Department of Education

Region X
Division of Cagayan de Oro City
West, I District
MACANHAN ELEMENTARY SCHOOL
Macanhan, Carmen, Cagayan de Oro City

Parent’s Name: ________________________________________________________________________

Parent’s Address: ______________________________________________________________________
Date: _____________________________

Dear Mr. and Mrs. _____________________________,

This letter is to inform you that I will be visiting your son/daughter

___________________________________________ (name of the child) at your home
as stated in the above address at ____________________ (time) on
__________________________ (date) as part of our K-12 Curriculum. I’m teacher
___________________________________, the teacher of your son/daughter here at
Macanhan Elementary School.
The purpose of the visit is to get to know and your child and discuss some important
information; the visit should only last 20-30 minutes.
I am available on _______________________ (date) between ______________(TIME)
AM/PM.
Do any of these days and times work for you?
Thank you in advance for allowing me to visit and the warm welcome in your home.

Sincerely,

DOROTHY JEAN D. RATUNIL

Class Adviser
Grade V- Newton

Approved:

MELBA S. OMANDAM
School Principal

……………………………………………………………………………………………………
Pupil’s Name: ________________________________________________
Parent’s Name: _______________________________________________
Relationship to pupil: ___________________________________________
______ Yes, please free to contact us by: Cellphone Number: ____________________
______ No, (Reason) ____________________________________________________
______________________________________________________________________
______________________________________________________________________
CERTIFICATE OF APPEARANCE
This is to certify that ___________________________________ who is an
employee of DepEd- Macanhan Elementary School has personally appeared at my
residence for the purpose of HOME VISITATION from _____________ to ___________
(time) dated __________________________.

This certification is being issued upon the request of ______________________

In compliance with the IPCRF and as part of K-12 Curriculum by the purpose of
establishing the evidence and duration of her appearance here at, the truth of which
vouchsafed and guaranteed by the undersigned.

________________________________________
Name of Parent/Guardian with Signature over Printed Name

Department of Education
Region X
Division of Cagayan de Oro City
West, I District
MACANHAN ELEMENTARY SCHOOL
Macanhan, Carmen, Cagayan de Oro City

Please be informed that __________________________________ a teacher adviser of

(Name of Teacher)
__________________________, Macanhan Elementary School is allowed to conduct a
(Grade Level and Section)
Home Visitation with her pupil _____________________________________________
(Name of the Pupil)
For the reason _________________________________________________________
(State reason of Home Visitation)
This permit is issued ____________________ day of ___________________, 2017.

__________________________________
(Printed Name over Signature of the Parent/Guardian)

MELBA S. OMANDAM
School Principal
 Department of Education
Region X
Division of Cagayan de Oro City
West, I District
MACANHAN ELEMENTARY SCHOOL
Macanhan, Carmen, Cagayan de Oro City

HOME VISITATION FORM

GRADE V- NEWTON

Name of Pupil: _____________________________________________

Learner’s Reference Number: __________________________________________

Address : _____________________________________________

Name of Father: _______________________________________________

Work of Father: ________________________________________________

Name of Mother: ________________________________________________

Work of Mother: ________________________________________________

Contact Number/s: ________________________________________________

HOME VISIT RATIONALE:

Communicate with parents for pupil’s Performance Factor

Follow –up pupil’s Reading Ability

Investigate some causes about pupil’s late/absent

Finding factors of behaviour showed in school

Getting to know more of pupil’s family

REMARKS/AGREEMENT:

______________________________________________________________________

______________________________ ________________________________
Parent’s Signature over Printed Name Parent’s Signature over Printed Name
 Department of Education
Region X
Division of Cagayan de Oro City
West, I District
MACANHAN ELEMENTARY SCHOOL
Macanhan, Carmen, Cagayan de Oro City

Ngalan sa bata: ______________________ Edad: ____Grado ug Seksiyon: _________

Ngalan sa Mama: ________________________Ngalan sa Papa: _________________
Pila ka buok membro sa Pamilya: _________ Trabaho sa Mama: _________________
Trabaho sa Papa: ______________________ Contact Number: __________________
Address: __________________________________ Petsa sa Pgbisita: _____________

1. Pila ka oras ang gihatag sa imong anak pagtuon sa iyang leksiyon?

2. Unsa ang pamaagi sa pagtuon sa imong anak sa iyang leksiyon?

3. Kinsa ang kauban sa imong anak sa pagtuon sa iyang leksiyon?

4. Unsa ang kasagaran buhaton sa imong anak?

a. Kung gikan sa eskwelahan?

b. Kung walay klase?

5. Aduna bay lain na gabasahon ang imong anak gawas sa libro na gipahulam sa
eskwelahan?

6. Isip us aka ginikanan/inahan/amahan unsa imong ikasulti bahin sa pagtulun-an

sa imong anak?

7. Unsa imong ikasulti sa atong tulunghaan?

8. Unsa ang ikatabang sa imong anak dinhi sa inyong panimalay?

9. Gadula ba ang imong anak sa computer?

10. Kung Oo pila ka oras ang iyang pagdula? Unsa ang kasagaran niya dulaon?

11. Kung pananglit makasala imong anak unsa ang imong buhaton sa iya?
(maghatag ug example)

12. Gatampo ba ikaw sa mga meeting/assembly/kalihukan sa tulunghaan?

Pirma sa ginikanan nga naghatag ug tubag sa mga pangutana:______________

Ngalan ug Pirma sa Maestra:____________________________