Senior High School Forms

SFRT 2017 SFRT 2017

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 Sch

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Scchhooool l NNaamme e SScchhooool l IIDD DDiissttrriicctt S

Seemmeesstteerr SScchhoooollYYeeaarr GrraaddeG eLLeevveell

S

Seeccttiioonn CCoouurrsse e ((FFoor r TTVVL L OOnnllyy))

1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 10 10 11 11 12 12 13 13 14 14 15 15 16 16 17 17 18 18 19 19 20 20 21 21 22 22 23 23 24 24 25 25 26 26 27 27 28 28 29 29 30 30 31 31 32 32 33 33 34 34 35 35 36 36 37 37 38 38 39 39 40 40 <=== TOTAL MALE <=== TOTAL MALE 1 1 2 2

"tension' #iddle Name)

"tension' #iddle Name) (mmddyyyy)(mmddyyyy)

CO#$L"T" !DD" CO#$L"T" !DD" N!#"

N!#"

(Last Name' First Name' Name (Last Name' First Name' Name   (      (    # # 

             _F  F     )       )    

%IT*D!T

%IT*D!T _{eli&iouseli&ious} !++iliation

!++iliation *ouse No,*ouse No, treet itio treet itio $uro-#unici.ality #unici.ality City City

r Senior High School (SF1-SHS)

r Senior High School (SF1-SHS)

SFRT 2017 SFRT 2017

r Senior High School (SF1-SHS)

r Senior High School (SF1-SHS)

D

Diivviissiioonn ee&&iioonn

Trac- and Strand Trac- and Strand

($lease re+er to the le&end) ($lease re+er to the le&end) (i+ learner is not

(i+ learner is not Livin& 1ith $arent)Livin& 1ith $arent)

"tension' #iddle Name)

"tension' #iddle Name) _{Name "tension' #iddleName "tension' #iddle}

Name) Name) $!"NT $!"NT _{"#!/"#!/} elationshi. elationshi. G0!DI!N G0!DI!N Contact Contact Num2er o+ Num2er o+ $arent $arent Guardian Guardian Father3s Name Father3s Name

(Last Name' First Name' Name

(Last Name' First Name' Name (Last Name' First Name'(Last Name' First Name' (Last Name' First Name'(Last Name' First Name'_{Name "tension' #iddleName "tension' #iddle}

#other3s #aiden #other3s #aiden

Name

Name NameName

"tension' #iddle Name)

"tension' #iddle Name) (mmddyyyy)(mmddyyyy)

CO#$L"T" !DD" CO#$L"T" !DD" N!#"

N!#"

(Last Name' First Name' Name (Last Name' First Name' Name   (      (    # # 

             _F  F  

%IT*D!T

%IT*D!T _{eli&iouseli&ious} !++iliation

SFRT 2017 SFRT 2017

r Senior High School (SF1-SHS)

r Senior High School (SF1-SHS)

D

Diivviissiioonn ee&&iioonn

Trac- and Strand Trac- and Strand

($lease re+er to the le&end) ($lease re+er to the le&end) (i+ learner is not

(i+ learner is not Livin& 1ith $arent)Livin& 1ith $arent)

"tension' #iddle Name)

"tension' #iddle Name) _{Name "tension' #iddleName "tension' #iddle}

Name) Name) $!"NT $!"NT _{"#!/"#!/} elationshi. elationshi. G0!DI!N G0!DI!N Contact Contact Num2er o+ Num2er o+ $arent $arent Guardian Guardian Father3s Name Father3s Name

(Last Name' First Name' Name

(Last Name' First Name' Name (Last Name' First Name'(Last Name' First Name' (Last Name' First Name'(Last Name' First Name'_{Name "tension' #iddleName "tension' #iddle}

#other3s #aiden #other3s #aiden

Name

Name NameName

"tension' #iddle Name)

"tension' #iddle Name) (mmddyyyy)(mmddyyyy)

CO#$L"T" !DD" CO#$L"T" !DD" N!#"

N!#"

(Last Name' First Name' Name (Last Name' First Name' Name   (      (    # # 

             _F  F  

%IT*D!T

%IT*D!T _{eli&iouseli&ious} !++iliation

SFRT 2017 SFRT 2017 "tension' #iddle Name)

"tension' #iddle Name) (mmddyyyy)(mmddyyyy)

3 3 4 4 5 5 6 6 7 7 8 8 9 9 10 10 11 11 12 12 13 13 14 14 15 15 16 16 17 17 18 18 19 19 20 20 21 21 22 22 23 23 24 24 25 25 26 26 27 27 28 28 29 29 30 30 31 31 32 32 33 33 34 34 35 35 36 36 37 37 3 3 3! 3! "# "#  !ttendance i+ T

