prototype forms for implementation in public elementary and secondary schools

32
School Form 1 (SF 1) School Register (This replaces Form 1, Master List & STS Form 2-Family Background and Profile) School ID Region Division District School Name School Year Grade Level Section LRN RELIGION ADDRESS PARENTS Barangay Province Name NAME (Last Name, First Name, Middle Name) Sex (M/F) BIRTH DATE (mm/dd/ yyyy) AGE as of 1st Friday June MOTHER TONGUE (Grade 1 to 3 Only) IP (Ethnic Group) GUARDIAN (If not House #/ Street/ Sitio/ Purok Municipality/ City Father's Name (Last Name, First Name, Middle Name) Mother's Maiden Name (Last Name, First Name, Middle Name)

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These are the new school forms like SF1, SF2, SF3, SF4, SF5, SF6 and SF7 to be used by the teachers and the school heads for the school year 2014-2015 in public elementary and secondary schools onwards until being superseded or replaced.

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Page 1: Prototype Forms for Implementation in Public Elementary and Secondary Schools

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

School ID Region Division District

School Name School Year Grade Level Section

LRN RELIGION

ADDRESS PARENTS REMARKS

Barangay Province Name Relation-ship

NAME(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE (mm/dd/ yyyy)

AGE as of 1st Friday

JuneMOTHER TONGUE (Grade 1 to 3 Only)

IP (Ethnic Group)

GUARDIAN (If not Parent)

Contact Number of Parent or

GuardianHouse #/ Street/ Sitio/Purok

Municipality/ City

Father's Name (Last Name, First Name, Middle Name)

Mother's Maiden Name (Last Name, First Name, Middle

Name)(Please refer to the

legend on last page)

Page 2: Prototype Forms for Implementation in Public Elementary and Secondary Schools

LRN RELIGION

ADDRESS PARENTS REMARKS

Barangay Province Name Relation-ship

NAME(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE (mm/dd/ yyyy)

AGE as of 1st Friday

JuneMOTHER TONGUE (Grade 1 to 3 Only)

IP (Ethnic Group)

GUARDIAN (If not Parent)

Contact Number of Parent or

GuardianHouse #/ Street/ Sitio/Purok

Municipality/ City

Father's Name (Last Name, First Name, Middle Name)

Mother's Maiden Name (Last Name, First Name, Middle

Name)(Please refer to the

legend on last page)

List and Code of Indicators under REMARKS column Prepared by: Certified Correct:Indicator Code Required Information Indicator Code Required Information REGISTERED BoSY EoSY

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

Page 3: Prototype Forms for Implementation in Public Elementary and Secondary Schools

LRN RELIGION

ADDRESS PARENTS REMARKS

Barangay Province Name Relation-ship

NAME(Last Name, First Name, Middle Name)

Sex (M/F)

BIRTH DATE (mm/dd/ yyyy)

AGE as of 1st Friday

JuneMOTHER TONGUE (Grade 1 to 3 Only)

IP (Ethnic Group)

GUARDIAN (If not Parent)

Contact Number of Parent or

GuardianHouse #/ Street/ Sitio/Purok

Municipality/ City

Father's Name (Last Name, First Name, Middle Name)

Mother's Maiden Name (Last Name, First Name, Middle

Name)(Please refer to the

legend on last page)

Transferred IN T/I Name of Public (P) Private (PR) School & Effectivity Date Balik-Aral B/A Name of school last attended & Year FEMALE(Signature of Adviser over Printed Name) (Signature of School Head over Printed Name)

Dropped DRP Reason and Effectivity Date LWD SpecifyTOTAL

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

Learner With Dissability

Page 4: Prototype Forms for Implementation in Public Elementary and Secondary Schools

School Form 2 (SF2) Daily Attendance Report of Learners(This replaces Form 1, Form 2 & STS Form 4 - Absenteeism and Dropout Profile)

School ID School Year Report for the Month of

Name of School Grade Level Section

(1st row for date)

