Republic of the Philippines

Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF ZAMBALES
SAN AGUSTIN HIGH SCHOOL
SAN AGUSTIN, CASTILLEJOS, ZAMBALES

FACE TO FACE LEARNING MODALITY

SURVEY FORM

Ang pamunuan ng San Agustin High School ay kasalukuyang nangangalap ng impormasyon patungkol sa
Face to face learning modality. Gusto naming marinig ang inyong saloobin ukol dito.

Pangalan ng magulang o tagapagalaga:

Address: Contact Number:

Pangalan ng (mga) anak: Baitang

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Kung sakaling pahintulutan ang Magkaharap na Pag-aaral ( face to face ),

pumapayag ka ba na dumalo/pumunta sa ganitong klase o paraan ng pagtuturo Oo Hindi
ang iyong (mga) anak?
Kung ang iyong sagot ay Hindi, pakisuyong pumili ng isa lamang pangunahing dahilan na nasa
ibaba o isulat ang iyong dahilan ng hindi pagpapahintulot.
Takot o pangambang mahawaaan ng virus na Covid-19.

Kasalukuyang may karamdaman or mahinang kalusugan.

Iba pang kadahilanan (sabihin ang dahilan)

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SCHOOL SAFETY ASSESSMENT TOOL (2021)

FOR THE PILOT FACE TO FACE LEARNING MODALITY
 SURVEY FORM
We are currently conducting an extensive assessment on the face-to-face learning modality. We want to make our
decisions based on information and feedback from the school community. We like to hear what you think!