 !ttendance i+ Trans+erred Outrans+erred Out

CO#$L"T" !DD" CO#$L"T" !DD" N!#"

N!#"

(Last Name' First Name' Name (Last Name' First Name' Name   (      (    # # 

             _F  F     )       )    

%IT*D!T

%IT*D!T _{eli&iouseli&ious} !++iliation

!++iliation *ouse No,*ouse No, treet itio treet itio $uro-#unici.ality #unici.ality City City 4555 TOT!L F"#!L" 4555 TOT!L F"#!L" 4555 CO#%IN"D 4555 CO#%IN"D Le&end6 List

Le&end6 List and and Code Code o+ Indicators o+ Indicators under "#under "#!/ !/ columncolumn d d d d I TI T #!L" #!L" F"#!L" F"#!L" %e&innin& o+ the %e&innin& o+ the emester emester Trans+erred Trans+erred Out Out Trans+erred Trans+erred In In T T T T

Name o+ School' Date o+ 8st Name o+ School' Date o+ 8st  !ttendance and Date o+ La  !ttendance and Date o+ Lastst

CCT

CCT Controlre+erenControlre+erencece num2er : "++ectivity Date num2er : "++ectivity Date Name o+ school last Name o+ school last attended : Year  attended : Year 

S.eci+y "ce.tionality o+ the S.eci+y "ce.tionality o+ the Learner 

Learner  S.eci+y Level :

S.eci+y Level : "++ectivity"++ectivity

CCT eci.ient CCT eci.ient %ali- !ral %ali- !ral Learner 9ith Learner 9ith "ce.tionality "ce.tionality !ccelerated !ccelerated CCT CCT % % L9" L9" !CL !CL

($lease re+er to the le&end) ($lease re+er to the le&end) (i+ learner is not

(i+ learner is not Livin& 1ith $arent)Livin& 1ith $arent) $!"NT

$!"NT G0!DI!NG0!DI!N _{ContactContact "#!/"#!/}

Num2er o+ Num2er o+ $arent $arent Father3s Name Father3s Name

(Last Name' First Name' Name

(Last Name' First Name' Name (Last Name' First Name'(Last Name' First Name' (Last Name' First Name'(Last Name' First Name'

#other3s #aiden #other3s #aiden

Name

SFRT 2017 SFRT 2017 ($lease re+er to the le&end)

($lease re+er to the le&end) (i+ learner is not

(i+ learner is not Livin& 1ith $arent)Livin& 1ith $arent)

"tension' #iddle Name)

"tension' #iddle Name) _{Name "tension' #iddleName "tension' #iddle}

Name) Name)

$re.ared %y6 $re.ared %y6

Si&nature o+ !dviser over $rinted Name Si&nature o+ !dviser over $rinted Name $!"NT $!"NT _{"#!/"#!/} elationshi. elationshi. G0!DI!N G0!DI!N Contact Contact Num2er o+ Num2er o+ $arent $arent Guardian Guardian Father3s Name Father3s Name

(Last Name' First Name' Name

(Last Name' First Name' Name (Last Name' First Name'(Last Name' First Name' (Last Name' First Name'(Last Name' First Name'

Name "tension' #iddle Name "tension' #iddle

#other3s #aiden #other3s #aiden

Name

Name NameName

"nd

SFRT 2017

"tension' #iddle Name) (mmddyyyy)

CO#$L"T" !DD" N!#"

(Last Name' First Name' Name   (    # 

      _F  

%IT*D!T _eli&ious

!++iliation *ouse No, _{#unici.ality}

Trans+erred Out Trans+erred In T T CCT eci.ient %ali- !ral CCT %

SFRT 2017 "tension' #iddle Name) (mmddyyyy)

CO#$L"T" !DD" N!#"

(Last Name' First Name' Name   (    # 

      _F     )    

%IT*D!T _eli&ious

!++iliation *ouse No, treet itio $uro-#unici.ality City TOT!L Trans+erred Out Trans+erred In T T CCT eci.ient %ali- !ral Learner 9ith "ce.tionality !ccelerated CCT % L9" !CL

($lease re+er to the le&end) (i+ learner is not Livin& 1ith $arent)

$!"NT G0!DI!N _{Contact "#!/}

Num2er o+ $arent Father3s Name

(Last Name' First Name' Name (Last Name' First Name' (Last Name' First Name'

