Prototype Forms For Implementation As of January 2014

Region VIII
School ID
School Name
LRN
NAME
(Last Name, First Name, Middle Name)
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
LRN
NAME
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
LRN
NAME
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
LRN
NAME
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
LRN
NAME
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
AGE as of 1st
Friday June
NAME
LRN
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
List and Code of Indicators under REMARKS column

Indicator
Code
Required Information
AGE as of 1st
Friday June
NAME
LRN
Sex (M/F)
BIRTH DATE
(mm/dd/ yyyy)
Transferred Out
T/O
Name of Public (P) Private (PR) School & Effectivity Date
Transferred IN
T/I
Name of Public (P) Private (PR) School & Effectivity Date
Dropped
Late Enrollment
DRP
LE
Reason and Effectivity Date

Reason (Enrollment beyond 1st Friday of June)
AGE as of 1st
Friday June
School Form 1 (SF 1) School Register

(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)
Division
Dis
School Year
Grade L
ADDRESS
MOTHER TONGUE
IP
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE
IP
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE
IP
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE
IP
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE
IP
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
Municipality/ City
Province
ADDRESS
MOTHER TONGUE
IP
(Ethnic Group)
Code
RELIGION
House #/ Street/
Sitio/
Purok
Required Information
Barangay
Municipality/ City
Province
REGISTERED
ADDRESS
MOTHER TONGUE
IP
(Ethnic Group)
RELIGION
House #/ Street/
Sitio/
Purok
Barangay
CCT
CCT Control/reference number & Effectivity Date
B/A
Name of school last attended & Year
LWD
ACL
Specify
Specify Level & Effectivity Data
Municipality/ City
Province
MALE
FEMALE
TOTAL
District
Section
Grade Level
PARENTS
Father's Name (Last Name, First
Name, Middle Name)
Mother's Maiden Name (Last Name,

First Name, Middle Name)
GUARDIAN
(If
not Parent)
Name
Relation-ship
Contact Number of
Parent or Guardian
PARENTS
Name, Middle Name)

GUARDIAN
(If
not Parent)
Name
Relation-ship
Contact Number of
Parent or Guardian
PARENTS
Name, Middle Name)

GUARDIAN
(If
not Parent)
Name
Relation-ship
Contact Number of
Parent or Guardian
PARENTS
Name, Middle Name)

GUARDIAN
(If
not Parent)
Name
Relation-ship
Contact Number of
Parent or Guardian
PARENTS
Name, Middle Name)

GUARDIAN
(If
not Parent)
Name
Relation-ship
Contact Number of
Parent or Guardian
PARENTS
Name, Middle Name)
BoSY
EoSY

Prepared by:
GUARDIAN
(If
not Parent)
Name
Relation-ship
Contact Number of
Parent or Guardian
Certified Correct:
GUARDIAN
PARENTS
Name, Middle Name)
(If
not Parent)

Name
(Signature of Adviser over Printed Name)
BoSY Date:
EoSYDate:
Relation-ship
Contact Number of
Parent or Guardian
(Signature of School Head over Printed Nam
BoSY Date:
EoSYDate:
REMARKS
(Please refer to the legend
on last page)
REMARKS
on last page)
REMARKS
on last page)
REMARKS
on last page)
REMARKS
on last page)
ect:
REMARKS
on last page)
REMARKS
on last page)
School Head over Printed Name)
EoSYDate:
School Form 2 (SF2) Daily Atten
(This replaces Form 1, Form 2 & STS Form 4
School ID
School Year
Name of School
(1st row for date)
LEARNER'S NAME
M
TH
TH
TH
(1st row for date)
LEARNER'S NAME
M
MALE | TOTAL Per Day
TH
TH
TH
(1st row for date)
LEARNER'S NAME
M
TH
TH
TH
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 columns after Learner's Name.
3. To compute the following:
Registered Learners as of end of the month
a. Percentage of Enrolment =
Enrolment as of 1st Friday of the school year
Total Daily Attendance
b. Average Daily Attendance =
Number of School Days in reporting month
Average daily attendance
c. Percentage of Attendance for the month =
1. CODES F
(blank) - Pre
x 100
x 100
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 School Form 4. Once signed by the
principal, this form should be returned to the adviser.
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days and/or those at risk of
dropping out.
2. REASON
a. Domestic
a.1. Had to t
a.2. Early m
a.3. Parents
a.4. Family p
b. Individua
b.1. Illness
b.2. Overage
b.3. Death
b.4. Drug Ab
(1st row for date)
LEARNER'S NAME
M
TH
TH
5. The adviser will provide neccessary interventions including but not limited to home visitation to learner/s who were absent for 5 consecutive days and/or those at risk of
dropping out.
6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period.
* Beginning of School Year cut-off report is every 1st Friday of the School Year
School Form 2 : Page ___ of ________
TH
b.5. Poor ac
b.6. Lack of
b.7. Hunger/
c. School-R
c.1. Teacher
c.2. Physica
c.3. Peer inf
d. Geograph
d.1. Distance
d.2. Armed c
d.3. Calamit
e. Financial
e.1. Child lab
f. Others (S
Attendance Report of Learners
Form 4 - Absenteeism and Dropout Profile)
Report for the Month of