M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F ABSENT TARDY

MALE | TOTAL Per Day

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

Total for the Month REMARKS (If DROPPED OUT, state reason, please refer

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

Page 5: Prototype Forms for Implementation in Public Elementary and Secondary Schools

(1st row for date)

M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F ABSENT TARDY

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

Total for the Month REMARKS (If DROPPED OUT, state reason, please refer

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

FEMALE | TOTAL Per Day

Combined TOTAL PER DAY

GUIDELINES: 1. CODES FOR CHECKING ATTENDANCE Month: Summary

1. The attendance shall be accomplished daily. Refer to the codes for checking learners' attendance. M F TOTAL

2. Dates shall be written in the columns after Learner's Name.* Enrolment as of (1st Friday of June)

3. To compute the following: 2. REASONS/CAUSES FOR DROPPING OUT

a. Percentage of Enrolment =Registered Learners as of end of the month

x 100a. Domestic-Related Factors

Enrolment as of 1st Friday of the school year a.1. Had to take care of siblings

b. Average Daily Attendance = Total Daily Attendance a.2. Early marriage/pregnancy

Number of School Days in reporting month a.3. Parents' attitude toward schooling

c. Percentage of Attendance for the month =Average daily attendance

x 100a.4. Family problems

Registered Learners as of end of the month b. Individual-Related Factors

b.1. IllnessAverage Daily Attendance

b.2. Overageb.3. Death

Percentage of Attendance for the month b.4. Drug Abuseb.5. Poor academic performance

Number of students absent for 5 consecutive days:6. Attendance performance of learners will be reflected in Form 137 and Form 138 every grading period. b.6. Lack of interest/Distractions

* Beginning of School Year cut-off report is every 1st Friday of the School Year b.7. Hunger/MalnutritionDrop out

c. School-Related Factorsc.1. Teacher Factor

Transferred outc.2. Physical condition of classroomc.3. Peer influence

Transferred ind. Geographic/Environmentald.1. Distance between home and schoold.2. Armed conflict (incl. Tribal wars & clanfeuds) I certify that this is a true and correct report.

d.3. Calamities/Disasterse. Financial-Related

e.1. Child labor, work (Signature of Teacher over Printed Name)f. Others (Specify)

No. of Days of Classes:

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

Late Enrollment during the month (beyond cut-off)

Registered Learners as of end of the month

Percentage of Enrolment as of end of the month

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.

Page 6: Prototype Forms for Implementation in Public Elementary and Secondary Schools

(1st row for date)

M T W TH F M T W TH F M T W TH F M T W TH F M T W TH F ABSENT TARDY

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

Total for the Month REMARKS (If DROPPED OUT, state reason, please refer

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

School Form 2 : Page ___ of ________Attested by:

(Signature of School Head over Printed Name)

Page 7: Prototype Forms for Implementation in Public Elementary and Secondary Schools

School Form 3 (SF3) Books Issued and Returned(This replaces Form 1 & Inventory of Textbooks)

School ID School Year

School Name Grade Level Section

NO.

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

Date Date Date Date Date Date Date Date

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

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

Name)

REMARKS/ACTION TAKEN (Please refer to the

legend on last page)

Page 8: Prototype Forms for Implementation in Public Elementary and Secondary Schools

NO.

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

Date Date Date Date Date Date Date Date

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

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

Name)

REMARKS/ACTION TAKEN (Please refer to the

legend on last page)

TOTAL FOR MALE | TOTAL COPIES

TOTAL FOR FEMALE | TOTAL COPIES

TOTAL LEARNERS | TOTAL COPIES

GUIDELINES: In case of lost/unreturned books, please provide information with the following code: Prepared By: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. (Signature over printed name)4. The Total Number of Copies of Books Returned at the EoSYshall be reflected in the form. Date BoSY:____________ Date EoSY: ___________5. All textbooks being used must be included. Additional copies of this form may be used if needed.

A. In Column Date Returned, codes are: FM=Force Majeure, TDO: Transferred/Dropout, NEG=NegligenceB. In Column Remark/Action Taken, codes are: LLTR=Secured Letter from Learner duly signed by parent/guardian (for code FM), TLTR=Teacher prepared letter/report duly noted by School Head for submission to School Property Custodian (for code TDO), PTL=Paid by the Learner (for code NEG). References: DO#23, s.2001, DO#25, s.2003, DO#14, 2.2012.