#other3s #aiden

SFRT 2017 ($lease re+er to the le&end)

(i+ learner is not Livin& 1ith $arent)

"tension' #iddle Name) _{Name "tension' #iddle}

Name) $!"NT _"#!/ elationshi. G0!DI!N Contact Num2er o+ $arent Guardian Father3s Name

(Last Name' First Name' Name (Last Name' First Name' (Last Name' First Name'

Name "tension' #iddle

#other3s #aiden

Name Name

& + e r d + e r

 School Form $ %&il' Atten&nce Reort of Le&rners for Se

 School Form $ %&il' Atten&nce Reort of Le&rners for Se

School Name School ID District

Semester  School Year Grade Level

Section Courses (only +or TVL)

D!T" # T 9 T* F S # T 9 T* F S # T 9 T* F S # T 9 T* F S # T 8 ; < = > ? @ A B 8 88 8; 8< 8= 8> 8? 8@

4555 #!L"  TOT!L $er Day 555E 8 ; < = > ? @ A B 8 88 8; 8<

(Last Name' First Name' Name "tension' #iddle Name)

No, N!#"

ior High School (SF$-SHS)

ior High School (SF$-SHS)

Division e&ion Trac- and Strand

#onth o+ 

9 T* F S

8, I+ No Lon&er in School (NLS)' state reason' .lease re+er to le&end num2er, ;, I+ T!NSF""D INO0T' 1rite the name o+ School, <, I+ S*IFTING INO0T' 1rite the name o+

Trac-Strand$ro&ram),

Total +or the #onth "#!/

D!T"

# T 9 T* F S # T 9 T* F S # T 9 T* F S # T 9 T* F S # T

(Last Name' First Name' Name " tension' #iddle Name)

D!T"

# T 9 T* F S # T 9 T* F S # T 9 T* F S # T 9 T* F S # T

(Last Name' First Name' Name " tension' #iddle Name) 8= 8> 8? 8@ 8A 8B ; ;8 ;; ;< ;= ;> ;? ;@

4555 F"#!L"  TOT!L $er Day 555E Com2ined TOT!L $er Day

a, $ercenta&e o+ "nrolment 5 _{e&istered Learners as o+ end o+ the month}  8 "nrolment as o+ 8st Friday o+ the school year 

2, !vera&e Daily !ttendance 5 Total Daily !ttendance

Num2er o+ School Days in re.ortin& month

c, $ercenta&e o+ !ttendance +or the month 5  !vera&e daily attendance  8 e&istered Learners as o+ end o+ the month

e,8, Child la2or'

1or-No, N!#" " , "  G a, Domesticelated Factors 2, Individualelated Factors c, choolelated Factors d, Geo&ra.hic"nvironmental e, Financialelated 8, The attendance shall 2e accom.lished daily, e+er to the codes +or chec-in& learners3 attendance

;, To com.ute the +ollo1in&6

(2lan-)  $resent ()  !2sent Tardy (hal+ sha +or Late Comer' Lo1er +or Cuttin& Clas

a,8, *ad to ta-e care o+ si2lin&s a,;, "arly marria&e.re&nancy a,<, $arents3 attitude to1ard schoolin& a,=, Family .ro2lems

<, "very end o+ the month' the Class !dviser 1ill su2mit this +orm to the O++ice o+ the $rinci.al +or recordin& o+ summary ta2le into School Form =, Once si&ned 2y the School *ead' this +orm should 2e returned to the Class !dviser,

=, The Class !dviser 1ill .rovide neccessary interventions includin& 2ut not limited to home visitation to learners 1ho 1ere a2sent +or > consecutive days andor those at ris- o+ dro..in& out,

>, !ttendance .er+ormance o+ learners 1ill 2e re+lected in the SFBS*S o+ every &radin& .eriod,

2,8, Illness 2,;, Overa&e 2,=, Dru& !2use

2,>, $oor !cademic $er+ormance 2,?, Lac- o+ InterestDistractions 2,@, *un&er#alnutrition

c,8, Teacher Factor 

c,;, $hysical Condition o+ Classroom c,<, $eer In+luence

d,8, Distance 2et1een home and school d,;, !rmed con+lict (incl, tri2al 1ars : clan +eud d,<, CalamitiesDisasters

;, "! ON C!0 " FO NO LONG" C*OOL (NL

9 T* F S

8, I+ No Lon&er in School (NLS)' state reason' .lease re+er to le&end num2er, ;, I+ T!NSF""D INO0T' 1rite the name o+ School, <, I+ S*IFTING INO0T' 1rite the name o+

