G PreEvalForm LGCDD

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DILG REGION V Document Code

Pre-Evaluation FM-QP-RO5-LGCDD-23-04
Rev. No. Eff. Date Page
Training Services 00 07.01.19 1 of 1

(TITLE OF ACTIVITY)
(DATE AND VENUE)

Name: Office:

Position: LGU:

Please review the following list of topics to be discussed. Give some thought as to your level of
knowledge on the topics at present. Encircle the rating of your choice using the rating scale below.

1 - Very Low 2 - Low 3 - Average 4 - High 5 - Very High


Level of Knowledge Rating

1. 1 2 3 4 5
2. 1 2 3 4 5
3. 1 2 3 4 5
4. 1 2 3 4 5

5. 1 2 3 4 5

6. 1 2 3 4 5
7.
1 2 3 4 5

What do you expect to gain from this activity?

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

Please submit accomplished form to the Secretariat.


Thank you for your cooperation!

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