Page 9: Prototype Forms for Implementation in Public Elementary and Secondary Schools

School Form 4 (SF4) Monthly Learner's Movement and Attendance(This replaces Form 3 & STS Form 4-Absenteeism and Dropout Profile)

School ID Region Division District

School Name School Year Report for the Month of

SECTION NAME OF ADVISER

ATTENDANCE DROPPED OUT TRANSFERRED OUT TRANSFERRED IN

Daily Average (B) For the Month (B) For the Month (B) For the Month

M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F T M F 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

TOTALGUIDELINES: Prepared and Submitted by:

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

(Signature of School Head over Printed Name)

Page _____ of _____ pages

GRADE/ YEAR LEVEL

REGISTERED LEARNERS (As of End of the

Month)Percentage for

the Month(A) Cumulative as of Previous Month

(A+B) Cumulative as of End of the

Month(A) Cumulative as of Previous Month

(A+B) Cumulative as of End of the

Month(A) Cumulative as of Previous Month

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

Page 10: Prototype Forms for Implementation in Public Elementary and Secondary Schools

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

Region Division District

School ID School Year Curriculum

School Name Grade Level Section

LRN

As of end of current School Year

SUMMARY TABLE

STATUS MALE FEMALE TOTAL

PROMOTED

IRREGULAR

RETAINED

LEVEL OF PROFICIENCY (K to 12 Only)

MALE FEMALE TOTAL

LEARNER'S NAME (Last Name, First Name, Middle 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/S (This column is for K to 12 Curriculum and remaining RBEC in High School. Elementary grades level that are still implementing RBEC

need not to fill up these columns)

From previous school years completed as of end of current

School Year

BEGINNNING (B: 74% and

below)

DEVELOPING (D: 75%-79%)

APPROACHING PROFICIENCY

(AP: 80%-84%)

PROFICIENT (P: 85% -89%)

ADVANCED (A: 90% and above)

Page 11: Prototype Forms for Implementation in Public Elementary and Secondary Schools

LRN

As of end of current School Year

LEARNER'S NAME (Last Name, First Name, Middle 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/S (This column is for K to 12 Curriculum and remaining RBEC in High School. Elementary grades level that are still implementing RBEC

need not to fill up these columns)

From previous school years completed as of end of current

School Year

TOTAL MALE

PREPARED BY:

Class Adviser

(Name and Signature)

CERTIFIED CORRECT & SUBMITTED:

School Head

(Name and Signature)

REVIEWED BY:

(Name and Signature)

Division Representative

GUIDELINES:

1. For All Grade/Year Levels

ADVANCED (A: 90% and above)

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.

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

Page 12: Prototype Forms for Implementation in Public Elementary and Secondary Schools

LRN

As of end of current School Year

LEARNER'S NAME (Last Name, First Name, Middle 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/S (This column is for K to 12 Curriculum and remaining RBEC in High School. Elementary grades level that are still implementing RBEC

need not to fill up these columns)

From previous school years completed as of end of current

School Year

TOTAL FEMALE

COMBINED School Form 5: Page ____ of ________

5. Protocols of validation & submission is under the discretion of the Schools Division Superintendent

Page 13: Prototype Forms for Implementation in Public Elementary and Secondary Schools

School Form 6 (SF6)Summarized Report on Promotion and Level of Proficiency

(This replaces Form 20)

School ID Region Division

School Name District School Year

SUMMARY TABLEGRADE 1 /GRADE 7 GRADE 2 / GRADE 8 GRADE 3 / GRADE 9 GRADE 4 / GRADE 10 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 MALE FEMALE

PROMOTED

IRREGULAR (Grade 7 onwards only)

RETAINED

LEVEL OF PROFICIENCY (K to 12 Only) MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE TOTAL MALE FEMALE

TOTAL

Prepared and Submitted by: Reviewed & Validated by: Noted by:SCHOOL HEAD DIVISION REPRESENTATIVE SCHOOLS DIVISION SUPERINTENDENT

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.