Trac-Strand$ro&ram),

Total +or the #onth %

9 T* F S

8, I+ No Lon&er in School (NLS)' state reason' .lease re+er to le&end num2er, ;, I+ T!NSF""D INO0T' 1rite the name o+ School, <, I+ S*IFTING INO0T' 1rite the name o+

Trac-Strand$ro&ram),

H "nrolment (as o+ 8st Friday o+ the semester) 

Late "nrolment durin& the month (2eyond cuto++)  e&istered Learners as o+ end o+ the month  $ercenta&e o+ "nrolment as o+ end o+ the month   !vera&e Daily !ttendance 

$ercenta&e o+ !ttendance +or the month  Num2er o+ students a2sent +or > consecutive days 

I certi+y that this re.ort is true and correct6

Si&nature o+ Class !dviser over $rinted Name

 !ttested %y6

s)

Total +or the #onth %

"#!/

No, o+ Days o+ Classes6   _ummary

No Lon&er in chool (NL Trans+erred Out Trans+erred In hi+tin& Out hi+tin& In ed 5 0..er ses) ONG" IN D!T" # T 9 T* F S # T 9 T* F S # T 9 T* F S # T 9 T* F S # T

(Last Name' First Name' Name "tension' #iddle Name)

D!T"

# T 9 T* F S # T 9 T* F S # T 9 T* F S # T 9 T* F S # T

(Last Name' First Name' Name "tension' #iddle Name)

a, Death

2, Trans+erred to School !2road c, Trans+erred to International School d, Trans+erred to !LS

No, N!#"

+, Others ( .eci+y)

9 T* F S

8, I+ No Lon&er in School (NLS)' state reason' .lease re+er to le&end num2er, ;, I+ T!NSF""D INO0T' 1rite the name o+ School, <, I+ S*IFTING INO0T' 1rite the name o+

Trac-Strand$ro&ram),

Si&nature o+ School *ead over $rinted Name Total +or the #onth

%

9 T* F S

8, I+ No Lon&er in School (NLS)' state reason' .lease re+er to le&end num2er, ;, I+ T!NSF""D INO0T' 1rite the name o+ School, <, I+ S*IFTING INO0T' 1rite the name o+

Trac-Strand$ro&ram),

Si&nature o+ School *ead over $rinted Name Total +or the #onth

%

"#!/

SchoolName SchoolID District Divisi

SchoolName SchoolID District Divisi

Semester SchoolYear GradeLevel _{Trac- and Stra}

Section Courses (only +or TVL)

%oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #

Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (m

Issued eturned Issued eturned Issued eturned Issued eturned Issued eturned Issued eturned Issued eturned Issued eturned Issued

8 ; < = > ? @ A B 8 88 8; 8< 8= 8> 8? 8@ 8A 8B ; ;8 ;; ;< ;= ;> ;? ;@ ;A ;B < <8 <; << <= <> <? <@ <A <B = TOT!L #!L" 555E 8 ; < = > ? @ A B 8

(Last Name' First Name' Name "tension' #iddle Name)

chool Form < %oo-s Issued and eturned +or enior *i&h chool ( F<

No N!#"

on _e&ion

on _e&ion nd

duleTit le %oo-  #oduleTitle

ddyy) Date (mmddyy)

eturned Issued eturned

($lease re+er to the codes 2elo1)

F< * )

"#!/ !CTION T!/"N

%oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #

Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (m

I d  t d I d  t d I d  t d I d  t d I d  t d I d  t d I d  t d I d  t d I d

(Last Name' First Name' Name "tension' #iddle Name)

%oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #oduleTitle %oo-  #

Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (mmddyy) Date (m

Issued eturned Issued eturned Issued eturned Issued eturned Issued eturned Issued eturned Issued eturned Issued eturned Issued

(Last Name' First Name' Name "tension' #iddle Name) 88 8; 8< 8= 8> 8? 8@ 8A 8B ; ;8 ;; ;< ;= ;> ;? ;@ ;A ;B < <8 <; << <= <> <? <@ <A TOT!L F"#!L" 555E CO#%IN"D 555E $re.ared %y6  Si&nat

8, Title o+ %oo-s Issued to each learner must 2e recorded 2y the Class !dviser, ;, The Date o+ Issuance and the Date o+ eturn shall 2e re+lected in the +orm, <, The Total Num2er o+ Co.ies issued shall 2e re+lected in the +orm, =, The Total Num2er o+ Co.ies o+ %oo-s eturned shall 2e re+lected in the +orm,

