School Register Summary

School Form 1 (SF 1) School Register
(This replace Form 1, Master List & STS Form 2-Family Background and Profile)
School ID School Name
305293
Region NCR
F. G. Calderon Integrated School (High School)
Division
Manila
School Year
2013 - 2014
ADDRESS RELIGION House # / Street/Sitio/ Purok
1010J.Trinidad 2908Dagupan St. Karilagan St. 2906Tambunting 1061T.Bugalon 1081J.K.Hermosa 2808Gagalangin 1084D.Gomez 170 Macabalo 1281Int.29Tambunting 1283Int.6Tambunting 2880Pilar 2nd.Ave.Grace Park 119A.Bustamante 2990Dagupan Ext. 1081 K.Hermosa 2962 Benita 2856 Dagupan Ext. 1165 Int. Tambunting 43 184 200 177 203
District
II
Rose
GUARDIAN (If not Parent) Name Relationship Contact Number
Grade Level GRADE 7 SECTION

NAME OF PARENTS Province
Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Romy Sonny Jerry Jeffrey
Roberto
AGE as of LRN NAME (Girls) Sex (Last Name, First Name, Middle Name) (M/F) BIRTH DATE (mm/ dd/yy) (nos. of years as per last birthday) BIRTH PLACE (Province) MOTHER TONGUE
IP (Specify Ethnic Group)
Baranga Municipality/ City y

195 184 184 379 203 200 186 190 203 373 Tondo Manila Tondo Manila Tondo Manila Sta.Cruz,Manila Tondo,Manila Tondo Manila Tondo Manila Tondo Manila Cal.City Sta.Cruz,Manila Sta. Cruz Manila Tondo Manila Caloocan City Caloocan City Tondo Manila Tondo,Manila Tondo,Manila Tondo Manila Tondo Manila 200 227 120 184
198
Father (1st name only if family name identical to learner)

Roderick Danilo Hector
Mother (Maiden)
Merly De Guzman Marivic Abarca Ludy Rancess Rosalie Bercasio Marissa Cajelis
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
136419060035 1364211201`93
Aspili,Raymond De Guzman Baal jr.,Danilo Abarca Bartina,Eunel
M M M M M M M M M M M M M M M M M M M M M M M
Feb.10,2000 Nov.22,2000 Sept.22,1997 April4,1999 Dec.14,2000 July 26,2000 June1,2001 Oct.2,2000 May 25,2000 May2,2000 Aug.29,2000 Nov.1,2000 Feb.22,2000
Aug.20,2000
13 13 14 14 12 13 12 12 13 13 13 12 13 12 12 12 12 14 13 13 12 12 13 12.00
Manila
Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila
Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog
INC Catholic Catholic Catholic Catholic Catholic Catholic Catholic Catholic Catholic Catholic Catholic Catholic Catholic Catholic Catholic Catholic
136425060024 136420060078 136420060127 136420060128 136419060110 13642006162 136420050138 136420060187 136421060065 136420060192 136418060061 136420060241 158535060088 136420120770
Bercasio,John Rex Cajelis,Christopher Cuizon,Rolly Firmalo Jr. Cumla,Jihn Ciser Entero De Dis,Abrielle John Sabado Dimalanta,Anderssen Mabunga Ermitanio,Joshua Sinugbuhan Evangelista,Renzo Claveria Favila,James Albert Dellralye Fernandez,Jefferson Jerao,Jonel Gabriel Ventura Juance Jr.,Eduardo Sevilla Letada,Jeffrey Dela Cruz Manozon,Kyle Ashley Navelgas Mateo,Meldenson O.
Rolly Jessie Gabriel Boysen Deogracias Zollo Marvin
Rebecca Firmalo Jovelyn Entero Corazon Sabado Adeluisa Mabunga Lilia Sinugban Rebecca Claveria Julita Dellralye Teresa Fernandez
258-32-18
Arnel Peter Tito Ramil
Eliza Ventura Laura Ramos Marissa dela Cruz Rosalin Navelgas
Nov.19,2000
Aug.14,2001 Aug.1,2001 Apr.23,1999 Feb.20,2000 Mar.2,2000 Apr.3,2001 Jan.6,2001 Apr.2,2000 Dec.16,2000
136418060083 136421080897 136420060308 136418060123 136421060168 1.58535E+11
Mendoza,Christian O. Mioza,Angelito M. Molina,Lord Benedict O. Senoc,Jhon Paul P. Tobias,Karl Jhemar S.
Manila Manila Manila Manila
Tagalog Tagalog Tagalog Tagalog