BEGINNNING (B: 74% and below)

DEVELOPING (D: 75%-79%)

APPROACHING PROFICIENCY (AP: 80%-84%)

PROFICIENT (P: 85% -89%)

ADVANCED (A: 90% and above)

Page 14: Prototype Forms for Implementation in Public Elementary and Secondary Schools

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.

Page 15: Prototype Forms for Implementation in Public Elementary and Secondary Schools

School Form 6 (SF6)Summarized Report on Promotion and Level of Proficiency

(This replaces Form 20)

TOTAL

TOTAL

TOTAL

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.

Page 16: Prototype Forms for Implementation in Public Elementary and Secondary Schools

School Form 7 (SF7) School Personnel Assignment List and Basic Profile(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 School Year

(A) Nationally-Funded Teaching & Teaching Related Items (B) Nationally-Funded Non Teaching Items (C ) Other Appointments and Funding Sources

Teaching

Sex

EDUCATIONAL QUALIFICATION Daily Program (time duration)

Minor

Ave. Minutes per Day

Ave. Minutes per Day

Title of Plantilla Position (as it appears in the appointment

document/PSIPOP)Number of Incumbent

Title of Plantilla Position (as it appears in the appointment

document/PSIPOP)Number of Incumbent

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

Appointment: (Contractual, Substitute,

Volunteer, others specify)

Fund Source (SEF, PTA,

NGO's etc.)

Number of Incumbent

Non-Teaching

Employee No. (or Tax Identification

Number -T.I.N.)

Name of School Personnel (Arrange by

Position, Descending) Fund

SourcePosition/

Designation

Nature of Appointment/ Employment

Status

Subject Taught (include Grade &

Section), Advisory Class & Other Ancillary

Assignments

Remarks (For Detailed Items,

Indicate name of school/office, For IP's

-Ethnicity)Degree / Post

GraduateMajor/

SpecializationDAY

(M/T/W/TH/F)

From (00:00)

To (00:00)

Total Actual Teaching

Minutes per Week

Page 17: Prototype Forms for Implementation in Public Elementary and Secondary Schools

Sex

EDUCATIONAL QUALIFICATION Daily Program (time duration)

Minor

Employee No. (or Tax Identification

Number -T.I.N.)

Name of School Personnel (Arrange by

Position, Descending) Fund

SourcePosition/

Designation

Nature of Appointment/ Employment

Status

Subject Taught (include Grade &

Section), Advisory Class & Other Ancillary

Assignments

Remarks (For Detailed Items,

Indicate name of school/office, For IP's

-Ethnicity)Degree / Post

GraduateMajor/

SpecializationDAY

(M/T/W/TH/F)

From (00:00)

To (00:00)

Total Actual Teaching

Minutes per Week

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

Ave. Minutes per Day

GUIDELINES: Submitted by:

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. (Signature of School Head over Printed Name)

3. Please reflect subjects being taught and if teacher handling advisory class or Ancillary Assignment. Other administrative duties must also reported.

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 Form 19 must be submitted to the Division Office .

Page 18: Prototype Forms for Implementation in Public Elementary and Secondary Schools

Sex

EDUCATIONAL QUALIFICATION Daily Program (time duration)

Minor

Employee No. (or Tax Identification

Number -T.I.N.)

Name of School Personnel (Arrange by

Position, Descending) Fund

SourcePosition/

Designation

Nature of Appointment/ Employment

Status

Subject Taught (include Grade &

Section), Advisory Class & Other Ancillary

Assignments

Remarks (For Detailed Items,

Indicate name of school/office, For IP's

-Ethnicity)Degree / Post

GraduateMajor/

SpecializationDAY

(M/T/W/TH/F)

From (00:00)

To (00:00)

Total Actual Teaching

Minutes per Week

4. Daily Program Column is for teaching personnel only. Updated as of: ___________________________School Form 7, Page ___ of ________