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Republic of the Philippines

Department of Education
Region VII, Central Visayas
Division of Dumaguete City
Camanjac National High School
Dumaguete City

FEEDBACK FORM

Date: ___________________

Name of teacher/adviser: _____________________________________

Are you a parent or student?

___ Parent/Guardian

___ Student

How satisfied were you with the service of your teacher/adviser?

____ (5) Highly satisfied

____ (4) Satisfied

____ (3) Moderately satisfied

____ (2) Dissatisfied

____ (1) Highly Dissatisfied

Please tell us the primary reason for leaving this rating:

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

_____________________________________

NAME AND SIGNATURE OVER PRINTED NAME

Tel. No. (035) 522-7673 Email: camanjacnhs@gmail.com


Republic of the Philippines
Department of Education
Region VII, Central Visayas
Division of Dumaguete City
Camanjac National High School
Dumaguete City

Tel. No. (035) 522-7673 Email: camanjacnhs@gmail.com

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