Sei sulla pagina 1di 64

Region

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)

BIRTH PLACE
(Province)
(nos. of years as
per last birthday)

MOTHER TONGUE

AGE as of 1st
Friday of June
LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/ dd/yy)

BIRTH PLACE
(Province)
(nos. of years as
per last birthday)

MOTHER TONGUE

AGE as of 1st
Friday of June
LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/ dd/yy)

BIRTH PLACE
(Province)
(nos. of years as
per last birthday)

MOTHER TONGUE

AGE as of 1st
Friday of June
LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/ dd/yy)

BIRTH PLACE
(Province)
(nos. of years as
per last birthday)

MOTHER TONGUE

AGE as of 1st
Friday of June
LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/ dd/yy)

BIRTH PLACE
(Province)
(nos. of years as
per last birthday)

MOTHER TONGUE

AGE as of 1st
Friday of June
LRN

NAME
(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE
(mm/ dd/yy)

BIRTH PLACE
(Province)
(nos. of years as
per last birthday)

MOTHER TONGUE

AGE as of 1st
Friday of June
NAME
(Last Name, First Name, Middle Name)

LRN

Sex (M/F)

BIRTH DATE
(mm/ dd/yy)

BIRTH PLACE
(Province)

MOTHER TONGUE

(nos. of years as
per last birthday)

List and code of Indicators under REMARK column


Indicator

Code

Required Information

Indicator

Transferred Out

T/O

Name of Public (P) Private (PR) School & Effectivity Date

CCT Recipient

Transferred IN
Dropped
Late Enrollment

T/I
DRP
LE

Name of Public (P) Private (PR) School & Effectivity Date


Reason and Effectivity Date
Reason (Enrollment beyond 1st Friday of June)

Balik-Aral
Learner With Dissability
Accelarated

School Form 1 (SF 1) School Register


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

Division

District
School Year

Grade Level

ADDRESS
IP
(Specify Ethnic Group)

NAME

RELIGION
House # / Street/Sitio/
Purok

Barangay

Municipality/ City

Province

Father (1st name only if family name


identical to learner)

ADDRESS
IP
(Specify Ethnic Group)

NAME

RELIGION
House # / Street/Sitio/
Purok

Barangay

Municipality/ City

Province

Father (1st name only if family name


identical to learner)

ADDRESS
IP
(Specify Ethnic Group)

NAME

RELIGION
House # / Street/Sitio/
Purok

Barangay

Municipality/ City

Province

Father (1st name only if family name


identical to learner)

ADDRESS
IP
(Specify Ethnic Group)

NAME

RELIGION
House # / Street/Sitio/
Purok

Barangay

Municipality/ City

Province

Father (1st name only if family name


identical to learner)

ADDRESS
IP
(Specify Ethnic Group)

NAME

RELIGION
House # / Street/Sitio/
Purok

Barangay

Municipality/ City

Province

Father (1st name only if family name


identical to learner)

ADDRESS
IP
(Specify Ethnic Group)

NAME

RELIGION
House # / Street/Sitio/
Purok

Barangay

Municipality/ City

Province

Father (1st name only if family name


identical to learner)

ADDRESS
IP
(Specify Ethnic Group)

RELIGION
House # / Street/Sitio/
Purok

Code

NAME

Barangay

Municipality/ City

Province

Required Information

Father (1st name only if family name


identical to learner)

BoSY

CCT

CCT Control/reference number & Effectivity Date

MALE

B/A
LWD
ACL

Name of school last attended & Year


Specify
Specify Level & Effectivity Data

FEMALE
TOTAL

Section
NAME OF PARENTS

nly if family name


earner)

GUARDIAN (If not Parent)

REMARK/S
Contact Number (Parent
/Guardian)

Mother (Maiden: 1st Name, Middle & Last


Name)

Name

Relationship

(Please refer to the legend on last


page)

NAME OF PARENTS

nly if family name


earner)

GUARDIAN (If not Parent)

REMARK/S
Contact Number (Parent
/Guardian)

Mother (Maiden: 1st Name, Middle & Last


Name)

Name

Relationship

(Please refer to the legend on last


page)

NAME OF PARENTS

nly if family name


earner)

GUARDIAN (If not Parent)

REMARK/S
Contact Number (Parent
/Guardian)

Mother (Maiden: 1st Name, Middle & Last


Name)

Name

Relationship

(Please refer to the legend on last


page)

NAME OF PARENTS

nly if family name


earner)

GUARDIAN (If not Parent)

REMARK/S
Contact Number (Parent
/Guardian)

