Division of City Schools

HOME VISITATION REPORT

Date: ______________
Dear Parent/s:
I have found the following problems/potentials with your son/daughter
Name of Pupil: ____________________________________
Problems;
( ) always absent in the class
( ) always backfighting/quarrelling with her/his peers
( ) not listening to the class
( ) always late in coming to school
( ) not attending the flag ceremony
( ) escaping from the class
( ) problem in reading both English and Filipino

Potentials;
( ) well-behaved and friendly
( ) clean and neat/properly well-groomed
( ) honest
( ) industrious
( ) always participated in all activities in school
( ) always participated in class recitation
( )has potential in becoming a leader someday

Very truly yours,

___________________________
Teacher
Please check the box:
( ) I promise to follow-up my son/daughter for her/his improvement
( ) I’m happy that my son/daughter has a potential/s as indicated above I will always
follow-up him/her. Thank you.

___________________________
Name and Signature of Parent