Republic of the Philippines

Department of Education
Caraga Region
SCHOOLS DIVISION OF SURIGAO DEL SUR
MARIHATAG DISTRICT

ANTIPOLO NATIONAL HIGH SCHOOL

Antipolo, Marihatag Surigao del Sur

DATA GATHERING TOOL FOR THE DISTRIBUTION AND RETRIEVAL OF PAG-ASA FOR GRADE 11
S.Y. 2020 – 2021

SEMESTER: ______ QUARTER NO. ______ SET: _______

No. Name of the Learner Date Received Signature Date Returned Signature
1
2
3
4
5
6
7
8
9
10
11
13
14

Prepared by:

JACQUILINE A. ABARCA Approved by:

Class Adviser MARISSA C. JALA
Head Teacher I