Mother (Maiden: 1st Name, Middle & Last


Name)

Name

Relationship

(Please refer to the legend on last


page)

NAME OF PARENTS

nly if family name


earner)

GUARDIAN (If not Parent)

REMARK/S
Contact Number (Parent
/Guardian)

Mother (Maiden: 1st Name, Middle & Last


Name)

Name

Relationship

(Please refer to the legend on last


page)

NAME OF PARENTS

nly if family name


earner)

GUARDIAN (If not Parent)

REMARK/S
Contact Number (Parent
/Guardian)

Mother (Maiden: 1st Name, Middle & Last


Name)

Name

Relationship

(Please refer to the legend on last


page)

NAME OF PARENTS

GUARDIAN (If not Parent)

REMARK/S
Contact Number (Parent
/Guardian)

nly if family name


earner)

EoSY

Mother (Maiden: 1st Name, Middle & Last


Name)

Name

Prepared by:

Certified Correct:

(Signature of Adviser over Printed Name)

BoSY Date:

(Please refer to the legend on last


page)

Relationship

EoSYDate:

(Signature of School Head over Printed Name)

BoSY Date:

EoSYDate:

School Form 2 (SF2) Daily Attendance Report of Learners


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

School ID

School Year

Report for the Month of

Name of School
LEARNER'S NAME
(Last
Name, First Name, Middle Name)
1

Ablas, Glenn

Allerite, Joseph

Alute, Joe

Alute, Ryan

Artiaga, Bryan

Ato, Avito

Balabis, Aira Joy

Buling, Franklin

Bungcaras, Arman
Caong, Daniel Jr.

10
11
12

Casangcapan, Aris
Celeste, Emmenyl

13 Dela Cruz, Aeron


14 Dionisio, John
15 Estabilla, Gregorio
16 Fegi, Jomari

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

LEARNER'S NAME
(Last
Name, First Name, Middle Name)
17 Gazo, Amorsolo Fernando
18 Gazo, Daryl
19 Giban, Cris Angelo
20 Henabio, Vincent
21 Joven, Joseph
22 Laude, Lhex
23 Makiling, Artemio
24 Mendoza, Eduardo
25 Mendoza, Edward
26 Nunez, Arven
27 Ouano, Jemar
28 Pascual, Kyle Jessel
29 Piamonte, Ronnel
30 Romero, John Paul
31 Salasinas, Gerald
32 Salido, Joel
33 Sarvida, Joel
34 Sarvida, Johnny
35 Senial, Crisanto
36 Sibunga, Moises
37 Tomada, Jupeth Ellis
38 Vasquez, Dino John
39 Vasquez, Roland

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

LEARNER'S NAME

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

(Last
Name, First Name, Middle Name)
MALE | TOTAL Per Day
1

Acosta, Sheryl

Alba, Shiela Ellamar

Alfaro, Lorena

Amaro, Judy Ann


Asma, Rosemarie

5
6
7
8
9
10
11
12

Balic, Jereal
Cambaya, Monalisa
Entia, Angelita
Gazo, Rosalinda
Magboo, Sheena Joy
Mendoza, Bernadeth
Tayor, Jelie Dyl

FEMALE | TOTAL Per Day

Combined TOTAL PER DAY


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
Percentage of Enrolment =
a.
Enrolment as of 1st Friday of June
Average Daily Attendance =
Total Daily Attendance
b.
Number of School Days in reporting month
Average daily attendance
c. Percentage of Attendance for the month =
Registered Learner as of End of the month

1. CODES FOR CHECKING ATTENDANCE


blank- Present; (x)- Absent; Tardy (half shaded= Upper for Late
Commer, Lower for Cutting Classes)

x 100

x 100

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

LEARNER'S NAME

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

(Last
Name, First Name, Middle Name)
b. Individual-Related Factors

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.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

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 & clanfeuds)
d.3. Calamities/Disasters
e. Financial-Related
e.1. Child labor, work

School Form 2: Page 2 of ________

f. Others

ners

Section
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.)

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.)

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.)

Month:

Summary for the Month

No. of Days of Classes:

* Enrolment as of (1st Friday of June)


Late Enrollment during the month
cut-off)
Registered Learner as of end of the month
Percentage of Enrolment as of end of the month

(beyond

TOTAL

Total for the Month

ABSENT

REMARK/S (If DROPPED OUT, state reason, please refer to legend


number 2.
If TRANSFERRED IN/OUT, write the name of School.)

