ACADEMIC PSYCHO-SOCIAL ASSISTANCE PROGRAM Name of Student: ______________________________________________________ Previous Year and section: ______________________________________________________ Date of Enrollment: ______________________________________________________

A Commitment to Improve Academic Performance, Behavior and Attendance (For School Year_______________) Student I promise to: Attend classes regularly and punctually. Consult with teachers. Attend group sessions called by the guidance counselor. Attend special classes organized by the school. Limit my involvement in extracurricular activities. Develop desirable habits and attitudes. Study in the library as often as possible. __________________________________
Name and Signature of Student

Parent I promise to: Closely monitor my childs academic performance, attendance and behavior in school. Consult with teachers, homeroom adviser and guidance counselor at least once every quarter. Provide a home atmosphere conducive to study and personal formation. Attend card giving and parenting seminars. Recognize/reinforce improved performance and behavior of my child. __________________________________
Name and Signature of Parent

Homeroom Adviser I promise to: Be available for consultation. Assist the student develop desirable work habits and attitudes. Regularly monitor students performance and behavior and inform parents about it. _________________________________
Name and Signature of HR Adviser

Subject Teacher I promise to: Be available for consultation. Assist the student develop desirable work habits and attitudes. Regularly monitor students performance and behavior and inform parents about it. __________________________________
Name and Signature of Subject Teacher

Guidance Counselor

I promise to: Assist the student to develop desirable work habits and attitudes. Assist teachers and parents establish reinforcing measures for desirable student performance. Conduct conferences/seminars for the participants. Provide counseling to students. __________________________________
Name and Signature of Guidance Counselor

Name___________________________________________ Section______________________________________Status___________________________________ Causes of my Academic and/or Behavior Deficiencies

Previous

Year

My Targets (Goals) in terms of Grades and/or Behavior for School Year__________

What I Intend to do to Attain my Goals

___________________________________________ Name & Signature of Student __________________________________________ Name & Signature of Parent/Guardian Date:______________________________________

GUIDANCE CENTER
Philippine Science High School - Ilocos Region Campus Poblacion East, San Ildefonso Ilocos Sur RECORD OF TEACHER CONSULTATION OR LIBRARY HOURS Name:_______________________________________ Section:_____________________________ Month:_______________________________________ Date IN Time OUT Signature of Teacher / Librarian

I hereby certify that the abovemenntioned information is true and correct to the best of my knowledge. ______ ________________________ Signature of Student

GUIDANCE CENTER Distribution of Homeroom Modules

SECTION I Ruby I - Diamond I - Emerald II - Adelfa II - Dahlia II - Camia III - Lithium III Cesium III Beryllium IV - Photon IV Graviton ADVISER Jenahlyn Retreta Nelson Sablay Mary Grace Navarro Monaliza Mandac Elma Rapada Ronnie Calano Annellene Madrid Amy Paneda Sharon Palomares Jonellyn Albano Michelle Ducusin SIGNATURE