>, !ll tet2oo-s 2ein& used must 2e included, !dditional co.ies o+ this +orm may 2e used i+ needed,

 !, In Column Date eturned' codes are6 F#5Force #aeure' TDO6 Trans+erredDro.out' N"G5Ne&li&ence

%, In Column emar-!ction Ta-en' codes are6 LLT5Secured Letter +rom Learner duly si&ned 2y .arent&uardian (+or code F#)' TLT5Teacher .re.ared letterre.ort duly noted 2y School *ead +or su2mission to School $ro.erty Custodian (+or code TDO)' $TL5$aid 2y the Learner (+or code N"G), e+erences6 DO No,;<' s,;8' DO No,;>' s,;<' DO No,8=' s,;8;,

No, N!#"

G0ID"LIN" 6 In case o+ lostunreturned 2oo-s' .lease .rovide in+ormation 1ith the +ollo1in& code6

oduleTitle %oo-  #oduleTitle

mddyy) Date (mmddyy)

 t d I d  t d

($lease re+er to the codes 2elo1)

oduleTitle %oo-  #oduleTitle

mddyy) Date (mmddyy)

eturned Issued eturned

($lease re+er to the codes 2elo1)

re o+ Class !dviser over $rinted Name

"#!/ !CTION T!/"N

School

Name

District

Division

School

ID

Semester

Scho

T!C/ ST!ND # F T # F T # F T # F T # F T # F T # F T # F T # F T TOT!L FO G!D" 88 TOT!L FO G!D" 8; G!ND TOT!L "GIST""D L"!N"S (!s o+ "nd

o+ the #onth)  _!vera&eDaily J +or the_#onth

(!) Cumulative Num2er as o+ $revious #onth (%) Total +or the #onth  (!K%) Cumulative Num2er as o+ "nd o+ the #onth (!) Cumulative Num2er as o+ $revious #onth (%) Total +or the #onth  (!K%) Cumulative Num2er as o+ "nd o+ the #onth

chool Form = #onthly Learners3 #ovement and !ttendanc

D N D

$re.ared and Su2mitted %y6

 Si&nature

e&ion

l Year 

# F T # F T # F T # F T # F T # F T # F T # F T # F T (!) Cumulative Num2er as o+ $revious #onth (%) Total +or the #onth  (!K%) Cumulative Num2er as o+ "nd o+ the #onth (!) Cumulative Num2er as o+ $revious #onth (%) Total +or the #onth  (!K%) Cumulative Num2er as o+ "nd o+ the #onth (!) Cumulative Num2er as o+ $revious #onth (%) Total +or the #onth  (!K%) Cumulative Num2er as o+ "nd o+ the #onth

ance +or enior *i&h chool ( F= *

+ School *ead over $rinted Name

School Name

School ID

Semester

School Year

Trac- and Strand

#!L"

(Last Name' First Name' Name "tension' #iddle Name) List do1n su2ects 1here learner o2tained a ratin& 2elo1 @>J)

chool Form >! "nd o+ emester and chool ear tatus o+ Learn

L"!N"3 N!#" %!C/ 0%"CT

(Last Name' First Name' Name "tension' #iddle Name) List do1n su2ects 1here learner o2tained a ratin& 2elo1 @>J)

(Last Name' First Name' Name "tension' #iddle Name) List do1n su2ects 1here learner o2tained a ratin& 2elo1 @>J)

F"#!L"

  num2er o+ learners 1ho com.letedsatis+ied re7uirements in all su2ect areas 2oth in the 8st and ;nd semester  o+ learners 1ho 1ere not a2le to satis+ycom.lete re7uirements in one or 2oth semesters

L"!N"3 N!#" %!C/ 0%"CT

G0ID"LIN" 6

INDIC!TO 6

"nd o+ emester tatus

"nd o+ chool Year tatus

This +orm shall 2e accom.lished a+ter each semester in a school year' leavin& the "nd o+ School Year Status Column and Summary Ta2le +or " data elements shall 2e +illed u. only a+ter the ;nd semester or at the end o+ the School Year,

  num2er o+ learners 1ho did not meet e.ectations in one or more su2ect areas' re&ardless o+ num2er o+ su2ects +ailed Note6 Do not include learners 1ho are No Lon&er in School (   ) 

