Republic of the Philippines

Department of Education
Caraga Region
SCHOOLS DIVISION OF SURIGAO DEL SUR

TECHNICAL ASSISTANCE FEEDBACK FORM

Name of Instructional Coach: _____________________________________________________________________

The Division Office through the School Management Monitoring and Evaluation would like to invite you to
take a moment to complete this evaluation tool. Your feedback will offer improvement in the future conduct of the
Division training and conferences.
Thank you for your active participation.

1. At a rate of 1 to 4 (where 4 is the highest), please indicate your overall satisfaction with this Learning Action
Cell Activity. Encircle the number only.

Strongly Strongly
No Item Statements Agree Disagree
Agree Disagree
Technical Assistance (TA) provided is
1 4 3 2 1
very relevant and appropriate
The TA provider expounds well and clarify
2 issues and concerns raised by the 4 3 2 1
participants
The TA Provider is skillful/competent
3 4 3 2 1
enough to provide the TA needed
The provision of TA runs within the time
4 4 3 2 1
allotment
The activity/ learning engagement
5 4 3 2 1
employs adult learning approach

What is the extent of the Technical Assistance (TA) provided?

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Other Comments

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________
Balilahan, Mabua, Tandag City, Surigao del Sur, 8300
(086) 211-3225
surigaodelsur.division@deped.gov.ph
ISO Cert. No. AW/PH909100102