BORANG PEMANTAUAN HIGHLY IMMERSIVE PROGRAMME (HIP)

FASA 2

1 Name of State

2 Name of PPD

3 Name of School

4 Name of Head Master

5 School enrolment

6 No of English Teachers

7 Total no of teachers

8 Level of Immersiveness

Tick to indicate

In class Out of Class Extra Class Outreach

Immersive activites conducted by

9
school

Fill in to complete

10 Title of activites

11 Objective of activites

All students/a specific group of students

12 Activity/ies suited for

No and percentage of students

13
involved

14 Outcomes of activities

Evidence of student participation in

language activity/Evidence of students
15 using language (oral or written form) -
all forms of audios videos and
pictures are accepted.

School Head Teachers Students Parents/Community

Describe role(s) of the above in the

16
activities conducted

SISC+ SIP+ FasiLinus

Contribution(s) of the above in

17
immersive activity

Outcomes of dialog prestasi at school

18 or district levels. sekolah/PPD. -
information from school head.
19 Success Stories
20 Name of Outreach partner

Evidence of student particiation / use

21
of language

Overall feedback of the Outreach

22
programme

Self Assessment Tool

Please fill in overall mean scores of the following

School Head Teachers Parents Students

OVERALL FEEDBACK

NAME OF OFFICER DATE OF VISIT

 BORANG PEMANTAUAN HIGHLY IMMERSIVE PROGRAMME (HIP)

FASA 1 19 APRIL HINGGA 6 MEI 2016

1 Name of State

2 Name of PPD

3 Name of School

4 Name of Head Master

5 School enrolment

6 No of English Teachers

7 Total no of teachers

8 Level of Immersiveness

Tick to indicate

In class Out of Class Extra Class Outreach

Immersive activites conducted by

9
school

Fill in to complete

10 Title of activites

11 Objective of activites

All students/a specific group of students

12 Activity/ies suited for

No and percentage of students

13
involved

14 Outcomes of activities

Evidence of student participation in

language activity / Evidence of
15 students using language (oral or
written form) - all forms of audios
videos and pictures are accepted.

School Head Teachers Students Parents/Community

Describe role(s) of the above in the

16
activities conducted

SISC+ SIP+ FasiLinus

Contribution(s) of the above in

17
immersive activity

Outcomes of dialog prestasi at school

18 or district levels. sekolah/PPD. -
information from school head.

19 Success Stories
20 Name of Outreach partner

Evidence of student particiation / use

21
of language

Overall feedback of the Outreach

22
programme

Self Assessment Tool

Please fill in overall mean scores of the following

School Head Teachers Parents Students

OVERALL FEEDBACK

NAME OF OFFICER DATE OF VISIT

 BORANG PEMANTAUAN HIGHLY IMMERSIVE PROGRAMME (HIP)

1 Name of State

2 Name of PPD

3 Name of School

4 Name of Head Master

5 School enrolment

6 No of English Teachers

7 Total no of teachers

8 Level of Immersiveness

Fill in to complete

In class Out of Class Extra Class Outreach

9 Name of actvitiy/ies

Fill in to complete

10 Objective of actvities

11 Description of actvities

Activity/ies suited for

12 (Fill in which level the activity is suited
for)

No and percentage of students

13
involved over total no of students

14 Outcomes of activities

Strategies to sustain actvity /ies

15 (how often is the actvity/ies
conducted)

School Head Teachers Students Parents/Community

Describe role(s) of the following

16 officers in HIP implementation in your
schools

SISC+ SIP+ FasiLinus

Describe the contribution of the

17 folowing officers in HIP
implementation in your schools

school Level District level State level

Outcomes of dialog prestasi /

18
performance dialogue on HIP

Descriptions of Success Stories on

HIP implementation (please provide
19
samples of report,photos in JPEG
and vidoes in MP4)
20 Name of Outreach partner

Title and description of Outreach

21
actvity

Outcomes of student participation/

22
use of language

Strategies to sustain actvity /ies

23 (how often is the actvity/ies
conducted)

Self Assessment Tool

Please fill in overall mean scores of the following

School Head Teachers Parents Students

OVERALL FEEDBACK BY OFFICER ON VISIT

NAME OF OFFICER DATE OF VISIT

 BORANG PEMANTAUAN HIGHLY IMMERSIVE PROGRAMME (HIP)

FASA 1 19 APRIL HINGGA 6 MEI 2016

1 Name of State

2 Name of PPD

3 Name of School

4 Name of Head Master

5 School enrolment

6 No of English Teachers

7 Total no of teachers

8 Level of Immersiveness

Tick to indicate

In class Out of Class Extra Class Outreach

Immersive activites conducted by

9
school

Fill in to complete

10 Title of activites

11 Objective of activites

All students/a specific group of students

12 Activity/ies suited for

No and percentage of students

13
involved

14 Outcomes of activities

Evidence of student participation in

language activity / Evidence of
15 students using language (oral or
written form) - all forms of audios
videos and pictures are accepted.