Com.lete  num2er o+ learners 1ho com.letedsatis+ied the re7uirements in all su2ect areas (1ith &rade o+ at least @>J) Incom.lete

e&ular

Irre&ular  num2er

District

Division

e&ion

Grade Level

_Section

Courses (only +or TVL)

arners +or enior *i&h chool ( F>! *

  0##!Y T!%L" 8 T "# 0 CO#$L"T" INCO#$L"T" TOT!L 0##!Y T!%L" ;ND "# 0 CO#$L"T" INCO#$L"T" TOT!L

0##!Y T!%L" ("nd o+ the chool Year Only) 0 "G0L! I"G0L! TOT!L "ND OF "#" T" T!T0

(Com.lete Incom.lete) (e&ular Irre&ular) "ND OF C*OOL

Y"! T!T0

"ND OF

"#" T" "ND OF C*OOL_{Y"! T!T0} (e&ular Irre&ular)

(Com.lete Incom.lete)

$re.ared %y6

Si&nature o+ Class !dviser over $rinted Name

Certi+ied Correct %y6

Si&nature o+ School *ead over $rinted Name

evie1ed %y6

Si&nature o+ Division e.resentative over $rinted Name

d o+ School Year Status 2lan-un+illed at the end o+ the 8st Semester, These

(1ith &rade less than @>J)

"ND OF "#" T" T!T0 "ND OF C*OOL Y"! T!T0 (e&ular Irre&ular)

School Name School ID District Division e&ion

Semester  School Year Section

School Name School ID District Division e&ion Semester  School Year Section

Trac- and Strand Courses (only +or TVL)

No.

Note6 NCs are recorded here +or documentation 2ut is not a re7uirement +or

chool Form >% List o+ Learners 1ith Com.lete * e7uirements ( F>% *

LN #!L" 0##!Y T!%L" ! 0 TOT!L 0##!Y T!%L" % 0 NC III NC II NC TOT!L L"!N"3 F0LL N!#"

(Last Name' First Name' Name "tension' #iddle Name)

National Certi+ication Level !ttained (only i+ a..lica2le) Learners 1ho com.leted * $ro&ram 1ithin ; Ys or = semesters Learners 1ho com.leted * $ro&ram in more than ; Ys or semesters No.

(Last Name' First Name' Name "tension' #iddle Name)

evie1ed %y6

Si&nature o+ Class !dviser over $rinted Name

Certi+ied Correct : Su2mitted %y6

Si&nature o+ School *ead over $rinted Name

evie1ed %y6

Si&nature o+ Division e.resentative over $rinted Name &raduation,

8, This +orm should 2e accom.lished 2y the Class !dviser at "nd o+ School Year,

;, It should 2e com.iled and chec-ed 2y the School *ead and .assed to the Division O++ice 2e+ore &raduation,

LN L"!N"3 F0LL N!#" National Certi+ication Level !ttained (only i+ a..lica2le) G0ID"LIN" 6 F"#!L"

No.

(Last Name' First Name' Name "tension' #iddle Name)

evie1ed %y6

Si&nature o+ Class !dviser over $rinted Name

Certi+ied Correct : Su2mitted %y6

Si&nature o+ School *ead over $rinted Name

evie1ed %y6

Si&nature o+ Division e.resentative over $rinted Name &raduation,

8, This +orm should 2e accom.lished 2y the Class !dviser at "nd o+ School Year,

;, It should 2e com.iled and chec-ed 2y the School *ead and .assed to the Division O++ice 2e+ore &raduation,

LN L"!N"3 F0LL N!#" National Certi+ication Level !ttained (only i+ a..lica2le) G0ID"LIN" 6 F"#!L" No.

(Last Name' First Name' Name "tension' #iddle Name)

(only i+ a..lica2le)

LN L"!N"3 F0LL N!#"

National Certi+ication Level !ttained

No.

(Last Name' First Name' Name "tension' #iddle Name)

(only i+ a..lica2le)

LN L"!N"3 F0LL N!#"

National Certi+ication Level !ttained

School Name School ID District

Semester SchoolYear  

#!L" F"#!L" TOT!L #!L" F"#!L" TOT!L #!L" F"#!L" TOT!L

chool Form ? ummaried e.ort o+ Learner tatus as o+ "nd o+ emester and ch

G!D" L"V"L

"ND OF "#" T" T!T0

G!D" 88

School Name School ID District

Semester SchoolYear  

#!L" F"#!L" TOT!L #!L" F"#!L" TOT!L #!L" F"#!L" TOT!L

$re.ared and Su2mitted %y6 evie1ed : Validated %y6

Si&nature o+ School *ead over $rinted Name Si&nature o+ Division e.res

chool Form ? ummaried e.ort o+ Learner tatus as o+ "nd o+ emester and ch

G!D" L"V"L "ND OF "#" T" T!T0 G!D" 88 T!C/ T!NDCO0 " 0% TOT!L G!D" 8; T!C/ T!NDCO0 " 0% TOT!L TOT!L G0ID"LIN" 6

8, !+ter receivin& and validatin& the re.ort on Status o+ Learners su2mitted 2y the Class !dviser' the School *ead sh ;, This re.ort shall 2e +or1arded to the Division O++ice 2y the end o+ the semester,

