Republic of the Philippines

Department of Education
REGION VIII
SCHOOLS DIVISION OF EASTERN SAMAR
____________ ________________________________________________

Enclosure No. 3 to Div. Memo No. ___, s. 2020

_________________________________________________________________
School
___________________________________________
School Address
PARENTS MONITORING TOOL FOR LEARNER’S LEARNING OUTPUT

Name of Student: ___________________________ Address : ____________________________________________________________

Grade & Section: ____________________________ Name of Adviser & contact Number: _____________________________________
Instruction: Kindly fill in the corresponding columns with a check (/) mark and (X) mark to indicate the STUDENT LEARNING MODULE you
received and returned.
Legend : / - module received , X – module returned

Date Received ENG SCI MATH FIL AP TLE MAPEH ESP Date Returned Name of Distributor Signature Name of Receiver Signature

Address: Barangay Alang-alang, Capitol Site, Borongan City 6800, Eastern Samar
Email Add: eastern.samar@deped.gov.ph
Address: Barangay Alang-alang, Capitol Site, Borongan City 6800, Eastern Samar
Email Add: eastern.samar@deped.gov.ph