SALINAN

KAUNSELOR PELATIH

IK-PP05
Pensyarah Penyelia

PENILAIAN SAHSIAH DAN SIKAP

(PENSYARAH PENYELIA)
Nama Kaunselor Pelatih : ____________________________________________________________
No Matrik : _____________________________________

Jantina :L / P

Sekolah /Institusi :___________________________________________________________________

Tarikh : _________________________________ Masa : ____________________________
Sesi : ___________________________________ Penyeliaan :1/2/3
Pencapaian Sekarang :

Cemerlang

Baik

Sederhana

Lemah

Sangat Lemah

Ulasan Sahsiah dan Sikap dengan Pensyarah Penyelia dan Kaunselor Pembimbing:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Ulasan Sahsiah dan Sikap dengan Guru /Kakitangan/Pentadbir Sekolah/Institusi:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Ulasan Sahsiah dan Sikap dengan Klien /Pelajar/Kakitangan :
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Cadangan Penambahbaikan :
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

(
)
Tandatangan Pensyarah Penyelia
Cop:

Tarikh :__________________
** Untuk diserahkan kepada Kaunselor Pelatih

SALINAN
PENSYARAH PENYELIA

IK-PP05
Pensyarah Penyelia

PENILAIAN SAHSIAH DAN SIKAP

(PENSYARAH PENYELIA)
Nama Kaunselor Pelatih : ____________________________________________________________
No Matrik : _____________________________________

Jantina :L / P

Sekolah /Institusi :___________________________________________________________________

Tarikh : _________________________________ Masa : ____________________________
Sesi : ___________________________________ Penyeliaan :1/2
Pencapaian Sekarang :

Cemerlang

Baik

Sederhana

Lemah

Sangat Lemah

Ulasan Sahsiah dan Sikap dengan Pensyarah Penyelia dan Kaunselor Pembimbing:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Ulasan Sahsiah dan Sikap dengan Guru /Kakitangan/Pentadbir Sekolah/Institusi:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Ulasan Sahsiah dan Sikap dengan Klien /Pelajar/Kakitangan :
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Cadangan Penambahbaikan :
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

(
)
Tandatangan Pensyarah Penyelia
Cop:

Tarikh: __________________
** Untuk diserahkan kepada Kaunselor Pelatih