TIP Form 3-1

Republic of the Philippines

Department of Education
Region VI-Western Visayas
SCHOOLS DIVISION OFFICE OF CAPIZ
District: _________________________________________________
School: __________________________________________________

Year 1
First Quarter Second Quarter Third Quarter Fourth Quarter
Module 1 Module 2 Module 3 Module 4 Module 5 Module 6

Instructional Instructional Instructional Instructional Instructional Instructional Instructional Date of Evaluation

Supervision Supervision Date of Formal Supervision Supervision Date of Formal Supervision Supervision Date of Formal Supervision
Name of Newly-hired Teacher
Employed / Observation Remarks
Classroom Remarks
Employed / Observation Remarks
Classroom Classroom of Newly-hired
Employed / Employed / Employed / Observation Employed / Employed /
Date Date Teacher
Date Date Date Date Date

1
2
3
4
5
6
7
8
9
10

Prepared by: Noted by: Approved:

___________________________________________ __________________________________ _________ ______________________________________
(Signature over printed name of Coordinator/Mentor/School Head) (Signature over printed name School Head/Principal) (Signature over printed name of PSDS)
 TIP Form 3-2

Republic of the Philippines

Department of Education
Region VI-Western Visayas
SCHOOLS DIVISION OFFICE OF CAPIZ
School: __________________________________________________

Year 2
First Quarter Second Quarter Third Quarter Fourth Quarter

Instructional Instructional Instructional Date of

Instructional Date of Formal Supervision Date of Formal Supervision Date of Formal Supervision Evaluation of
Name of Newly-hired Teacher Supervision Classroom Remarks Classroom Remarks Classroom Remarks
Employed / Employed / Employed / Newly-hired
Employed / Date Observation Date Observation Date Observation Date Teacher

8
9
10

Prepared by: Noted by: Approved:

___________________________________________ ______________________________________ ______________________________________

(Signature over printed name of Coordinator/Mentor/School Head) (Signature over printed name of School Head) (Signature over printed name of PSDS)
 TIP Form 3-3

Republic of the Philippines

Department of Education
Region VI-Western Visayas
SCHOOLS DIVISION OFFICE OF CAPIZ
School: __________________________________________________

Year 3
First Semester Second Semester

Instructional
Instructional Date of Formal Date of Formal Date of
Name of Newly-hired Teacher Supervision Classroom Remarks Supervision Classroom Remarks Completion of
Employed /
Employed / Date Observation Observation the Program
Date

8
9
10

Prepared by: Noted by: Approved:

___________________________________________ ______________________________________ ______________________________________

(Signature over printed name of Coordinator/Mentor/School Head) (Signature over printed name of School Head) (Signature over printed name of PSDS)