Grade Level
Section
Total for the Month
)
F
TH
TH
ABSENT
TARDY
REMARKS (If DROPPED OUT, state reason, please refer to legend

number 2.
If TRANSFERRED IN/OUT, write the name of School.)
Total for the Month
)
F
TH
TH
ABSENT
TARDY

number 2.
Total for the Month
)
F
TH
ODES FOR CHECKING ATTENDANCE
nk) - Present; (x)- Absent; Tardy (half shaded= Upper for Late Commer, Lower
for Cutting Classes)
EASONS/CAUSES FOR DROPPING OUT

omestic-Related Factors
Had to take care of siblings
Early marriage/pregnancy
Parents' attitude toward schooling
Family problems
dividual-Related Factors
Illness
Overage
Death
Drug Abuse
TH
Month:
ABSENT
TARDY

number 2.
No. of Days of Classes:
* Enrolment as of (1st Friday of June)

Late Enrollment during the month
(beyond cut-off)
Percentage of Enrolment as of end of the month
Average Daily Attendance
Percentage of Attendance for the month
Summary
M
TOTAL
Total for the Month
)
F
TH
Poor academic performance

Lack of interest/Distractions
Hunger/Malnutrition
chool-Related Factors
Teacher Factor
Physical condition of classroom
Peer influence
eographic/Environmental
Distance between home and school
Armed conflict (incl. Tribal wars & clanfeuds)
Calamities/Disasters
nancial-Related
Child labor, work
hers (Specify)
TH
ABSENT
TARDY

number 2.
Number of students absent for 5 consecutive days:

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)
School Form 3 (SF3) Books Issued
(This replaces Form 1 & Inventory of Textb
School ID
School Year
School Name
NO.
Grade Level
Subject Area & Title
Date
Date
Date
Date
LEARNER'S NAME
Issued
Returned
Issued
Returned
Issued
Returned
Issued
NO.
Date
Date
Date
Date
LEARNER'S NAME
Issued
TOTAL FOR MALE | TOTAL COPIES
Returned
Issued
Returned
Issued
Returned
Issued
NO.
Date
Date
Date
Date
LEARNER'S NAME
Issued
Returned
Issued
Returned
Issued
Returned
Issued
NO.
Date
Date
Date
Date
LEARNER'S NAME
Issued
Returned
Issued
Returned
Issued
Returned
Issued
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 copies of this form may be used if needed.
In case of lost/unreturned books, please provide informatio
A. In Column Date Returned, codes are: FM=Force Majeure, T

B. In Column Remark/Action Taken, codes are: LLTR=Secured
prepared letter/report duly noted by School Head for submissio
NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14, 2
oks Issued and Returned
& Inventory of Textbooks)
Section
ct Area & Title
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
REMARKS/ACTION TAKEN
(Please refer to the legend on last page)
Date
Returned
Issued
Returned
ct Area & Title
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
Returned
ct Area & Title
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
Returned
ct Area & Title
Date
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
Issued
Date
Returned
e provide information with the following code:
M=Force Majeure, TDO: Transferred/Dropout, NEG=Negligence

are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code FM), TLTR=Teacher
l Head for submission to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code
25, s.2003, DO#14, 2.2012.
Issued
Returned
Prepared By:
(Signature over printed name)

