173020349 deped forms latest 1

SECTION

AGE as of

(nos. of years as

per last birthday)

House # /

Street/Sitio/

Purok

Barangay Municipality/ City Province Name

GUARDIAN (If not Parent)

Father (1st name only if family

name identical to learner) Mother (Maiden)

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

LRNSex

(M/F)

BIRTH

DATE (mm/

dd/yy)

BIRTH

PLACE

(Province)

MOTHER

TONGUE

NAME

(Last Name, First Name, Middle Name)

School Name

School ID Region Division District

School Year

RELIGION

ADDRESS NAME OF PARENTS

Grade Level

IP

(Specify

Ethnic Group)

AGE as of

(nos. of years as

per last birthday)

House # /

Street/Sitio/

Purok





LRNSex

(M/F)

BIRTH

DATE (mm/

dd/yy)

BIRTH

PLACE

(Province)

MOTHER

TONGUE

NAME

(Last Name, First Name, Middle Name) RELIGION


IP

(Specify

Ethnic Group)

AGE as of

(nos. of years as

per last birthday)

House # /

Street/Sitio/

Purok





LRNSex

(M/F)

BIRTH

DATE (mm/

dd/yy)

BIRTH

PLACE

(Province)

MOTHER

TONGUE

NAME

(Last Name, First Name, Middle Name) RELIGION


IP

(Specify

Ethnic Group)

Indicator Code Required Information Indicator Code Required Information BoSY EoSY

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

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

Late Enrollment LE Reason (Enrollment beyond 1st Friday of June) Accelarated ACL Specify Level & Effectivity Data Date:

CCT Control/reference number & Effectivity Date

(Signature of Adviser over Printed Name)

TOTAL

List and code of Indicators under REMARK columnPrepared by:

REMARK/S

Relationship Contact Number(Please refer to the legend on last

page)


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

REMARK/S


page)


REMARK/S


page)


Date:

Certified Correct:

(Signature of School Head over Printed Name)

School ID School Year

Name of School

ABSENT TARDY

REMARK/S (If DROPPED OUT, state reason,

please refer to legend number 2.

If TRANSFERRED IN/OUT, write the name of

School.)

School Form 2 (SF2) Daily Attendance Report for learner

DATE (1st row for date, 2nd row for Day: M,T,W,TH,F)

(This cancel Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

*LEARNER'S NAME


SectionGrade Level

Month Reporting

Total for the

Month

MALE | TOTAL Per Day

ABSENT TARDY




School.)


*LEARNER'S NAME


Total for the

Month

GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month:

M F TOTAL

2. REASONS/CAUSES OF DROP-OUTS

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

b. Individual-Related Factors

b.1. Illness

b.2. Overage

5. Attendance performance of learner is expected to reflect in Form 137 and Form 138 every grading period 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 I certify that this is a true and correct report.

d.1. Distance between home and school

(Signature of Teacher over Printed Name)

d.3. Calamities/Disasters

d.2. Armed conflict (incl. Tribal wars & clan

feuds)

FEMALE | DAILY TOTAL

a.

b.

c.

Total Daily Attendance

Number of School Days in reporting month

Registered Learner as of End of the month

Registered Learner as of End of the Month

Combined TOTAL PER DAY

* Automatic Generation thru LIS

Transferred out

x 100

x 100

Registered Learner as of end of the month

4. Every End of the month, the teacher/adviser submit this form to the office of the principal for recording of summary table into the Form 3. Once signed by the principal, this form should be returned to the adviser.

Average daily attendance

Beginning of School Year cut-off report is every 1st Friday of School Calendar Days

3. To compute the following:

Transferred in

Percentage of Enrolment as of end of the month

Average Daily Attendance

Late Enrollment (beyond cut-off)

blank- Present; (x)- Absent; Tardy (half shaded=

Upper for Late Commer, Lower for Cutting

Classes)

Enrolment as of 1st Friday of June

Average Daily Attendance =

Percentage of Enrolment =

1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance.2. Dates shall be written in the preceding columns beside Learner's Name.

Percentage of Attendance for the month =

* Enrolment as of (1st Friday of June)

Summary for the Month

No. of Days of

Classes:

Number of students with 5 consecutive days of absences:

Drop out

Percentage of Attendance for the month

ABSENT TARDY




School.)


*LEARNER'S NAME


Total for the

Month

e. Financial-Related Attested by:

e.1. Child labor, workSchool Form 2: Page 2 of ________ f. Others (Signature of School Head over Printed Name)

School ID School Year

School Name

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

TOTAL FOR MALE | TOTAL COPIES

Date

Grade Level

(This replace Form 1 & Inventory of Text Book)

School Form 3 (SF3) Books Issued and Returned

Date Date

Section

Date Date

NO.

