Sample Anecdotal Record

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Sample Anecdotal Record

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AGUSAN NATIONAL HIGH SCHOOL

SHS Department
T. Sanchez St., Butuan City ANHSSHSGC Form
Guidance Center

Anecdotal Record

NAME OF STUDENT:____________________________________________________
GRADE & SECTION________________________________________________________

Date & Place Observed Behavior Action Taken Observer

Time

Comments/Observations:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Prepared by:

______________________________________ _______________
Signature over Printed Name Date

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