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Template No.

LEARNER’S NEEDS, PROGRESS AND ACHIEVEMENT CARDEX

Name: __________________________________________________ Gender: Male Female


School: ____________________________________ Grade & Section: ________________ Birthday: ____________
Address: ______________________________________________ Adviser: _______________________________
Contact No.: _________________ E-mail: _____________________ Quarter: _____________ S.Y: _____________

Remarks of Action
Date Reported Report Intended for Details of Concern Action to be Taken
Taken
Need Dialogue Ongoing

Progress Consultation Accomplished

Achievement Home Visitation Details:


__________________
Assembly/ Forum __________________
__________________
Need Dialogue Ongoing

Progress Consultation Accomplished

Achievement Home Visitation Details:


__________________
Assembly/ Forum __________________
__________________
Need Dialogue Ongoing

Progress Consultation Accomplished

Achievement Home Visitation Details:


__________________
Assembly/ Forum __________________
__________________
Need Dialogue Ongoing

Progress Consultation Accomplished

Achievement Home Visitation Details:


__________________
Assembly/ Forum __________________
__________________

Remarks:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Template No. 2

PARENTS/GUARDIANS COMMUNICATION CARDEX

Name: _________________________________________________________ Parent Mother


Father
Address: _______________________________________________________ Guardian Relative
Other (Specify)
Contact No.: ____________________________________________________

Name of Student: ________________________________________________ Gender: Male Female

School: ____________________________________ Grade & Section: __________________ Quarter: 1st 2nd 3rd 4th

Name of Adviser: ________________________________________________ School Year: _________________________

Date Reported Type of Encounter Details of Concern Agreed Resolution Signature

Dialogue Parent / Guardian:

Consultation __________________

Home Visitation Teacher:

Assembly/ Forum __________________

Dialogue Parent / Guardian:

Consultation __________________

Home Visitation Teacher:

Assembly/ Forum __________________

Dialogue Parent / Guardian:

Consultation __________________

Home Visitation Teacher:

Assembly/ Forum __________________

Dialogue Parent / Guardian:

Consultation __________________

Home Visitation Teacher:

Assembly/ Forum __________________

Remarks:

_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________

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