Tagalaog
Catholic Catholic Catholic Catholic

Catholic
993 A. 2234 C. Narra St. 0510 BMBA 2nd Ave. 2951 Dagupan Ext.
3145 Int. 60 Pilar St.
Tondo Manila Tondo Manila Caloocan City Tondo Manila

Tondo Manila
Marites Memoracion Remmabel Jemma Perez Maribel Sallao

Citadel Biso
Trinidad,Kristopher B.

305293
Region NCR
Division
Manila
School Year
2013 - 2014
ADDRESS RELIGION House # / Street/Sitio/ Purok Baranga Municipality/ City y Province
District
II
Rose

NAME OF PARENTS Father (1st name only if family name identical to learner) Mother (Maiden)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Agnes,Almira A.
136420060025 13642012077
Antenor,Mary Joyce P. Baraquia,Aira Mae T. Carpio,Danielle Anne Marie De Vera,Lyka
136420060164 136421060061 136418060046 136420060219
Dizon,Krista Elaine V. Domingo,Regene C. Evangelista,Crystal Mae M. Gonzales,Carmina V. Guansing,Angelica May T. Lacoste.Ma. Katarina R. Malabo,Aira C.
136420120566 136420060270
Manalili,Abigail R. Mamaril,Andrea Justine S. Malonzo,Kyla Marie O.
136420060305 136420060322 136419060275
Mirasol,Mc Kenzi Colene F. Nemis,Laiza Mae L. Ortega,Innah Nia P. San Jose,Arriza Micaela L.
136419060358 136420060437 136606060231 136419120586 136612060063
Tecson,Desiree Kate H. Tejano,Charlotte Denise D. Teoxon,Jalene Fozz B. Velasquez,Wilma W. Vinluan,Briza F.
F F F F F F F F F F F F F F F F F F F F F F F F
Apr.13,2001 Feb.17,2001 Aug.23,2001 Sep.3,2001 Dec.31,1999

Dec.6,2000
12 12 12 12 13 12 13 12 13 14 13 12 14 12 13 11 12 12 12 12 12 13 12 12
Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Manila Caloocan City
Manila
1364 Blk.22 Lot 1 Torcillo St. Dagat- Dagatan Manila Manila
Cal. City Tondo Manila Tondo Manila Caloocan City Caloocan City Manila Manila Jeffrey Leonard Marites Parungao Edna Tesoro
Tagalog Tagalog
Catholic Catholic
3042 Dagupan Ext. 3106 Abucay St. 30-A Marulas A 722 Guida One St.
184 202
Tagalog Tagalog Tagalog Tagalog
Catholic Catholic Catholic Catholic
3015 Pilar St. 3147 Pilar St. 428 3rd. Ave. 1281 Tambunting St. 1226 Dinalupihan St. 1044 AC Tabora St.
18 199 120 373
Tondo Manila Tondo Manila Caloocan City Sta. Cruz Manila Tondo Manila Tondo Manila
Manila Manila Manila Manila
Maximino Reynato Santo Rivak
Elvira Villareal Gina Cancel Emellyn Mallari Elena Buaya
May.19,2000 Jan.11,2001 Apr.22,2000 June.19,1999 July.3,2000 Aug.4,2001 Jun.17,1999 Feb.18,2001 Nov.26,1999