Date Date

Subject Area & Title Subject Area & Title

*LEARNER'S NAME


Date Date

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

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

Date Date DateDate Date

NO.

Date Date

Subject Area & Title Subject Area & Title

*LEARNER'S NAME


Date Date

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

TOTAL FOR FEMALE | TOTAL COPIES

TOTAL LEARNERS | TOTAL COPIES

* Automatic Generation thru LIS

GUIDELINES: Prepared By:

(Signature over printed name)

School Form 3: Page 2 of ________

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.

Region Division District

School ID

School Name School Year Month Reporting

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

1 0 1 1 0

ELEMENTARY/SECONDARY:

# Need home visitation as per DECS Service Manual (page, section) Prepared and Submitted by:

GUIDELINES:

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.

Region: Division: District

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

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 4 (SF4) Monthly Learner's Movement and Attendance

DROPPED OUT TRANSFERRED OUT TRANSFERRED IN

Average Percentage(A) Cumulative as

of Previous Month(B) For the Month

(A+B) Cumulative

as of End of the

Month

(A+B) Cumulative

as of End of the

Month

(A) Cumulative as

of Previous Month(B) For the Month

(A+B)

Cumulative as of

End of the

Month

NAME OF ADVISER

GRADE/

YEAR

LEVEL

SECTION

REGISTERED

LEARNER

(As of End of the

Month)

ATTENDANCE

(B) For the Month(A) Cumulative as

of Previous Month

GRADE 1/GRADE 7

KINDER

TOTAL

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".

GRADE 2/GRADE 8

GRADE 3/GRADE 9

GRADE 4/GRADE 10

GRADE 5/GRADE 11

GRADE 6/GRADE 12

TOTAL FOR NON-GRADED

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.

T

1

Region: Division: District

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

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

TRANSFERRED IN

(A+B)

Cumulative as of

End of the

Month

Region Division District

Curriculum

Grade Level Section

MALE FEMALE

RETAINED

INCOMPLETE SUBJECT/S

(This column is for K to 12 Curriculum and remaining RBEC in

High School. Elementary grades level that still implementing

RBEC need not to fill up this column)

Completed as of end of current

SYas of End of the current SY

PROMOTED

School Form 5 (SF 5) Report on Promotion & Level of Proficiency(This replace Forms 18-E1, 18-E2, 18A)

LRN

GENERAL

AVERAGE

(Numerical Value in

3 decimal places for

honor learner,2 for

non-honor &

Descriptive Letter)

ACTION TAKEN:

PROMOTED,

IRREGULAR or

RETAINED

School Name

School ID

LEARNER'S NAME (Last

Name, First Name, Middle Name)

School Year

SUMMARY TABLE

IRREGULAR

MALE FEMALE

LEVEL OF PROFICIENCY

DEVELOPING

(D: 75%-79%)

BEGINNNING

(B: 74% and

below)

APPROACHING

PROFICIENCY

(AP: 80%-84%)

PROFICIENT

(P: 85% -89%)

ADVANCED

(A: 90% and

above)







LRN

GENERAL

AVERAGE

(Numerical Value in


honor learner,2 for

non-honor &

Descriptive Letter)

ACTION TAKEN:

PROMOTED,

IRREGULAR or

RETAINED


Name, First Name, Middle Name) SUMMARY TABLE

MALE FEMALE

CERTIFIED CORRECT & SUBMITTED:

GUIDELINES:

TOTAL FEMALE

COMBINED

TOTAL MALE

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

3. Must tallied with the total enrollment

report as of End of School Year GESP /GSSP

(BEIS)

PREPARED BY:

Class Adviser

(Name and Signature)

School Head


1. For All Grades Level







LRN

GENERAL

AVERAGE

(Numerical Value in


honor learner,2 for

non-honor &

Descriptive Letter)

ACTION TAKEN:

PROMOTED,

IRREGULAR or

RETAINED


Name, First Name, Middle Name) SUMMARY TABLE

MALE FEMALE


TOTAL

School Form 5 (SF 5) Report on Promotion & Level of Proficiency(This replace Forms 18-E1, 18-E2, 18A)

SUMMARY TABLE

TOTAL

LEVEL OF PROFICIENCY

SUMMARY TABLE

TOTAL

CERTIFIED CORRECT & SUBMITTED:

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

3. Must tallied with the total enrollment

report as of End of School Year GESP /GSSP

(BEIS)

PREPARED BY:

Class Adviser


School Head


1. For All Grades Level

SUMMARY TABLE

TOTAL


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

LEVEL OF PROFICIENCY MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL

Prepared and Submitted by: Reviewed & Validated by: Noted by:

