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    Home Vistation Form

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    jojielyn.navarro
    The document contains forms and checklists used by Bannawag Elementary School for conducting home visitations. The forms collect information such as the student's name, address, birthdate, gender, contact details, reasons for absences, causes for potential dropping out, remarks and agreements made between parents/guardians and teachers. Signatures of parents/guardians and students are also required on the forms. The forms and checklists aim to understand factors affecting students' education through discussions during home visitations.

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

    Home Vistation Form

    Uploaded by

    jojielyn.navarro
    10 views4 pages
    The document contains forms and checklists used by Bannawag Elementary School for conducting home visitations. The forms collect information such as the student's name, address, birthdate, gender, contact details, reasons for absences, causes for potential dropping out, remarks and agreements made between parents/guardians and teachers. Signatures of parents/guardians and students are also required on the forms. The forms and checklists aim to understand factors affecting students' education through discussions during home visitations.

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    home-vistation-form

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    The document contains forms and checklists used by Bannawag Elementary School for conducting home visitations. The forms collect information such as the student's name, address, birthdate, gender, contact details, reasons for absences, causes for potential dropping out, remarks and agreements made between parents/guardians and teachers. Signatures of parents/guardians and students are also required on the forms. The forms and checklists aim to understand factors affecting students' education through discussions during home visitations.

    Copyright:

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

    Home Vistation Form

    Uploaded by

    jojielyn.navarro
    The document contains forms and checklists used by Bannawag Elementary School for conducting home visitations. The forms collect information such as the student's name, address, birthdate, gender, contact details, reasons for absences, causes for potential dropping out, remarks and agreements made between parents/guardians and teachers. Signatures of parents/guardians and students are also required on the forms. The forms and checklists aim to understand factors affecting students' education through discussions during home visitations.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 4

    Republic of the Philippines

    Department of Education
    REGION II – CAGAYAN VALLEY
    SCHOOLS DIVISION OF SANTIAGO CITY
    BANNAWAG ELEMENTARY SCHOOL
    P3, BANNAWAG NORTE, SANTIAGO CITY
    CHECKLIST FOR HOME VISITATION 9. How do you see him / her as a pupil?
    ______Fair _____Good _____Very Good
    Name of Pupil: ________________________________________________ 10. Do you have a regular job?
    Parent/Guardian: _____________________________________________ _____Yes _____No
    Date: _______________________________________________________ If Yes, please specify ___________________________________________

    Check the _____ which corresponds to the parent’s/ guardian’s answer. Remarks:
    ____________________________________________________________
    1. What is the first thing that your child does after class? ____________________________________________________________
    _____Assignment _____Play/watch TV ____Home chores ____________________________________________________________
    Other, please specify _____________________________________
    2. What time does he/she sleep? ___________________________
    _____ 9 and beyond _____ not later than 11 Parent’s / Guardian’s Signature
    3. Do you ask him/her about school or check his/her assignment?
    _____Yes _____No _____Sometimes
    4. Who helps him/her on his /her assignment? ___________________________
    _____Father _____Mother _____Siblings Adviser
    Other, please specify _____________________________________
    5. On weekends, do you check his/her notes?
    _____Yes _____No _____Sometimes
    6. How is he/she as a son/daughter?
    ______Fair _____Good _____Very Good
    7. How is his/her relationship with his /her siblings?
    ______Fair _____Good _____Very Good

    8. Does he/she have a regular playtime?


    _____Yes _____No

    Bannawag Elementary School


    Address: Purok 3, Bannawag Norte, Santiago City
    Email: 103836@deped.gov.ph
    Republic of the Philippines
    Department of Education
    REGION II – CAGAYAN VALLEY
    SCHOOLS DIVISION OF SANTIAGO CITY
    BANNAWAG ELEMENTARY SCHOOL
    P3, BANNAWAG NORTE, SANTIAGO CITY
    HOME VISITATION FORM
    S.Y._________

    Name of Student: LRN: Grade Level/Section: ____________________

    Address: ________________________________Birthday: Gender: _______ Age: ____ Contact: ____________

    Name of Parent/ Reasons/Causes of Parent’s/Guardian’s Student’s


    Date of Visit Guardian Absences ___ for Remarks/Agreement Signature Over Signature Over
    Dropping Out ___ Printed Printed
    ○ Sickness ○ Truancy
    ○ Home Chores ○ Indifference
    ○ Employment ○ Classroom Atmosphere
    ○ Family Problems ○ Distance of Home
    ○ Lack of Interest ○ Hunger/Malnutrition
    ○ Parents attitude ○ Had to take care of siblings
    towards schooling ○ Teacher Factor

    ○ Sickness
    ○ Home Chores ○ Truancy
    ○ Employment ○ Indifference
    ○ Family Problems ○ Classroom Atmosphere
    ○ Lack of Interest ○ Distance of Home
    ○ Parents attitude ○ Hunger/Malnutrition
    towards schooling ○ Had to take care of
    siblings
    ○ Teacher Factor

    Bannawag Elementary School


    Address: Purok 3, Bannawag Norte, Santiago City
    Email: 103836@deped.gov.ph
    Republic of the Philippines
    Department of Education
    REGION II – CAGAYAN VALLEY
    SCHOOLS DIVISION OF SANTIAGO CITY
    BANNAWAG ELEMENTARY SCHOOL
    P3, BANNAWAG NORTE, SANTIAGO CITY
    Name of Parent/ Reasons/Causes of Parent’s/Guardian’s Student’s
    Date of Visit Guardian Absences ___ for Remarks/Agreement Signature Over Signature Over
    Dropping Out ___ Printed Printed
    ○ Sickness ○ Truancy
    ○ Home Chores ○ Indifference
    ○ Employment ○ Classroom Atmosphere
    ○ Family Problems ○ Distance of Home
    ○ Lack of Interest ○ Hunger/Malnutrition
    ○ Parents attitude ○ Had to take care of siblings
    towards schooling ○ Teacher Factor

    ○ Sickness
    ○ Home Chores ○ Truancy
    ○ Employment ○ Indifference
    ○ Family Problems ○ Classroom Atmosphere
    ○ Lack of Interest ○ Distance of Home
    ○ Parents attitude ○ Hunger/Malnutrition
    towards schooling ○ Had to take care of
    siblings
    ○ Teacher Factor

    Prepared by:
    Noted:
    ___________________________
    _______________________________ Teacher
    Principal/Guidance Counselor

    Bannawag Elementary School


    Address: Purok 3, Bannawag Norte, Santiago City
    Email: 103836@deped.gov.ph
    Republic of the Philippines
    Department of Education
    REGION II – CAGAYAN VALLEY
    SCHOOLS DIVISION OF SANTIAGO CITY
    BANNAWAG ELEMENTARY SCHOOL
    P3, BANNAWAG NORTE, SANTIAGO CITY

    Bannawag Elementary School


    Address: Purok 3, Bannawag Norte, Santiago City
    Email: 103836@deped.gov.ph

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