Last	First	Middle	Extension	Sex
					Female Male
LRN	Birthday	Age	Date of SHS Admission(MM/DD/YYYY)	High School Completer
				Gen Ave :
Junior High School Completer	Date of Graduation/Completion(MM/DD/YYYY)	Name of School	School Address	PEPT Passer
Gen Ave :				Rating :
ALS A&E Passer	Others(Pls.Specify)	Date of Examination/Assessment(MM/DD/YYYY)	Name and Address of Community Learning Center	Status
Rating :	Others :			Transferred Out Graduated
Remarks	Form 137 Date Issued (MM/DD/YYYY)	History