School Head Teachers Students Parents/Community

Describe role(s) of the above in the

16
activities conducted

SISC+ SIP+ FasiLinus

Contribution(s) of the above in

17
immersive activity

Outcomes of dialog prestasi at school

18 or district levels. sekolah/PPD. -
information from school head.

19 Success Stories
20 Name of Outreach partner

Evidence of student particiation / use

21
of language

Overall feedback of the Outreach

22
programme

Self Assessment Tool

Please fill in overall mean scores of the following

School Head Teachers Parents Students

OVERALL FEEDBACK

NAME OF OFFICER DATE OF VISIT

 BORANG PEMANTAUAN HIGHLY IMMERSIVE PROGRAMME (HIP)

FASA 1 19 APRIL HINGGA 6 MEI 2016

1 Name of State

2 Name of PPD

3 Name of School

4 Name of Head Master

5 School enrolment

6 No of English Teachers

7 Total no of teachers

8 Level of Immersiveness

Tick to indicate

In class Out of Class Extra Class Outreach

Immersive activites conducted by

9
school

Fill in to complete

10 Title of activites

11 Objective of activites

All students/a specific group of students

12 Activity/ies suited for

No and percentage of students

13
involved

14 Outcomes of activities

Evidence of student participation in

language activity / Evidence of
15 students using language (oral or
written form) - all forms of audios
videos and pictures are accepted.

School Head Teachers Students Parents/Community

Describe role(s) of the above in the

16
activities conducted

SISC+ SIP+ FasiLinus

Contribution(s) of the above in

17
immersive activity

Outcomes of dialog prestasi at school

18 or district levels. sekolah/PPD. -
information from school head.

19 Success Stories
20 Name of Outreach partner

Evidence of student particiation / use

21
of language

Overall feedback of the Outreach

22
programme

Self Assessment Tool

Please fill in overall mean scores of the following

School Head Teachers Parents Students

OVERALL FEEDBACK

NAME OF OFFICER DATE OF VISIT

BORANG RESPONDEN HIGHLY IMMERSIVE PROGRAMME (HIP)

RESPONDEN :
Tick to indicate your response to th
Items be

Not at all

There is an immersive English

1
environment in the school.

Students are given the opportunity to use

2
the language actively in school.

Weaker students are given the

3
opportunity to participate actively.

All members of the school are involved in

4
the activity/ies.

BORANG RESPONDEN HIGHLY IMMERSIVE PROGRAMME (HIP)

RESPONDEN :
Tick to indicate your response to th
Items be

Not at all

There is an immersive English

1
environment in the school.

Students are given the opportunity to use

2
the language actively in school.

Weaker students are given the

3
opportunity to participate actively.
 All members of the school are involved in
4
the activity/ies.

BORANG RESPONDEN HIGHLY IMMERSIVE PROGRAMME (HIP)

RESPONDEN :
Tick to indicate your response to th
Items be

Not at all

There is an immersive English

1
environment in the school.

Students are given the opportunity to use

2
the language actively in school.

Weaker students are given the

3
opportunity to participate actively.

All members of the school are involved in

4
the activity/ies.

BORANG RESPONDEN HIGHLY IMMERSIVE PROGRAMME (HIP)

RESPONDEN :
Tick to indicate your response to th
Items be

Not at all

There is an immersive English

1
environment in the school.

Students are given the opportunity to use

2
the language actively in school.
 Weaker students are given the
3
opportunity to participate actively.

All members of the school are involved in

4
the activity/ies.

BORANG RESPONDEN HIGHLY IMMERSIVE PROGRAMME (HIP)

RESPONDEN :
Tick to indicate your response to th
Items be

Not at all

There is an immersive English

1
environment in the school.

Students are given the opportunity to use

2
the language actively in school.

Weaker students are given the

3
opportunity to participate actively.

All members of the school are involved in

4
the activity/ies.
dicate your response to the statements below relating to the HIP activities
being carried out

Somewhat Mostly Fully Agree

dicate your response to the statements below relating to the HIP activities
being carried out

Somewhat Mostly Fully Agree

dicate your response to the statements below relating to the HIP activities
being carried out

Somewhat Mostly Fully Agree

dicate your response to the statements below relating to the HIP activities
being carried out

Somewhat Mostly Fully Agree

dicate your response to the statements below relating to the HIP activities
being carried out

Somewhat Mostly Fully Agree