8, !+ter receivin& and validatin& the re.ort on Status o+ Learners su2mitted 2y the Class !dviser' the School *ead sh ;, This re.ort shall 2e +or1arded to the Division O++ice 2y the end o+ the semester,

<, Column +or "nd o+ School Year shall 2e accom.lished at the end o+ SY or every a+ter the ;nd semester  =, $rotocols o+ validation : su2mission are under the discretion o+ the Schools Division Su.erintendent,

Division e&ion

#!L" F"#!L" TOT!L #!L" F"#!L" TOT!L #!L" F"#!L" TOT!L

Noted %y6

entative over $rinted Name Si&nature o+ Division Su.erintendent over $rinted Name (Fill u. only at the end o+ the second semester,)

and chool ear +or enior *i&h chool ( F? *

"ND OF C*OOL Y"!

ll com.ute the &rade level total .er trac-strandcourse and school total,

School

Name

School

ID

District

School

Name

School

ID

District

Semester

School

Year  

Se

#ino Title o+ $lantilla $osition

(as it a..ears in the a..ointment document$SI$O$)

Num2er o+ Incum2ent

Title o+ $lantilla $osition

(as it a..ears in the a..ointment document$SI$O$) Num2er o+ Incum2ent Title o+ D Teacher' "m.loyee No,(or Ta Identi+ication

Num2er T,I,N,)

Name o+ School $ersonnel (!rran&e 2y $osition' Descendin&) Fund Source $osition Desi&nation Nature o+  !..ointment "m.loyment Status (e&ular $ro2ationary $art Time) De&ree $ost&raduate #aor S.ecialiation S.ecialied Trainin& !ttended

chool Form @ chool $ersonnel %asic $ro+ile and !ssi&n

(!) NationallyFunded eachin& : eachin& elated Item (%) NationallyFunded Non eachin& Items

"D0C!TION!L 0!LIFIC!TION

"m.loyee

No, Name o+ School $ersonnel

Nature o+  !..ointment

"m.loyment

Se

#ino "m.loyee

No,(or Ta Identi+ication

Num2er T,I,N,)

Name o+ School $ersonnel (!rran&e 2y $osition' Descendin&) Fund Source $osition Desi&nation Nature o+  !..ointment "m.loyment Status (e&ular $ro2ationary $art Time) De&ree $ost&raduate #aor S.ecialiation S.ecialied Trainin& !ttended "D0C!TION!L 0!LIFIC!TION "m.loyee

No, Name o+ School $ersonnel

Nature o+  !..ointment

"m.loyment

Se

#ino "m.loyee

No,(or Ta Identi+ication

Num2er T,I,N,)

Name o+ School $ersonnel (!rran&e 2y $osition' Descendin&) Fund Source $osition Desi&nation Nature o+  !..ointment "m.loyment Status (e&ular $ro2ationary $art Time) De&ree $ost&raduate #aor S.ecialiation S.ecialied Trainin& !ttended

;, !ll school .ersonnel' re&ardless o+ .ositionnature o+ a..ointment should 2e included in this +orm and should 2e listed +rom the hi&hest ran- to <, $lease re+lect su2ects 2ein& tau&ht includin& advisory class or ancillary assi&nment (i+ any), Other administrative duties must also 2e re.orte =, Daily $ro&ram Column is +or teachin& .ersonnel only,

8, This +orm shall 2e accom.lished at the 2e&innin& o+ each semester 2y the School *ead and is su2mitted to the Division O++ice, In case o+ mov .ersonnel durin& the semester' an u.dated S*SF@ must 2e su2mitted to the Division O++ice at the end o+ the semester,

"D0C!TION!L 0!LIFIC!TION

G0ID"LIN" 6

Division

e&ion

Division

e&ion

Num2er o+ Incum2ent

Teachin& NonTeachin&

Daily $ro&ram (time duration)

r 

First Semester6

Second Semester6

 !dvisory6

 !ncillary !ssi&nments6

 !ve, #inutes .er Day First Semester6

Second Semester6

 !dvisory6

 !ncillary !ssi&nments6

 !ve, #inutes .er Day First Semester6

  esi&nation

(as it a..ears in the contractdocument6 Cler-' Security Guard' Driver etc,)

