EBROBILLOS

FORM 4: LAC ENGAGEMENT REPORT

This form should be accomplished by each LAC Member at the end of every LAC session.

NAME OF MEMBER: LAC SESSION ID.:

REGION: DATE OF LAC SESSION:

DIVISION: NUMBER OF LAC SESSION:

Part A
Please indicate the extent to which you agree with each of the following statements by
ticking
the appropriate box. (SD = Strongly Disagree; D = Disagree; N = Neutral; A = Agree; SA =
Strongly agree)

Comments / Remarks
(For example, if you disagree
or strongly disagree, please
SD D N A SA indicate why.)

THE LAC SESSION

1. I learned a lot from my √

colleagues in this LAC session.

2. The LAC session deepened √

my understanding of the SLM
content.

3. My perspective on the topic/s √

covered has changed as a
result of the LAC session.

4. I participated actively in the √

LAC session by sharing my
assignment and insights,
asking questions, and giving
feedback on what colleagues
shared.

5. I interacted with different √

 people during the LAC
session.

ACTION PLAN

6. I feel motivated to apply in √

my region/division/district
what I have learned in this
lesson.

7. I intend to apply what I have √

learned from the lesson in my
region/division/district

Part B
Please provide the information requested.

1. I need further clarification and/or resources on the following topics:

LDM and SLM

2. I encountered the following problems or challenges:

On accomplishing the LDM due to time constraint

3. Other comments/suggestions:

Please provide more discussions about this LDM module 1 √