Feedback Forms and Individual Monitoring Plan LEARNER'S FEEDBACK FORM

Name of Learner:______________________________________
FOR LEARNERS
Section: __________________________________________________
School: Abra High School Quarter: First

District: Bangued Week No.: 1

Instruction:
We want to hear from you to ensure the quality of your distance learning
experience. Please check one box per item with your honest answer.

On Weekly Learning Plan/Tasks

1. Did you read and understand the weekly learning Yes No

tasks carefully?

2. Were you able to understand and follow the Yes No

learning tasks easily?

On Learning Material/Content

1. Were you able to understand all the instructions Yes No

clearly?
2. Did you find all the activities suitable and easy to Yes No
understand?

3. Did you find the content/activities Yes No

interesting?

4. Did the activities help you understand the Yes No

lesson?

5. Did the learning material (video, module, e- Yes No

module) help you understand the lesson?

6. Did you accomplish all the tasks on the Yes No

given time?

On Parent's/Guardian's/Siblings' Support
 1. Were you guided by your parent/guardian/siblings Yes No FOR PARENTS
in accomplishing the activities?
INSTRUCTION TO PARENT/GUARDIAN
2. Did you find the help/assistance of you Yes No
parent/guardian/siblings important? Name of Parent/Guardian: Section:
___________________________________________________________
On Teachers' Support
School: Quarter:
1. Did you ask questions/clarifications/assistance from Yes No Abra High School, SHS First Quarter
your teacher through Text/Call/Messenger? District: Week:
Bangued 1
2. Did your teacher provided you help and assistance Yes No Dear Parents:
as needed?
This instruction form will serve as your guide in making the distance learning experience
3. Did your teacher provided you assistance in a Yes No of your child effective and well-delivered. Don’t hesitate to contact the teacher of your
friendly manner? child/ward if you have further questions or clarifications with this instruction.
On Post-Assessment
Instructions:
1. Did you find the questions suitable and easy to Yes No 1. Read and understand the instruction carefully.
understand?
2. After receiving/opening the learning package, check with your
2. What was your score in the post assessment? Yes No child/ward if it contains the following items:
Indicate the score over the item. (Example: 8/10)
a. instruction for the learner and parent;
b. list of learning package;
Others: Write any other comments, feedbacks or suggestions
below c. learning plan/task;
__________________________________________________________ d. printed modules for the week;
__________________________________________________________ e. flash drive containing the video/e-modules;
f. indicated filename of video module for the week;
g. activity/answer sheets as applicable (separate sheet of paper
may be required in answering activities in the module; and,
Signature of Learner: feedback forms for the learner and parent;
______________________________________ 3. With your child/ward, compare the items received with the list
Date Accomplished: of the learning package provided.
4. Together with your child/ward, read and understand the
learning task for the week as indicated in the learning plan.
5. Browse the part of the module and the content of the flash
drive together with your child/ward.
6. Guide your child in accomplishing the printed module. Open
the identified filename of the video as applicable. Assist your
child in playing/watching the video as necessary.
7. Assist your child in accomplishing the activities but let your child PARENTS' FEEDBACK FORM
answer independently.
8. Instill honesty to your child/ward by ensuring that he/she Name of Parent/Guardian:_________________________
answers first the activity/assessment before referring to the
Section of
answer key.
Child/Ward_______________________________
9. Call the teacher or send a message to the teacher for any School: Abra High School Quarter: First
questions/concerns.
District: Bangued Week No.: 1
10. Assist your child in answering the post assessment. If your child
gets lower than 80%, help the child go back to the specific
activity where he/she got wrong answers and go over the Instruction:
exercises/activities. We want to hear from you to ensure the quality of
the distance learning experience of your
11. Repack the accomplished modules with the answer sheet and child/ward. Please check one box per item with
all the contents of the learning package based on the list at the your honest answer
end of the week.
12. Hand over the accomplished learning package to the
designated messenger.
On Weekly Learning Plan/Tasks
We highly acknowledge your cooperation. Please be guided accordingly!
1. Did you read and understand the weekly learning Yes No
Name of Teacher: plan/tasks carefully?
Contact Number:
Email Address: 2. Were the instructions clear? Yes No
Messenger Account: 3. Did you help your child/ward understand the Yes No
weekly learning plan/tasks?

On Parents/Guardian/Siblings' Support

1. Were you or his/her siblings able to guide your Yes No

child/ward in accomplishing the activities as
needed?
2. Did you find the help/assistance you provided Yes No
important?

3. Did you provide conducive learning environment Yes No

to your child/ward?

4. Did you instill the value of independent learning to Yes No

your child as possible?

On Teachers' Support
1. Did you help your child/ward in asking Yes No
questions/clarifications/assistance from her/his
teacher through Text/Call/Messenger?

2. Were you satisfied with the help/assistance Yes No

provided by the teacher to your child/ward?

3. Were you satisfied with the attitude of the teacher Yes No

in providing the needed assistance to your
child/ward?
On Post-Assessment

1. Did your child observe honesty in answering the Yes No

assessment?

2. Were you satisfied with the score of your child in Yes No

the post assessment?

Others: Write any other comments, feedbacks or

suggestions below
__________________________________________________
_________________________________________________
__________________________________________________
__________________________________________________

Signature of Parent:
______________________________________
Date Accomplished:
_____________________________________