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    Home Visitation Form

    Uploaded by

    Paul Patrick Guanzon
    The document is a home visitation form from Dalipuga National High School in Iligan City, Philippines. It collects information about the student, including name, age, grade and address. It documents the purpose of the visit, such as discussing parental involvement or academic performance. Attendees of the visit are noted. Issues to be discussed include health, behavior, absenteeism and recommendations like improving communication or reinforcing healthy habits. Signatures are required from the teacher and parent to confirm the visit.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Home Visitation Form

    Uploaded by

    Paul Patrick Guanzon
    58 views4 pages
    The document is a home visitation form from Dalipuga National High School in Iligan City, Philippines. It collects information about the student, including name, age, grade and address. It documents the purpose of the visit, such as discussing parental involvement or academic performance. Attendees of the visit are noted. Issues to be discussed include health, behavior, absenteeism and recommendations like improving communication or reinforcing healthy habits. Signatures are required from the teacher and parent to confirm the visit.

    Original Title

    HOME VISITATION FORM

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    The document is a home visitation form from Dalipuga National High School in Iligan City, Philippines. It collects information about the student, including name, age, grade and address. It documents the purpose of the visit, such as discussing parental involvement or academic performance. Attendees of the visit are noted. Issues to be discussed include health, behavior, absenteeism and recommendations like improving communication or reinforcing healthy habits. Signatures are required from the teacher and parent to confirm the visit.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    58 views4 pages

    Home Visitation Form

    Uploaded by

    Paul Patrick Guanzon
    The document is a home visitation form from Dalipuga National High School in Iligan City, Philippines. It collects information about the student, including name, age, grade and address. It documents the purpose of the visit, such as discussing parental involvement or academic performance. Attendees of the visit are noted. Issues to be discussed include health, behavior, absenteeism and recommendations like improving communication or reinforcing healthy habits. Signatures are required from the teacher and parent to confirm the visit.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    You are on page 1of 4

    Republic of the Philippines

    Department of Education
    REGION X- NORTHERN MINDANAO
    DIVISION OF ILIGAN CITY
    NORTH 1- DISTRICT
    DALIPUGA NATIONAL HIGH SCHOOL
    DALIPUGA, ILIGAN CITY
    ___________________________________________________________________________________

    HOME VISITATION FORM


    Date:_________________
    Time:________________

    I. Learner’s Personal Information


    Complete Name:
    Nick Name: Age: Grade & Section:
    Address: Gender: Birthdate:

    II.Purpose of Home Visit:


    ( Please check the box)
    To discuss with the parents about their involvement in school
    To address their child’s learning difficulties such as reading issues, numeracy issues and writing issues
    To identify their child’s performance in their class home
    To discuss their child’s behavior in their class home
    Others:

    III.Present during the home visit ( Please check the box and write the complete name )
    Father Auntie
    Mother Uncle
    Elder Brother/Sister Guardian
    Grandparent/s Others

    IV. Issues to be discussed


    Learner’s health
    Academic Performance
    Behavior / Attitude / Interest
    Absenteeism
    Tardiness
    Cutting classes
    Return Visit
    Others:

    V. Recommendations
    Update the parents through communication ( call, text or letter)
    Provide information for parents on learner’s update and on monitoring
    Provide Parent’s guide to help the learners at home
    Approach or inform teacher when needed
    Reinforce the importance of healthy eating and physical activity
    Encourage parents / guardians to visit class home
    Involve parents/ guardians to participate school activities
    Others:

    Teacher Parent/ Guardian


    ( Signature over printed name) ( Signature over printed name)
    Picture during the Home Visit:

    __________________________________________________________________________________

    Address: Dalipuga, Iligan City


    Telephone No.: (063) 225-2798
    Email: dalipuganationalhighschool@gmail.com
    Republic of the Philippines
    Department of Education
    REGION X- NORTHERN MINDANAO
    DIVISION OF ILIGAN CITY
    NORTH 1- DISTRICT
    DALIPUGA NATIONAL HIGH SCHOOL
    DALIPUGA, ILIGAN CITY
    ___________________________________________________________________________________

    ATTENDANCE

    __________________________________________________________________________________

    Address: Dalipuga, Iligan City


    Telephone No.: (063) 225-2798
    Email: dalipuganationalhighschool@gmail.com
    Republic of the Philippines
    Department of Education
    REGION X- NORTHERN MINDANAO
    DIVISION OF ILIGAN CITY
    NORTH 1- DISTRICT
    DALIPUGA NATIONAL HIGH SCHOOL
    DALIPUGA, ILIGAN CITY
    ___________________________________________________________________________________

    DATE:

    COMPLETE NAME STUDENT’S RELATIONSHIP TO SIGNATURE


    COMPLETE NAME THE STUDENT

    __________________________________________________________________________________

    Address: Dalipuga, Iligan City


    Telephone No.: (063) 225-2798
    Email: dalipuganationalhighschool@gmail.com
    Republic of the Philippines
    Department of Education
    REGION X- NORTHERN MINDANAO
    DIVISION OF ILIGAN CITY
    NORTH 1- DISTRICT
    DALIPUGA NATIONAL HIGH SCHOOL
    DALIPUGA, ILIGAN CITY
    ___________________________________________________________________________________

    __________________________________________________________________________________

    Address: Dalipuga, Iligan City


    Telephone No.: (063) 225-2798
    Email: dalipuganationalhighschool@gmail.com

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