Republic of the Philippines

DEPARTMENT OF EDUCATION
Region I
Division of La Union
STO. TOMAS NATIONAL HIGH SCHOOL
Senior High School
Patac, Santo Tomas, La Union

LEARNER’S NEEDS, PROGRESS AND ACHIEVEMENT CARDEX

Name: _________________________________________ Gender: Male Female
Grade & Strand: ________________________________ Date of Birth: __________________________
Address: _______________________________________ Adviser: __________________________
Contact #: ______________________________________ Quarter __________________________
E-mail: _________________________________________ School Year:

DATE REPORT INTENDED DETAILS ACTION TO BE REMARKS OF

REPORTED FOR CONCERN TAKEN ACTION TO BE
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 __________________
__________________
__________________

Need Dialogue Ongoing

Progress Consultation Accomplished
Achievement Home Visitation Details:
Assembly/Forum __________________
__________________
__________________

REMARKS:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

Prepared by: MICHAEL STEPHEN R. GRACIAS

Master Teacher I
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region I
Division of La Union
STO. TOMAS NATIONAL HIGH SCHOOL
Senior High School
Patac, Santo Tomas, La Union

PARENTS/GUARDIANS COMMUNICATION CARDEX

Mother
Name: _____________________________________________________ Parent
Father
Relative
Address: ___________________________________________________ Guardian
Other (Specify)
Contact #: __________________________________________________
Name of Student: ____________________________________________ Gender: Male Female
st nd
Grade & Strand: ____________________________________________ Quarter: 1 2 3rd 4th
Name of Adviser: ____________________________________________ School Year: __________________

DATE TYPES OF DETAILS OF AGREED

REPORTED SIGNATURE
ENCOUNTER CONCERN RESOLUTION
Dialogue Parent/Guardian:
Consultation
Home Visitation
Assembly/Forum Teacher:

Dialogue Parent/Guardian:
Consultation
Home Visitation
Assembly/Forum Teacher:

Dialogue Parent/Guardian:
Consultation
Home Visitation
Assembly/Forum Teacher:

Dialogue Parent/Guardian:
Consultation
Home Visitation
Assembly/Forum Teacher:

Dialogue Parent/Guardian:
Consultation
Home Visitation
Assembly/Forum Teacher:

REMARKS:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

Prepared by: MICHAEL STEPHEN R. GRACIAS

Master Teacher I