Nov.20,2001
Tagalog Tagalog Tagalog Tagalog Tagalog Tagalog Kapampangan Tagalog Tagalog Tagalog Tagalog Tagalog
Catholic Catholic Catholic
1010 Trinidad St. 3054 Dagupan Ext. 2960 E Tambunting St. 2927 Orani St.
197 184 374
Tondo Manila Tondo Manila Sta. Cruz Manila Tondo Manila
Manila Manila Manila
Roberto Danilo Romeo
Minda Cabigan Aileen Ramos Anavina Samson
Catholic Catholic Catholic Catholic Catholic Saksi ni Jehova Catholic Catholic Catholic
3145 Int. 16 Pilar St. 3192 Int. Pilar St. 509 Int. 2 Pilar Sevilla St. 1044 A.C. Tabora St. 3490 F. Aguilar St. 1222 E. Tambunting St. 52 A F. Roxas 2nd Ave. 3209 Molave Ext. 306 Int, 7 L Nadurata St.
200 199 37 195 39 374 45 194 43
Tondo Manila Tondo Manila Tondo Manila Tondo Manila Tondo Manila Sta. Cruz Manila Caloocan City Tondo Manila Caloocan City
Manila Manila Manila Manila Manila Manila Manila Manila Manila
Rico Louwi Francisco Archie Emerito Melvin Joel Ferdinand Teodoro
Arlene Fuego Myrna Lowlita Rutchel Pelaez Imelda Lacas Michell Hernandez Hilda Dorimon Fely Bulaon Carmen Wantin Francisca Fama
Apri.15,2001 May.29,2001 Feb.18,2001 May.22,2001 April.4,2001 June.19,2000 April.4,2001 April.23,2001
List and code of Indicators under REMARK column Indicator Transferred Out Transferred IN Dropped Code T/O T/I DRP Required Information Name of Public (P) Private (PR) School & Effectivity Date Name of Public (P) Private (PR) School & Effectivity Date Reason and Effectivity Date Indicator CCT Recipient Balik-Aral Learner With Dissability Code CCT B/A LWD Required Information CCT Control/reference number & Effectivity Date Name of school last attended & Year
MALE FEMALE TOTAL
BoSY
EoSY
Prepared by:
Certified Correct:
(Signature of Adviser over Printed Name)
(Signature of School Head over

305293
Region NCR
Division
Manila
School Year
2013 - 2014
ADDRESS RELIGION House # / Street/Sitio/ Purok Baranga Municipality/ City y Province
District
II
Rose

NAME OF PARENTS Father (1st name only if family name identical to learner) Mother (Maiden)
Accelarated
ACL
Date:
Date:
REMARK/S (Please refer to the legend on last page)
Certified Correct:
(Signature of School Head over Printed Name)
School Form 2 (SF2) Daily Attendance Report for learner

(This cancel Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)
School ID Name of School
305293
School Year
2013-2014
Month Reporting
Grade Level Section
25
M
F.G Calderon Integrated School

4
M
TH
TH
TH
TH
1 2
3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 MALE
*LEARNER'S NAME (Last Name, First Name, Middle Name)
DATE (1st row for date, 2nd row for Day: M,T,W,TH,F) 5 6 7 8 11 12 13 14 15 18 19 20 21 22 26 27 28 29
Total for the Month ABSENT TARDY
REMARK/S (If DROPPED OUT, state reason, please refer to legend number 2. If TRANSFERRED IN/OUT, write the name of School.)
TH
TH
TH
TH
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
FEMALE
Combined TOTAL PER DAY
DATE (1st row for date, 2nd row for Day: M,T,W,TH,F) 4 5 6 7 8 11 12 13 14 15 18 19 20 21 22 25 26 27 28 29
TH
TH
TH
TH
* Automatic Generation thru LIS
DATE (1st row for date, 2nd row for Day: M,T,W,TH,F) 4 5 6 7 8 11 12 13 14 15 18 19 20 21 22 25 26 27 28 29
GUIDELINES: 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. 3. To compute the following: Registered Learner as of End of the Month a. Percentage of Enrolment = Enrolment as of July Total Daily Attendance b. Average Daily Attendance = Number of School Days Average daily attendance Percentage of Attendance for the month = c. 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. 5. 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
1. CODES FOR CHECKING ATTENDANCE blank- Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer, Lower for Cutting Classes)
Month:
No. of Days of Classes:
Summary for the Month

