Republika ng Pilipinas
(Republic of the Philippines)
                                                     Kagawaran ng Edukasyon
                                                      (Department of Education)
                                   KAWANIHAN NG EDUKASYONG ELEMENTARYA
                                             (BUREAU OF ELEMENTARY EDUCATION)
                                                        Rehiyon XII
                                                                (Region XII)
                F.B. CONCHA MEMORIAL PRIMARY SCHOOL
                          PALAGIANG TALAAN SA MABABANG PAARALAN
                                   (ELEMENTARY PUPILS PERMANENT RECORD)
   I      Pangalan _________________________________ Sanagay __________________ Paaralan
   ____________________________
             (Name)          (Apelyido)        Unang ngalan          M.I       (Division)                                 (School)
   II   Kasarian _____ Petsa ng Kapanganakan _________ Pook ____________________ Petsa ng
   Pagpasok ___________________
               (Sex)                      (Date of Birth)                          (Place) Bayan/Lalawigan/Lungsod          (Date of
   Entrance)
           Magulang/Tagapag-alaga ___________________________                         ________________________________
   ___________________
                  (Parent/Guardian)                           Pangalan                                              Tirahan
   Hanapbuhay
                                                                 (Name)                                                (Address)
                                                                (Occupation)
                                 PAG-UNLAD SA MABABANG PAARALAN
                                             (ELEMENTARY SCHOOL PROGRESS)
                      Grade I  School _______________________                                                    Grade II- School
   ________________________
                     School Year ___________________                                                                     School Year
   _____________________
Learning               Periodic Rating           Final                   Learning               Periodic Rating           Final
Areas             1       2     3    4           Grad       Remar        Areas              1       2     3     4         Grad     Remar
                                                   e        ks                                                              e      ks
English                                                                  English
Mathematic                                                               Mathematics
s
Filipino                                                                 Filipino
MAKABAYA                                                                 MAKABAYAN
N
*Sibika at                                                               *Sibika at
Kultura                                                                  Kultura
*Character                                                               *Character
Educ.                                                                    Educ.
                                 Gen .                                                                   Gen.
                                 Average                                                                 Average
                  Eligible for Admission to Grade _________________                                Eligible for Admission to Grade
   ________________
                             Grade III  School ______________________                                             Grade IV  School
   __________________
                                            School Year___________________
   School Year ______________
 Learning            Periodic Rating         Final Remar            Learning                    Periodic Rating           Final    Remar
    Areas                                    Grad ks                  Areas                                               Grad     ks
                                               e                                                                            e
                 1        2      3     4                                                    1      2      3        4
Engliish                                                          English
Mathemati                                                         Mathematic
cs                                                                s
Science &                                                    Science &
Health                                                       Health
Filipino                                                     Fiipino
MAKABAYA                                                     MAKABAYAN
N
*Sibika at                                                   *HEKASI
Kultura
*Character                                                   *EPP
Educ.
                                                             *MSEP
                                                             *Character
                                                             Educ.
                           Gen.                                                           Gen.
                           Average                                                        Average
             Eligible for Admission to Grade __________________                   Eligible for Admission to Grade
   _______________
                         Grade V  School ______________________                                 Grade VI  School
   __________________
                                   School ______________________                                           School
   __________________
Learning         Performance Rating         Final Remar          Learning     Performance Rating         Final      Remar
Areas                                       Grad ks              Areas                                   Grad       ks
                                              e                                                            e
                  1       2    3       4                                      1      2       3      4
English                                                          English
Mathemati                                                        Mathematic
cs                                                               s
Science &                                                        Science &
Health                                                           Heath
Filipino                                                         Filipino
MAKABAYA                                                         MAKABAYAN
N
*HEKASI                                                          *HEKASI
*EPP                                                             *EPP
*MSEP                                                            *MSEP
*Character                                                       *Character
Educ.                                                            Educ.
                           Gen.                                                    Gen.