TARDY

Average Daily Attendance


Percentage of Attendance for the month
Number of students with 5 consecutive days of absences:
Drop out
Transferred out
Transferred in

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)

School Form 3 (SF3) Books Issued and R


(This replaced Form 1 & Inventory of Text Book)

School ID

School Year

School Name

NO.

LEARNER'S NAME

Grade Level
Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Date

Date

Date

Date

(Last Name, First Name, Middle


Name)
Issued

Returned

Issued

Returned

Issued

Returned

Issued

Returned

NO.

LEARNER'S NAME

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Date

Date

Date

Date

(Last Name, First Name, Middle


Name)
Issued

TOTAL FOR MALE | TOTAL COPIES

Returned

Issued

Returned

Issued

Returned

Issued

Returned

NO.

LEARNER'S NAME

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Date

Date

Date

Date

(Last Name, First Name, Middle


Name)
Issued

Returned

Issued

Returned

Issued

Returned

Issued

Returned

NO.

LEARNER'S NAME

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Date

Date

Date

Date

(Last Name, First Name, Middle


Name)
Issued

Returned

Issued

Returned

Issued

Returned

Issued

Returned

TOTAL FOR FEMALE | TOTAL COPIES


TOTAL LEARNERS | TOTAL COPIES
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.
5. All textbooks being used must be included. Additional copy/ies of this form may use if needed.

In case of losses/unreturned, please provide information with

A. In Column Date Returned, codes are: FM=Force Majeure, TD


B. In Column Remark/Action Taken, codes are: LLTR=Secured Le
prepared letter/report duly noted by School Head for submission t
NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14, 2.2

d Returned

Section
Subject Area & Title

Subject Area & Title

Date
Issued

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

REMARK/ACTION TAKEN
refer to the legend on last page)

Date
Returned

Issued

Returned

(Please

Subject Area & Title

Subject Area & Title

Date
Issued

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

REMARK/ACTION TAKEN
refer to the legend on last page)

Date
Returned

Issued

Returned

(Please

Subject Area & Title

Subject Area & Title

Date
Issued

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

REMARK/ACTION TAKEN
refer to the legend on last page)

Date
Returned

Issued

Returned

(Please

Subject Area & Title

Subject Area & Title

Date
Issued

Subject Area & Title

Date
Returned

Issued

Subject Area & Title

Date
Returned

Issued

REMARK/ACTION TAKEN
refer to the legend on last page)

Date
Returned

on with the following code:

re, TDO: Transferred/Dropout, NEG=Negligence


ured Letter from Learner duly signed by parent/guardian (for code FM), TLTR=Teacher
ssion to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code
14, 2.2012.

Issued

(Please

Returned

Prepared By:

(Signature over printed name)


Date BoSY:____________ Date EoSY: ___________
School Form 3: Page 2 of ________

School Form 4 (SF4) Monthly Learner's Movement an


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

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

Percentage for the


Month
M

(A) Cumulative as of
Previous Month
M

(B) For 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.

nt and Attendance

file)

District

School Year

Report for the Month of


TRANSFERRED OUT

(A+B) Cumulative as of (A) Cumulative as of


End of the Month
Previous Month
M

(B) For the Month


M

TRANSFERRED IN

(A+B) Cumulative as of (A) Cumulative as of


End of the Month
Previous Month
M

(B) For the Month


M

(A+B) Cumulative as
of End of the Month
M

Prepared and Submitted by:

(Signature of School Head over Printed Name)

School Form 5 (SF 5) Report on Promotion & Level of Prof


(This replaced Forms 18-E1, 18-E2, 18A and List of Graduates)

Region

Division

School ID

School Year

School Name

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
Elementary grades level t

Completed as of end of cu

LRN

LEARNER'S NAME

(Last Name, First Name,


Middle Name)

TOTAL MALE

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
Elementary grades level t

Completed as of end of cu

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
Elementary grades level t

Completed as of end of cu

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
Elementary grades level t

Completed as of end of cu

vel of Proficiency

s)

District
Curriculum
Grade Level

Section

ETE SUBJECT/S
lumn is for K to 12 Curriculum and remaining RBEC in High School.
ary grades level that still implementing RBEC need not to fill up this
column)

ed as of end of current SY

as of End of the current SY


SUMMARY TABLE
STATUS

MALE

FEMALE

PROMOTED

*IRREGULAR

RETAINED

LEVEL OF PROFICIENCY

TOTAL

ETE SUBJECT/S
lumn is for K to 12 Curriculum and remaining RBEC in High School.
ary grades level that still implementing RBEC need not to fill up this
column)

ed as of end of current SY

as of End of the current SY


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)

PREPARED BY:

Class Adviser
(Name and Signature)

TOTAL

ETE SUBJECT/S
lumn is for K to 12 Curriculum and remaining RBEC in High School.
ary grades level that still implementing RBEC need not to fill up this
column)

ed as of end of current SY

as of End of the current SY


CERTIFIED CORRECT & SUBMITTED:

School Head
(Name and Signature)

REVIEWED BY:

(Name and Signature)


Division Representative
GUIDELINES:
1. For All Grade/Year Levels
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.
3. On the summary table, reflect the total number of learners
promoted, retained and irregular ( *for grade 7 onwards only) and the
level of proficiency according to the individual general average

ETE SUBJECT/S
lumn is for K to 12 Curriculum and remaining RBEC in High School.
ary grades level that still implementing RBEC need not to fill up this
column)

ed as of end of current SY

as of End of the current SY


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 Form 6 (SF6) Summarized Report on Promotion


and Level of Proficiency
(This replaced Form 20)

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
Nos. of DEVELOPING

(B: 74% and below)


(D: 75%-79%)

Nos. of APPROACHING PROFICIENCY


(AP: 80%-84%)

Nos. of PROFICIENT

Nos. of ADVANCED

(P: 85% -89%)

(A: 90% and above)

TOTAL

Prepared and Submitted by:

Reviewed & Validated by:


SCHOOL HEAD

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

n 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

SCHOOLS DIVISION SUPERINTENDENT

School Form 7 (SF7) S

(This replaced Fo
Form 29-Tea

School ID

Region

School Name
(A) Nationally-Funded Teaching & Teaching Related Items

Title of Plantilla Position


(as
appeared in the appointment document/PSIPOP)

Employee No. (or Tax Name of School Personnel


(Arrange by Position,
Identification Number
-T.I.N.)
Descending)

Number of Incumbent

Sex

Fund Source

(B) Nationally-Funded Non Teaching

Title of Plantilla Position


(as appear
appointment document/PSIPOP)

Position/ Designation

Nature of Appointment/
Employment Status

Employee No. (or Tax Name of School Personnel


(Arrange by Position,
Identification Number
-T.I.N.)
Descending)

Sex

Fund Source

Position/ Designation

Nature of Appointment/
Employment Status

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

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 t
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.

7 (SF7) School Personnel Assignment List and Basic Profile

is replaced Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)

Division
District

Non Teaching Items

(as appeared in the

OP)

(C ) Other Appointments and Funding Sou

Number of
Incumbent

Title of Designation
(Designation as appeared in the
contract/document: Teacher, Clerk, Security
Guard, Driver etc.)

EDUCATIONAL QUALIFICATION

Degree / Post
Graduate

Major/ Specialization

Appointment: (Contractual, Substitute,


Volunteer, others specify)

* Daily Program (time duratio

Minor

Subject Taught (include


Grade & Section), Advisory
Class & Other Ancillary
DAY (M/T/W/TH/F) From (00:00)
Assignment

Ave. Minutes per

Ave. Minutes per

Ave. Minutes per

EDUCATIONAL QUALIFICATION

Degree / Post
Graduate

Major/ Specialization

* Daily Program (time duratio

Minor

Subject Taught (include


Grade & Section), Advisory
Class & Other Ancillary
DAY (M/T/W/TH/F) From (00:00)
Assignment

Ave. Minutes per

Ave. Minutes per

Ave. Minutes per

Ave. Minutes per


Submitted by:

ersonnel during SY, updated Form 19 must submit to the Division Office .

rank down to the lowest. This form shall also serve as inventory list of school personnel.

so reported.

Updated as of: ______________

School Year

and Funding Sources

Fund Source

(SEF, PTA,
NGO's etc.)

Number of Incumbent
Teaching

Non-Teaching

gram (time duration)

To (00:00)

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Remark/s (For Detailed Items,


Total Actual Teaching Indicate name of school/office, For
IP's -Ethnicity)
Minutes Assignment
per Week

gram (time duration)

To (00:00)

Remark/s (For Detailed Items,


Total Actual Teaching Indicate name of school/office, For
IP's -Ethnicity)
Minutes Assignment
per Week

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

(Signature of School Head over Printed Name)


___________________________
School Form 7, Page 2 of ________

School Form 2: Page 2 of ________

d. Geographic/Environmental
d.1. Distance between home and school
d.2. Armed conflict (incl. Tribal wars & clanfeuds)
d.3. Calamities/Disasters
e. Financial-Related
e.1. Child labor, work
f. Others

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)

ool Head over Printed Name)

Potrebbero piacerti anche