M F
* Enrolment as of Registered Learner as of end of the month *Percentage of Enrolment as of
x 100
x 100
School Form 2: Page 2 of ________
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 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 d.1. Distance between home and school d.2. Armed conflict (incl. Tribal wars & clan feuds) d.3. Calamities/Disasters e. Financial-Related e.1. Child labor, work f. Others
Average Daily Attendance Percentage of Attendance for the month Number of students with 5 consecutive days of absences:
Drop out Transferred out Transferred in I certify that this is a true and correct report.
(Signature of Teacher over Printed Name) Attested by: (Signature of School Head over Printed Name)
Attendance Report for learner
orm 4 - Absenteeism and Dropout Profile)
Summary for the Month

TOTAL
School Form 3 (SF3) Books Issued and Returned

(This replace Form 1 & Inventory of Text Book)

Subject Area & Title Subject Area & Title
School Year Grade Level

Subject Area & Title Subject Area & Title
Section
Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title Subject Area & Title
NO.
*LEARNER'S NAME (Last Name, First Name, Middle Name) Date Issued Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned
TOTAL FOR MALE
TOTAL COPIES
Subject Area & Title
NO.
*LEARNER'S NAME (Last Name, First Name, Middle Name) Date Issued Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned Issued Date Returned
TOTAL FOR FEMALE TOTAL LEARNERS
| |
TOTAL COPIES TOTAL COPIES Prepared By:
* Automatic Generation thru LIS 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.
(Signature over printed name) 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 NCR Division MANILA District II
305293
F.G. CALDERON INTEGRATED SCHOOL (H.S.)

REGISTERED LEARNER (As of End of the Month) M F T M ATTENDANCE DROPPED OUT (A) Cumulative as (B) For the Month of Previous Month T M F T M F T
School Year
2013-2014
TRANSFERRED OUT
Month Reporting
JULY
TRANSFERRED IN
NAME OF ADVISER
GRADE/ YEAR LEVEL
SECTION
Average
F T
Percentage M F
(A+B) Cumulative (A+B) Cumulative (A+B) (A) Cumulative as (A) Cumulative as as of End of the (B) For the Month as of End of the (B) For the Month Cumulative as of of Previous Month of Previous Month Month Month End of the Month M F T M F T M F T M F T M F T M F T M F T
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) 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". Prepared and Submitted by:
MERCEDITA S. TOLENTINO
2. Furnish copy to Division Office: a week after July 31, October 30 & March 31 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 School Year
District Curriculum
Grade Level Section
LRN
LEARNER'S NAME (Last Name, First Name, Middle Name)
GENERAL AVERAGE (Numerical Value in 3 decimal places)
ACTION TAKEN: PROMOTED or RETAINED (RBEC only)
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 SY as of End of the current SY
SUMMARY TABLE
MALE FEMALE TOTAL
PROMOTED
RETAINED
LEVEL OF PROFICIENCY
MALE FEMALE TOTAL
BEGINNNING (B: 74% and below) DEVELOPING (D: 75%-79%)
APPROACHING PROFICIENCY (AP: 80%-84%)
PROFICIENT (P: 85% -89%) ADVANCED (A: 90% and above)
LRN
TOTAL MALE
PREPARED BY:
DANALYN V. SERVILLON 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 the level of proficiency according to the individual general average TOTAL FEMALE COMBINED 3. Must tallied with the total enrollment report as of End of School Year GESP /GSSP (BEIS)
LRN
* May generate thru Learner's Information System or may lift from Master List of Learners.
School Form 5: Page 2 of ________
School Form 6 (SF6) Summarized Report on Promotion and Level of Proficiency

