Republic of the Philippines

Department of Education
Division of General Santos City
Datu Andiam Manza National High School
Tinagacan, General Santos City

Name of Student:___________________ Year and Section________________________

Adviser:__________________________ Time and Date of Visit____________________

Kindly Check the choices below if he/she manifested the following:

Late submission of modules/answer sheets

Unsubmitted answer sheets

No output required by the teacher

Incomplete output

Others, (Please specify)____________________________________________

Adviser’s Expected Outcomes/Targets

________________________________________________________________________

Parent’s Remarks:

________________________________________________________________________

Adviser’s Remarks/Recommendations:

__________________________________________________________________________

Actual Results:

__________________________________________________________________________

________________________________ _____________________________
Parent’s /Guardian Name and Signature Adviser’s Name And Signature

Address:Barangay Tinagacan General Santos City

Telephone no: (083) 825-1691
Email: tinagacan.nhs@deped.gov.ph