                           Average                                                 Average
           Eligible for Admission to Grade ___________________                    Eligible for Admission to Grade
  ____________________
                                                     Republika ng Pilipinas
                                                    (Republic of the Philippines)
                                                    Kagawaran ng Edukasyon
                                                     (Department of Education)
                                  KAWANIHAN NG EDUKASYONG ELEMENTARYA
                                            (BUREAU OF ELEMENTARY EDUCATION)
                                                       Rehiyon XII
                                                               (Region XII)
                  F.B. CONCHA MEMORIAL PRIMARY SCHOOL
                       PALAGIANG TALAAN SA MABABANG PAARALAN
                                   (ELEMENTARY PUPILS PERMANENT RECORD)
  I      Pangalan ________________________LRN_________________ Sanagay _______________ Paaralan
  ____________________
             (Name)         (Apelyido)         Unang ngalan         M.I       (Division)                                (School)
  II   Kasarian _____ Petsa ng Kapanganakan _________ Pook ____________________ Petsa ng
  Pagpasok ___________________
               (Sex)                     (Date of Birth)                          (Place) Bayan/Lalawigan/Lungsod        (Date of
  Entrance)
          Magulang/Tagapag-alaga ___________________________                        ________________________________
  ___________________
                  (Parent/Guardian)                         Pangalan                                               Tirahan
  Hanapbuhay
                                                               (Name)                                               (Address)
                                                              (Occupation)
                                  PAG-UNLAD SA MABABANG PAARALAN
                                            (ELEMENTARY SCHOOL PROGRESS)
                   Grade I  School _______________________                                                      Grade II- School
  ________________________
                    School Year ___________________                                                                    School Year
  _____________________
Learning Areas           Periodic Rating         Final                 Learning Areas            Periodic Rating       Final
                                                 Grad      Remar                                                       Grad     Remar
                                                   e       ks                                                            e      ks
                        1     2    3       4                                                     1     2    3      4
Mother Tongue                                                          Mother Tongue
Filipino                                                               Filipino
Enlgish                                                                Enlgish
Mathematics                                                            Mathematics
Araling                                                                Araling
Panlipunan                                                             Panlipunan
MAPEH                                                                  MAPEH
          MUSIC                                                                  MUSIC
        Art                                                                       Art
Physical Education                                                        Physical Education
      Health                                                                    Health
Edukasyon sa                                                           Edukasyon sa
Pagpapakatao                                                           Pagpapakatao
                                   Gen .                                                                   Gen.
                                   Average                                                                 Average
                 Eligible for Admission to Grade _________________                                Eligible for Admission to Grade
  ________________
                            Grade III  School ______________________                                             Grade IV  School
  __________________
                                           School Year___________________
  School Year ______________
Learning Areas         Periodic Rating      Final Rema             Learning                    Periodic Rating         Final    Remar
                                                Grad             Areas                                    Grad      ks
                                                       rks
                                                 e                                                         e
                    1      2     3        4                                   1      2       3      4
Mother Tongue                                                English
Filipino                                                     Mathematic
                                                             s
Enlgish                                                      Science &
                                                             Health
Mathematics                                                  Fiipino
Science                                                      MAKABAYAN
Araling                                                      *HEKASI
Panlipunan
MAPEH                                                        *EPP
    MUSIC                                                    *MSEP
                                                             *Character
          Art
                                                             Educ.
     Physical
    Education
      Health
   Edukasyon sa
   Pagpapakatao
                                Gen.                                                      Gen.
                                Average                                                   Average
             Eligible for Admission to Grade __________________                   Eligible for Admission to Grade
   _______________
                         Grade V  School ______________________                                 Grade VI  School
   __________________
                                   School ______________________                                           School
   __________________
Learning         Performance Rating         Final Remar          Learning     Performance Rating         Final      Remar
Areas                                       Grad ks              Areas                                   Grad       ks
                                              e                                                            e
                  1       2    3       4                                      1      2       3      4
English                                                          English
Mathemati                                                        Mathematic
cs                                                               s
Science &                                                        Science &
Health                                                           Heath
Filipino                                                         Filipino
MAKABAYA                                                         MAKABAYAN
N
*HEKASI                                                          *HEKASI
*EPP                                                             *EPP
*MSEP                                                            *MSEP
*Character                                                       *Character
Educ.                                                            Educ.
                               Gen.                                                Gen.
                               Average                                             Average
           Eligible for Admission to Grade ___________________                    Eligible for Admission to Grade
  ____________________
            Core          Behavior                Quarter
           Values        Statements              1 2 3 4
                        Expresses ones
      1. Maka-          spiritual beliefs
      Diyos             while respecting the
                        spiritual beliefs of
                        others
                        Shows adherence to
      2. Makatao        ethical principles by
                        upholding truth
            Cares for the
3. Maka-    environment and
            utilizes resources
            wisely, judiciously,
kalikasan   and economically
            Demonstrates pride
            in being a Filipino;
            exercises the rights
            and responsibilities
            of a Filipino citizen.
4.
            Demonstrates
Makabansa   appropriate
            behavior in carrying
            out activities in the
            school, community,
            and country