Republic of the Philippines

Department of Education
Region VI – Western Visayas
SCHOOLS DIVISION OF HIMAMAYLAN CITY
Himamaylan City, Negros Occidental
TALABAN ELEMENTARY SCHOOL

FEEDBACK FORM
Date:_______

Name of Parent: ________________________________ Grade: ___

Name of Pupil: _____________________________ Section:________

A . Describe Your Feedback:

B .Questions/Queries: C . Answer:

__________________________ ____________________________
Parents Name and Signature Name of Teacher

NOTED:

WENDEL B. DERUBIO
Head Teacher -III