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Republic of the Philippines

Division of Camarines Sur


ROLANDO R. ANDAYA SR. MEMORIAL HIGH SCHOOL
Bahay, Pasacao ,Camarines Sur
____________________________________________________
ANECDOTAL RECORD

Name of Student: __________________________________ Date: ____________________

Evaluator/Observer: ___________________________________________________________

Setting (place, people involved, atmosphere, etc):


 ___________________________________________________________________
______
 ___________________________________________________________________
______
 ___________________________________________________________________
______
Student’s Action or Behavior:
 ________________________________________________________________________
 ________________________________________________________________________
 _________________________________________________________________________
 _________________________________________________________________________
 _________________________________________________________________________
 ________________________________________________________________________
Evaluator’s Interpretation:
 _______________________________________________________________________
 _______________________________________________________________________
 _______________________________________________________________________
Student’s Comments:
 _______________________________________________________________________
 ________________________________________________________________________
 ________________________________________________________________________
 ________________________________________________________________________
 ________________________________________________________________________
 _______________________________________________________________________

Evaluator’s/Student Agreement:
 _______________________________________________________________________
 _______________________________________________________________________

Student’s Signature: _________________Evaluator’s Signature:______________________

Parent’s Comment:
 ________________________________________________________________________
 ________________________________________________________________________
 ________________________________________________________________________

Parent’s Signature: __________________________________________________________

Republic of the Philippines


Division of Camarines Sur
ROLANDO R. ANDAYA SR. MEMORIAL HIGH SCHOOL
Bahay, Pasacao ,Camarines Sur
____________________________________________________
ANECDOTAL RECORD
SARDO’S (STUDENT AT RISK OF DROPPING OUT)

Name of Student’s Reason for Absent Date/Time Student’s Parent’s


Signature Signature
Republic of the Philippines
Division of Camarines Sur
ROLANDO R. ANDAYA SR. MEMORIAL HIGH SCHOOL
Bahay, Pasacao ,Camarines Sur
____________________________________________________
ANECDOTAL RECORD
SCHOOL UNIFORM VIOLATION

Name of Student’s Reason for Absent Date/Time Student Parent


Signature Signature

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