava
( ) Scabies
( ) Eye infection
( ) Squinting eyes
( ) Otitis Media
( ) Impacted Cerumen
( ) Colds/Cough
( ) Sinusitis
( ) Ringworm
( ) Nosebleed
( ) Decayed Tooth
( ) defective speech
( ) Sore Throat
( ) Tonsilitis
( ) Asthma
( ) Allergy
( ) Bronchitis
( ) Primary Complex
( ) Convulsions
( ) Frequent headache
( ) Heart problem
( ) Frequent Stomach Ache

Other illness(specify):

b.3 Immunization
Learner's immunization shots are complete and current: yes /no
b.4 Physical Fitness and SY SY
Sports Talent Test (PFSTT) SY_____ SY_____ SY_____ SY_____ SY_____
b.4.1. Muscular Fitness
Partial: Curl Ups
Trunk: Lift (cm)
90-Degrees push- ups
b.4.2. Flexibility Fitness
Sit and Reach
Left leg bent (cm)
Right leg bent (cm)
Shoulder Flexibility
Right arm up (cm)
Left arm up (cm)
b.4.3. Physiological Fitness
1km run - Time: (min/sec)
b.5. Sports Talents
b.5.1 Anthropometrics
Sitting Height (cm)
Arm Span (cm)
b.5.2. Muscular Power
Standing Long Jump (m)
Basketball Pass (m)
b.5.3 Speed
40-meter sprint (sec.)

C. FAMILY& COMMUNITY PROFILE

Type of community ( ) Residential ( ) Commercial ( )Agricultural ( ) Industrial ( ) Fishing ( )M


Disaster Prone/ Armmed Conflict ( ) Yes ( ) No
Identified as IP Community? If yes, specify: _____________________________________________
With electrical services (Home) ( ) Yes ( ) No
With water services (Home) ( ) Yes ( ) No
Distance of Home from/to school: ___________ (km) Estimated time in going to school : ______ (hour)
Means of going to school: ( ) walking ( ) by boat ( ) vehicles

D. EDUCATIONAL PROFILE (see attached Form 137)

GUIDELINE:
The Learner Data Sheet shall be accomplish by the parent/pupil during enrolment. While, the medical/health record s
the health officer/clinic teacher at the beginning of every school year. (July?)
Municipality/Province

SY_____ SY_____

SY_____ SY_____

*Orderof ailments (eyes, ears, etc.)


SY_____ SY_____

*to be commented by PE Teachers

) Industrial ( ) Fishing ( ) Mining

chool : ______ (hour)

t. While, the medical/health record shall be accomplish by