REPUBLIC OF THE PHILIPPINES
Department of Education
National Capital Region
SCHOOLS DIVISION OF TAGUIG CITY AND PATEROS
Maria Concepcion Cruz High School
Masikap Complex, Sta. Ana Pateros, Metro Manila
HOME VISITATION FORM
JUNIOR HIGH SCHOOL
Name of Learner:
LRN: Grade/Section:
Address: Gender:
Birthdate: Age:
Name of Father: Contact Number:
Name of Mother: Contact Number:
REASON FOR HOME VISITATION:
REMARKS/AGREEMENT:
PARENT’S SIGNATURE OVER STUDENT’S SIGNATURE OVER
PRINTED NAME PRINTED NAME
Noted:
MA. MAGDALENA P. CAMBALING
School Guidance Designate
Prepared by:
SHIRLEY M. CENDAÑA
Class Adviser
APPROVED:
JOSE MARK P. BOLIVAR
School Principal
REPUBLIC OF THE PHILIPPINES
Department of Education
National Capital Region
SCHOOLS DIVISION OF TAGUIG CITY AND PATEROS
Maria Concepcion Cruz High School
Masikap Complex, Sta. Ana Pateros, Metro Manila
STUDENT INCIDENT REPORT
Student Name: Adviser:
Reported for:
As the section adviser of your son/daughter, I would like to inform you that since
_______________ your son/daughter ___________________ was observed to have more than
__________ absences. For mostly unknown reasons, when reprimanded, not only by the adviser
but subject teachers, he/she just listen and promise to change but later after the confrontation
he/she will go back to the ways of why she is always reprimanded. As the adviser, I talked and
convince him/her to attend classes and fix his/her grades but he/she doesn’t listen and give an
act to the problem.
As per advised by our guidance designate and prefect of discipline, we would like to
inform you about your child’s school behavior and be invited to come and visit our school. If
ever you have decided to come please do not hesitate to ask his/her section adviser
or call .
Thank you for your cooperation.
With respect,
Section Adviser
Date:
RECEIVED BY:
REPUBLIC OF THE PHILIPPINES
Department of Education
National Capital Region
SCHOOLS DIVISION OF TAGUIG CITY AND PATEROS
Maria Concepcion Cruz High School
Masikap Complex, Sta. Ana Pateros, Metro Manila
KASUNDUAN
Student Name: Adviser:
Reported for:
Ako si magulang ni na estudyante po sa
dito sa Maria Concepcion Cruz High School. Inimbitahan po
ako na dumalo sa paaralan kung saan nag-aaral ang aking anak upang pag-usapan ang mga
problema pang-akademiko at mga posibleng solusyon sa mga ito.
Sa aming pag-uusap ay napagkasunduan naming na:
1. Ang aking anak ay sa Maria Concepcion Cruz High School sa
kadahilanang
Ang mga ito ay akin pong lubos na naiintindihan at sumasang-ayon sa mga napagkasunduang
hakbang at dapat gawin ng aking anak sa paaralan.
Lagda
Magulang
Petsa:
REPUBLIC OF THER PHILIPPINES
Department of Education
National Capital Region
SCHOOLS DIVISION OF TAGUIG CITY AND PATEROS
Maria Concepcion Cruz High School
Masikap Complex, Sta. Ana Pateros, Metro Manila
FAILED LEARNERS’ AGREEMENT
Student Name: Adviser:
Reported for:
This is to advise that pursuant to the provisions of the Department of Education, learners who
have accumulated 20% of absences will be dropped from the class. Not to mention the cutting
classes and behavioural issues committed by the learner.
The teacher/section adviser is advised to inform and give action to such kind of behaviour.
Subject teachers and other concerned personnel is hereby informed that the above named
learner is NO LONGER IN SCHOOL since .
Conformed by:
Filipino Edukasyon sa Pagpapakatao
English Araling Panlipunan
Mathematics Music, Arts, Physical Education, & Health
Science Technology and Livelihood Education
NOTED BY:
MA. MAGDALENA P. CAMBALING ELOISA C. IMSON
Guidance Advocate Coordinator LIS/Grade 8 Level Coordinator
SHIRLEY M. CENDAÑA MIRIAM C. MABASA JOSE MARK P. BOLIVAR
Class Adviser Prefect of Discipline School Principal