 !..ointment6 (Contractual' Su2stitute' Volunteer' Others s.eci+y) Fund Source (S"F' $T!' NGO3s etc,)

Su2ects Tau&ht' !dvisory Class : Other !ncillary

 !ssi&nments Grade and Sections ("numerate sections tau&ht) emar-s6

HFor Detailed Items' Indicate name o+ schoolo++ice' HFor I$  "thnicity)

HFor additional loads +rom *S .lease indicate the num2er o+ teachin& minutes .er 1ee-) D!Y (#T9 T*F) From (6) To (6) Total !ctual Teachin& #inutes .er

9ee-si&nment +or enior *i&h chool ( F@ *

(C ) Other !..ointments and Fundin& ources

Daily $ro&ram (time duration)

Su2ects Tau&ht' !dvisory Grade and_Sections

emar-s6

HFor Detailed Items' Indicate name o+ schoolo++ice' HFor I$  "thnicity)

Daily $ro&ram (time duration)

r 

Su2ects Tau&ht' !dvisory Class : Other !ncillary

 !ssi&nments Grade and Sections ("numerate sections tau&ht) emar-s6

HFor Detailed Items' Indicate name o+ schoolo++ice' HFor I$  "thnicity)

HFor additional loads +rom *S .lease indicate the num2er o+ teachin& minutes .er 1ee-) D!Y (#T9 T*F) From (6) To (6) Total !ctual Teachin& #inutes .er 9ee-Second Semester6  !dvisory6  !ncillary !ssi&nments6

 !ve, #inutes .er Day First Semester6

Second Semester6

 !dvisory6

 !ncillary !ssi&nments6

 !ve, #inutes .er Day First Semester6

Second Semester6

 !dvisory6

 !ncillary !ssi&nments6

 !ve, #inutes .er Day First Semester6

Second Semester6

 !dvisory6

 !ncillary !ssi&nments6

 !ve, #inutes .er Day

Daily $ro&ram (time duration)

Su2ects Tau&ht' !dvisory Grade and_Sections

emar-s6

HFor Detailed Items' Indicate name o+ schoolo++ice' HFor I$  "thnicity)

Daily $ro&ram (time duration)

r 

Su2ects Tau&ht' !dvisory Class : Other !ncillary

 !ssi&nments Grade and Sections ("numerate sections tau&ht) emar-s6

HFor Detailed Items' Indicate name o+ schoolo++ice' HFor I$  "thnicity)

HFor additional loads +rom *S .lease indicate the num2er o+ teachin& minutes .er 1ee-) D!Y (#T9 T*F) From (6) To (6) Total !ctual Teachin& #inutes .er

9ee-the lo1est, Si&nature o+ School *ead over $rinted Name

,

0.dated as o+6

School Form @' $a&e PPP o+ PPPPPPPP ement o+ teachers and other

SF A

De.artment o+ "ducation

SFRT 2017

SF A

(For !ll Grade Levels) 

School Name

District Division

School ID

Grade Section Trac-Strand (S*S)

#!L" 

Name "tension' #iddle Name)

De.artment o+ "ducation

chool Form A Learner3s %asic *ealth and Nutrition e.ort +or enior *i&h

Nutritional ta Learner3s Name

(Last Name' First Name'

(##DDYYYY)

%irthdate 9ei&ht

(-&) *ei&ht(m *ei&htQ(mQ) %# (-&mQ)

SFRT 2017 Name "tension' #iddle Name)

Nutritional ta Learner3s Name

(Last Name' First Name'

(##DDYYYY)

%irthdate 9ei&ht

(-&) *ei&ht(m *ei&htQ(mQ) %# (-&mQ)

SFRT 2017 Name "tension' #iddle Name)

Date o+ !ssessment6 Conducted!ssessed %y6 Certi+ied Correct %y6

Nutritional ta Learner3s Name

(Last Name' First Name'

(##DDYYYY)

%irthdate 9ei&ht

(-&) *ei&ht(m *ei&htQ(mQ) %# (-&mQ)

0##!Y !%L"

"R L #!L" F"#!L" TOT!L Nutritional tatus ummary Ta2le *e everely

SFRT 2017 e&ion

School Year 

&h chool ( FA * )

onal tatus emar-s ei&ht +or !&e (*F!) #I Cate&ory

SFRT 2017 onal tatus emar-s ei&ht +or !&e (*F!) #I Cate&ory