STUDENT'S FEEDBACK FORM

Name of Student: ___________________________________Quarter: _____________________________

School: ____________________________________________Week: _____________________________
District: ____________________________________________

Check the box for your appropriate/honest answer.

1. Did the video module help you unsderstand the lesson?
2. Were you able to follow the instructions in all the parts of the printed module?
3. Were you able to understand and accomplish all the activities ?
4. Were you guided by your parent/guardian/siblings in accomplishing the activities?
5. Did you ask questions/clarifications/querries to your teacher through Text/Call/Messenger?
6. Did you receive any answer from your teacher?
7. What was your score in the post assessment? Indicate the score over the item. (Example: 8/10)
8. Others (Write any other comments/feedbacks/suggestions)
___________________________________________________________________________________________
___________________________________________________________________________________________

Signature of student/pupil
__________________
__________________

Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
__________________

____________________________
____________________________
 PARENT'S/GUARDIAN'S FEEDBACK FORM

Name of Parent/Guardian:_______________________________Quarter: ________________________________

School: ______________________________________________ Week: ________________________________
District: ______________________________________________

Check the box for your appropriate/honest answer.

1. Did you find an instruction in the learning package? Yes
2. Did you read and follow the instructions carefully? Yes
3. Were the instructions clear? Yes
4. Did you guide/assist your child based on the instructions given? Yes
5. Did you ask questions/clarifications to the teacher of your child through Text/Call/Messenger? Yes
6. Did you receive any answers from the teacher? Yes
7. Were you clarified of your queries/questions? Yes
8. Others (Write any other comments/feedbacks/suggestions)
___________________________________________________________________________________________
___________________________________________________________________________________________

Signature over printed name of parent

________________
________________

No
No
No
No
No
No
No

_______________________
_______________________
 INSTRUCTION TO PARENT/GUARDIAN

Name of Parent/Guardian:________________________________
School: ______________________________________________
District: ______________________________________________

1. After receiving/opening the learning package check if it contains the following items:
a. Instruction for the learner and parent.
b. Flash drive containing the video modules.
c. Printed modules for the week.
d. Feeback forms for the learner and parent.
e. Activity/answer sheets.
f. Indicated filename of video module for the week.
g. List of learning package
h. Calendar/schedule of activities for the learner for the week.
2. Open the identified filename of the video module for the day.(Teacher shall specify all the important details that the parent
3. Next, assist your child in playing/watching the video.
4. Assist your child in accomplishing the printed module.
5. Assist your child in accomplishing the activity/answer sheet but let your child answer independently.
6. Ensure that your child answers first the activity/assessment before referring to the answer key
7. Call the teacher or send a message to the teacher if you have a questions/concern
8. Assist your child in answering the post assessment. If your child gets lower than 80%, help the child go back to the specific a
wrong answers and go over the exercises/activities.
9. Repack the accomplished modules and all the contents of the learning package based on the list at the end of the week.
10. Hand over the accomplished learning package to the designated messenger.
O PARENT/GUARDIAN

Quarter: _____________________________
Week: _____________________________

all specify all the important details that the parent should do.)

hild answer independently.

ng to the answer key

r than 80%, help the child go back to the specific activity where he/she got

ckage based on the list at the end of the week.

 INSTRUCTION TO THE LEARNER

Name of learner:________________________________________ Quarter:

School: ______________________________________________ Week:
District: ______________________________________________

1.Open the learning package with your parent and check the completeness of the following:
a. Instruction for the learner and parent.
b. Flash drive containing the video modules.
c. Printed modules for the week.
d. Feedback forms for the learner and parent.
e. Activity/answer sheets.
f. Indicated filename of video module for the week.
g. List of learning package
h. Calendar/schedule of activities for the learner for the week.
2. Accomplish the task one at a time according to the proper sequence in the module. Using separate note book, take note als
your module.
3. Refer to the calendar or the learner’s task/s for the day to guide you on your required task/s to accomplish.
4. Be sure to answer first the activities/assessment before referring to the key answers at the last pages of your printed modu
clean papers for your answer sheets and other required outputs.
5. If you have any question or concern, you may refer this to your parent/guardian to possibly contact your teacher. You may
as needed.
6. During the last day of the week, be sure to answer the following: post assessment and the learner’s feedback form.
7. Through your parent or guardian, return the accomplished module and attached the required outputs.
N TO THE LEARNER

________________________________
________________________________

of the following:

e module. Using separate note book, take note also of important concepts from

our required task/s to accomplish.

ey answers at the last pages of your printed module. You may use separate

ardian to possibly contact your teacher. You may also replay the video module

essment and the learner’s feedback form.

ttached the required outputs.