Date BoSY:____________ Date EoSY: ___________
School Form 4 (SF4) Monthly Learner's M
(This replaces Form 3 & STS Form 4-Absenteeism
School ID
Region
Division
School Name
GRADE/
YEAR LEVEL
SECTION
NAME OF ADVISER
REGISTERED
LEARNERS
(As of End of the
Month)
M
ATTENDANCE
Daily Average
M
DROPPED OU
Percentage for the

Month
M
(A) Cumulative as of
Previous Month
M
(B) For the Mon

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 form 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 the Division Office with a copy a week after June 30, October 30 & March 31
Page _____ of _____ pages
rner's Movement and Attendance
-Absenteeism and Dropout Profile)
District
School Year
Report for the Month of
DROPPED OUT
B) For the Month

F
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:
School Form 5 (SF 5) Report on Promotion & Lev
(This replaces Forms 18-E1, 18-E2, 18A and List of Graduates
Region
Division
School ID
School Year
School Name
LRN
LEARNER'S NAME
(Last Name,
GENERAL AVERAGE
(Numerical Value in 2
decimal places and 3
decimal places for honor
learners, and Descriptive
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT
column is for K to 12 Curricu
level that are still im
From previous school years

of end of current Sch
LRN
LEARNER'S NAME
(Last Name,
TOTAL MALE
GENERAL AVERAGE
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT

LRN
LEARNER'S NAME
(Last Name,
GENERAL AVERAGE
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT

LRN
LEARNER'S NAME
(Last Name,
TOTAL FEMALE
COMBINED
GENERAL AVERAGE
Letter)
ACTION TAKEN:
PROMOTED,
IRREGULAR or
RETAINED
INCOMPLETE SUBJECT

ion & Level of Proficiency
List of Graduates)
District
Curriculum
Grade Level
Section
LETE SUBJECT/S
(This
r K to 12 Curriculum and remaining RBEC in High School. Elementary grades
el that are still implementing RBEC need not to fill up these columns)
ous school years completed as

nd of current School Year
As of end of current School Year

SUMMARY TABLE
STATUS
MALE
FEMALE
PROMOTED
IRREGULAR
RETAINED
LEVEL OF PROFICIENCY
TOTAL
LETE SUBJECT/S
(This


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
LETE SUBJECT/S
(This


CERTIFIED CORRECT & SUBMITTED:
School Head
REVIEWED BY:

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 teachers. The class adviser should
compute for the 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.
LETE SUBJECT/S
(This

4. Must tally with the total enrollment report as of End of School Year
GESP /GSSP (EBEIS)
5. Protocols of validation & submission is under the discretion of the
Schools Division Superintendent
School Form 5: Page ____ of ________
School Form 6 (SF6)
Summarized Report on Promotion and Level of Prof

(This replaces 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
BEGINNNING
74% and below)
DEVELOPING
75%-79%)
(B:
(D:
APPROACHING PROFICIENCY
(AP: 80%-84%)
PROFICIENT
(P: 85%
-89%)
ADVANCED
90% and above)
(A:
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 grade level total and school total.
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 is under the discretion of the Schools Division Superintendent.
f Proficiency
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) School Personnel Assignment List and

(This replaces Form 12-Monthly Status Report for Teachers, Form 19-Assignment List,
Form 29-Teacher Program and Form 31-Summary Information of Teachers)
School ID
Region
Division
School Name
District
(A) Nationally-Funded Teaching & Teaching Related Items
(B) Nationally-Funded Non Teaching Items

Title of Designation
Title of Plantilla Position

(as it
Number of Incumbent
appears in the appointment document/PSIPOP)
Title of Plantilla Position