(This cancel Form 20)

GRADE 1 / GRADE 7 GRADE 2 / GRADE 8
Region
Division District
School Year
GRADE 5 / GRADE 11 GRADE 6 / GRADE 12 TOTAL
SUMMARY TABLE
GRADE 3 / GRADE 9
GRADE 4 / GRADE 10
MALE PROMOTED RETAINED (RBEC) LEVEL OF PROFICIENCY MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE FEMALE
TOTAL MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
MALE
FEMALE
TOTAL
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: SCHOOL HEAD
Reviewed & Validated by: DPO/EPS
Noted by: 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)

(A) Nationally-Funded Teaching Related Items Title of Plantilla Position (as appeared in the appointment document) Number of Incumbent
Region
Division District
Number of Incumbent Nature of Appointment and Designation (Contractual, Substitute, Volunteer & others) KINDER
School Year
(C ) Other Appointments Fund Source LOCALLY FUNDED Number of Incumbent NonTeaching Teaching 1
(B) Nationally-Funded Non Teaching Items Title of Plantilla Position (as appeared in the appointment document)
EDUCATIONAL QUALIFICATION Name of School Personnel No. (Arrange by Position, Descending) Sex Fund Source Position/ Designation Nature of Appointment
Degree / Post Graduate
Major/ Specialization
Minor
Subject Taught (include Grade & Section) & Other Ancillary Assignment (Please Specify)
* Daily Program (time duration) Actual Teaching/ Service Render (Mins/Day) Remark/s (For Detailed Items, Indicate name of school/office, For IP's Ethnicity)
DAY
From
To
Ave. Minutes per Day
EDUCATIONAL QUALIFICATION Name of School Personnel No. (Arrange by Position, Descending) Sex Fund Source Position/ Designation Nature of Appointment
Degree / Post Graduate
Major/ Specialization
Minor
Subject Taught (include Grade & Section) & Other Ancillary Assignment (Please Specify)
* Daily Program (time duration) Actual Teaching/ Service Render (Mins/Day) Remark/s (For Detailed Items, Indicate name of school/office, For IP's Ethnicity)
DAY
From
To
Ave. Minutes per Day 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 school personnel. 3. * Daily Program Column is for teaching personnel only Submitted by:
(Signature of School Head over Printed Name) School Form 7, Page 2 of ________
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 SY SY *Programang Pantawid ng 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):
Municipality/Province
SY_____
SY_____
SY_____
SY_____
*Order of ailments (eyes, ears, etc.)
b.3 Immunization
Learner's immunization shots are complete and current: yes /no SY b.4 Physical Fitness and Sports Talent Test (PFSTT) 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
SY SY_____
SY_____
SY_____
SY_____
*to be commented by PE Teachers
Type of community ( ) Residential ( ) Commercial ( )Agricultural ( ) Industrial ( ) Fishing 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)
( ) Mining
GUIDELINE: The Learner Data Sheet shall be accomplish by the parent/pupil during enrolment. While, the medical/health record shall be accomplish by the
Region:
Division:
District

305293

School Year
2013-2014
TRANSFERRED OUT
NAME OF ADVISER
GRADE/ YEAR LEVEL
SECTION
Average
F T
Percentage M F
(A+B) Cumulative (A) Cumulative as as of End of the (B) For the Month of Previous Month Month M F T M F T 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 # Need home visitation as per DECS Service Manual (page, section) 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 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.
Prepared and Submitte
endance
2013-2014
TRANSFERRED OUT
Month Reporting
JULY
TRANSFERRED IN
(A+B) Cumulative (A+B) (A) Cumulative as (B) For the Month as of End of the (B) For the Month Cumulative as of of Previous Month Month End of the Month F T M F T M F T M F T M F T
Prepared and Submitted by:
Region:
Di
School Form 4 (SF4) Mon