SCHOOL HEAD DPO/EPS SCHOOLS DIVISION SUPERINTENDENT

GUIDELINES:

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

PROMOTED

RETAINED

School YearSchool Name

School ID

District

GRADE 2 / GRADE 8 GRADE 3 / GRADE 9 GRADE 4 / GRADE 10 GRADE 5 / GRADE 11 GRADE 6 / GRADE 12 TOTALSUMMARY TABLE

School Form 6 (SF6) Summarized Report on Promotion

(This cancel Form 20)

Region Division

IRREGULAR

TOTAL

Nos. of BEGINNNING

(B: 74% and below)

Nos. of DEVELOPING (D:

75%-79%)

and Level of Proficiency

GRADE 1 /GRADE 7

Nos. of APPROACHING

PROFICIENCY

(AP: 80%-84%)

Nos. of PROFICIENT

(P: 85% -89%)

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.

Nos. of ADVANCED

(A: 90% and above)

Region

Teaching

Degree / Post

Graduate

DAY

(M/T/W/

TH/F)

From

(00:00)

To

(00:00)

Actual

Teaching/

Service

Render

(Mins/Day)

School ID

School Name

Division

District

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 Year(C ) Other Appointments and Funding Sources

Subject Taught (include

Grade & Section) &

Other Ancillary

Assignment (Please

Specify)

Ave. Minutes per Day


* Daily Program (time duration)

Funded by

(SEF, PTA, NGO's etc.)

Nature of Appointment and Designation

(Contractual , Substitute, Volunteer & others)

Remark/s (For Detailed

Items, Indicate name of

school/office, For IP's -

Ethnicity)

Number of Incumbent

EDUCATIONAL QUALIFICATION

Major/

SpecializationMinor

SexFund

Source

Nature of

Appointment

Position/

Designation

Number of

Incumbent

Title of Plantilla Position

(as appeared in the appointment

document)

No. Name of School Personnel

(Arrange by Position, Descending)

Number of

Incumbent

Title of Plantilla Position

(as appeared in the appointment document)

(B) Nationally-Funded Non Teaching Items(A) Nationally-Funded Teaching Related Items


Degree / Post

Graduate

DAY

(M/T/W/

TH/F)

From

(00:00)

To

(00:00)

Actual

Teaching/

Service

Render

(Mins/Day)


Grade & Section) &

Other Ancillary

Assignment (Please

Specify)





Ethnicity)


Major/

SpecializationMinor

SexFund

Source

Nature of

Appointment

Position/

DesignationNo.

Name of School Personnel


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 .







Degree / Post

Graduate

DAY

(M/T/W/

TH/F)

From

(00:00)

To

(00:00)

Actual

Teaching/

Service

Render

(Mins/Day)


Grade & Section) &

Other Ancillary

Assignment (Please

Specify)





Ethnicity)


Major/

SpecializationMinor

SexFund

Source

Nature of

Appointment

Position/

DesignationNo.

Name of School Personnel



3. Subject Taught/Ancillary Assignment. Reflect all assignment per personnel such as ancillary/administrative duties.4. * Daily Program Column is for teaching personnel only.

School Form 7, Page 2 of ________

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 school personnel.

Non-

Teaching

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)

(C ) Other Appointments and Funding Sources




Ethnicity)

Number of Incumbent




Ethnicity)




Ethnicity)


School Form 7, Page 2 of ________

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

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

SY SY

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

Barangay

LEARNER DATA SHEET

Republic of the Philippines

Department of Education

Region: _____________________________

Division : ____________________________

School: _______________________________

*Programang Pantawid ng

Pamilyang Pilipino

( ) Allergy

( ) Bronchitis

( ) Primary Complex

( ) Convulsions

( ) Frequent headache

( ) Heart problem

( ) Frequent Stomach Ache

b.3 Immunization

Learner's immunization shots are complete and current: yes /no

SY SYb.4 Physical Fitness and

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 ( ) Mining

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:

Other illness(specify):

The Learner Data Sheet shall be accomplish by the parent/pupil during enrolment. While, the medical/health record shall be accomplish by

SY_____ SY_____

SY_____ SY_____

*Orderof ailments (eyes, ears, etc.)

LEARNER DATA SHEET

Republic of the Philippines

Department of Education

Region: _____________________________

Division : ____________________________

School: _______________________________

Municipality/Province

SY_____ SY_____

*to be commented by PE Teachers

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

Distance of Home from/to school: ___________ (km) Estimated time in going to school : ______ (hour)

The Learner Data Sheet shall be accomplish by the parent/pupil during enrolment. While, the medical/health record shall be accomplish by

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