(as it
appears in the appointment document/PSIPOP)
Number of
Incumbent
(as it ap
contract/document: Teach
Guard, Driver etc.)
EDUCATIONAL QUALIFICATION
Employee No. Name of School Personnel
(or Tax
(Arrange by Position, Descending)
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Major/ Specialization
Minor
(or Tax
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Minor
(or Tax
Identification
Number -T.I.N.)
Sex
Fund Source
Position/
Designation
Nature of
Appointment/
Employment Status
Degree / Post
Graduate
Minor
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 the school year, an updated SF 7 must be submitte
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.
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.
t List and Basic Profile
Assignment List,
Teachers)
School Year
(C ) Other Appointments and Funding Sources
esignation
(as it appears in the

ct/document: Teacher, Clerk, Security
uard, Driver etc.)
Appointment:
(Contractual, Substitute, Fund Source
Volunteer, others
(SEF, PTA, NGO's etc.)
specify)
Number of Incumbent
Teaching
NonTeaching
Daily Program (time duration)

Subject Taught (include
Grade & Section), Advisory
Class & Other Ancillary
Assignments
DAY
(M/T/W/TH/
F)
From
(00:00)
Remarks (For Detailed

Items, Indicate name of
Total Actual
school/office, For IP's
To (00:00) Teaching Minutes
-Ethnicity)
per Week
Ave. Minutes per Day

Assignments
DAY
(M/T/W/TH/
F)
From
(00:00)

Total Actual
-Ethnicity)
per Week

Assignments
DAY
(M/T/W/TH/
F)
From
(00:00)

Total Actual
-Ethnicity)
per Week

Submitted by:
F 7 must be submitted to the Division

Updated as of: ___________________________
School Form 7, Page ___ of ________
1. For the current SY, only the SF 5 Report on Promotion and SF 6 Summarized Report on Promotion w
2. IRREGULAR Status/Action Taken is apply only to Grade 7 onwards.
3. Descriptive Value for Level of Proficiency is only for grade levels implementing K to 12 program. Oth
4. Report on Dropped out and Transferred is not to be included in SF 5 and SF 6. (SF 4 may be used or
5. In the future, the format of the modified forms may be adjusted to align with the most recent polic
d Report on Promotion will be used to all grade/year levels both elementary and secondary, RBEC and K to 12
ting K to 12 program. Other grade/year level will keep that column blank.
6. (SF 4 may be used or the current form 3)
ith the most recent policy of K to 12 program.
dary, RBEC and K to 12

Prototype Forms For Implementation As of January 2014

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Region VIII

List and Code of Indicators under REMARKS column

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

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

Reason and Effectivity Date

School Form 1 (SF 1) School Register

CCT Control/reference number & Effectivity Date

Name of school last attended & Year

Mother's Maiden Name (Last Name,

Mother's Maiden Name (Last Name,

Mother's Maiden Name (Last Name,

Mother's Maiden Name (Last Name,

Mother's Maiden Name (Last Name,

Mother's Maiden Name (Last Name,

Mother's Maiden Name (Last Name,

(Signature of Adviser over Printed Name)

(Signature of School Head over Printed Nam

School Head over Printed Name)

School Form 2 (SF2) Daily Atten

(This replaces Form 1, Form 2 & STS Form 4

(1st row for date)

MALE | TOTAL Per Day

(1st row for date)

FEMALE | TOTAL Per Day

Combined TOTAL PER DAY

(1st row for date)

School Form 2 : Page ___ of ________

Attendance Report of Learners

Form 4 - Absenteeism and Dropout Profile)

Report for the Month of

REMARKS (If DROPPED OUT, state reason, please refer to legend

Total for the Month

REMARKS (If DROPPED OUT, state reason, please refer to legend

Total for the Month

ODES FOR CHECKING ATTENDANCE

EASONS/CAUSES FOR DROPPING OUT

REMARKS (If DROPPED OUT, state reason, please refer to legend

No. of Days of Classes:

* Enrolment as of (1st Friday of June)

Total for the Month

Poor academic performance

REMARKS (If DROPPED OUT, state reason, please refer to legend

Number of students absent for 5 consecutive days:

(Signature of Teacher over Printed Name)

School Form 3 (SF3) Books Issued

(This replaces Form 1 & Inventory of Textb

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

TOTAL FOR MALE | TOTAL COPIES

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

Subject Area & Title

TOTAL FOR FEMALE | TOTAL COPIES

School Form 2 : Page _ of ______