Region NCR
(This replace Form 3
305293

REGISTERED LEARNER (As of End of the Month) M F T M ATTENDANCE
NAME OF ADVISER
GRADE/ YEAR LEVEL
SECTION
Average
F T
Percentage 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
# Need home visitation as per DECS Service Manual (page, section) GUIDELINES: 1. This forms shall be accomplished every end of the month using the summary box of Form 1 submitted by the teacher 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 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/Y accomplish the summary column per grade/year level.
egion:
Division:
District
orm 4 (SF4) Monthly Learner's Movement and Attendance

(This replace Form 3 & STS Form 4-Absenteeism and Dropout Profile) Division MANILA District II
TED SCHOOL (H.S.)

DROPPED OUT (A) Cumulative as (B) For the Month of Previous Month T M F T M F T
School Year
2013-2014
TRANSFERRED OUT
ATTENDANCE
Percentage F
(A+B) Cumulative (A+B) Cumulative (A) Cumulative as as of End of the (B) For the Month as of End of the of Previous Month Month Month M F T M F T M F T M F
1 submitted by the teachers/advisers to update figures for the month. orted from previous month".
MERCEDIT
(Signature of Scho
"Name of Adviser, Grade/Year Level & Section". Instead, they will only
Month Reporting
JULY
TRANSFERRED IN (A+B) Cumulative (A+B) (A) Cumulative as as of End of the (B) For the Month Cumulative as of of Previous Month Month End of the Month T M F T M F T M F T
Region:
Di
School Form 4 (SF4) Mon

Region NCR
(This replace Form 3
305293

REGISTERED LEARNER (As of End of the Month) M F T M ATTENDANCE
NAME OF ADVISER
GRADE/ YEAR LEVEL
SECTION
Average
F T
Percentage 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
# Need home visitation as per DECS Service Manual (page, section) GUIDELINES: 1. This forms shall be accomplished every end of the month using the summary box of Form 1 submitted by the teacher 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 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/Y accomplish the summary column per grade/year level.
egion:
Division:
District
orm 4 (SF4) Monthly Learner's Movement and Attendance

(This replace Form 3 & STS Form 4-Absenteeism and Dropout Profile) Division MANILA District II
TED SCHOOL (H.S.)

DROPPED OUT (A) Cumulative as (B) For the Month of Previous Month T M F T M F T
School Year
2013-2014
TRANSFERRED OUT
ATTENDANCE
Percentage F
(A+B) Cumulative (A+B) Cumulative (A) Cumulative as as of End of the (B) For the Month as of End of the of Previous Month Month Month M F T M F T M F T M F
1 submitted by the teachers/advisers to update figures for the month. orted from previous month".
MERCEDIT
(Signature of Scho
"Name of Adviser, Grade/Year Level & Section". Instead, they will only
Month Reporting
JULY
TRANSFERRED IN (A+B) Cumulative (A+B) (A) Cumulative as as of End of the (B) For the Month Cumulative as of of Previous Month Month End of the Month T M F T M F T M F T
Region:
Division:
District

305293

School Year
2013-2014
TRANSFERRED OUT
Month Reporting
JULY
TRANSFERRED IN
NAME OF ADVISER
GRADE/ YEAR LEVEL
SECTION
Average
F T
Percentage M F
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) 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 Prepared and Submitted by:
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.
Region:
Division:
District

305293

School Year
2013-2014
TRANSFERRED OUT
Month Reporting
JULY
TRANSFERRED IN
NAME OF ADVISER
GRADE/ YEAR LEVEL
SECTION
Average
F T
Percentage M F
Region:
Division:
District

305293

School Year
2013-2014
TRANSFERRED OUT
Month Reporting
JULY
TRANSFERRED IN
NAME OF ADVISER
GRADE/ YEAR LEVEL
SECTION
Average
F T
Percentage M F
Region:
Division:
District

305293

School Year
2013-2014
TRANSFERRED OUT
Month Reporting
JULY
TRANSFERRED IN
NAME OF ADVISER
GRADE/ YEAR LEVEL
SECTION
Average
F T
Percentage M F

School Register Summary

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School Register Summary

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School Form 1 (SF 1) School Register

School ID School Name

Grade Level GRADE 7 SECTION

IP (Specify Ethnic Group)

Baranga Municipality/ City y

Father (1st name only if family name identical to learner)

Aspili,Raymond De Guzman Baal jr.,Danilo Abarca Bartina,Eunel

Rolly Jessie Gabriel Boysen Deogracias Zollo Marvin

Arnel Peter Tito Ramil

Eliza Ventura Laura Ramos Marissa dela Cruz Rosalin Navelgas

Aug.14,2001 Aug.1,2001 Apr.23,1999 Feb.20,2000 Mar.2,2000 Apr.3,2001 Jan.6,2001 Apr.2,2000 Dec.16,2000

136418060083 136421080897 136420060308 136418060123 136421060168 1.58535E+11

Mendoza,Christian O. Mioza,Angelito M. Molina,Lord Benedict O. Senoc,Jhon Paul P. Tobias,Karl Jhemar S.

Manila Manila Manila Manila

Tagalog Tagalog Tagalog Tagalog

Catholic Catholic Catholic Catholic

Tondo Manila Tondo Manila Caloocan City Tondo Manila

Marites Memoracion Remmabel Jemma Perez Maribel Sallao

School Form 1 (SF 1) School Register

School ID School Name

Grade Level GRADE 7 SECTION

IP (Specify Ethnic Group)

Antenor,Mary Joyce P. Baraquia,Aira Mae T. Carpio,Danielle Anne Marie De Vera,Lyka

136420060164 136421060061 136418060046 136420060219

Manalili,Abigail R. Mamaril,Andrea Justine S. Malonzo,Kyla Marie O.

136420060305 136420060322 136419060275

136419060358 136420060437 136606060231 136419120586 136612060063

Tecson,Desiree Kate H. Tejano,Charlotte Denise D. Teoxon,Jalene Fozz B. Velasquez,Wilma W. Vinluan,Briza F.

Apr.13,2001 Feb.17,2001 Aug.23,2001 Sep.3,2001 Dec.31,1999

1364 Blk.22 Lot 1 Torcillo St. Dagat- Dagatan Manila Manila

Tagalog Tagalog Tagalog Tagalog

Catholic Catholic Catholic Catholic

18 199 120 373

Manila Manila Manila Manila

Maximino Reynato Santo Rivak

Elvira Villareal Gina Cancel Emellyn Mallari Elena Buaya

May.19,2000 Jan.11,2001 Apr.22,2000 June.19,1999 July.3,2000 Aug.4,2001 Jun.17,1999 Feb.18,2001 Nov.26,1999

Catholic Catholic Catholic

197 184 374

Tondo Manila Tondo Manila Sta. Cruz Manila Tondo Manila

Manila Manila Manila

Roberto Danilo Romeo

Minda Cabigan Aileen Ramos Anavina Samson

200 199 37 195 39 374 45 194 43

Manila Manila Manila Manila Manila Manila Manila Manila Manila

Rico Louwi Francisco Archie Emerito Melvin Joel Ferdinand Teodoro

Apri.15,2001 May.29,2001 Feb.18,2001 May.22,2001 April.4,2001 June.19,2000 April.4,2001 April.23,2001

(Signature of Adviser over Printed Name)

(Signature of School Head over

School Form 1 (SF 1) School Register

School ID School Name

Grade Level GRADE 7 SECTION

IP (Specify Ethnic Group)

REMARK/S (Please refer to the legend on last page)

REMARK/S (Please refer to the legend on last page)

(Signature of School Head over Printed Name)

REMARK/S (Please refer to the legend on last page)

School Form 2 (SF2) Daily Attendance Report for learner

School ID Name of School

F.G Calderon Integrated School

*LEARNER'S NAME (Last Name, First Name, Middle Name)

Total for the Month ABSENT TARDY

Combined TOTAL PER DAY