Republic of the Philippines

Department of Education
Region VI – Western Visayas
Division of Iloilo
MIAGAO NATIONAL HIGH SCHOOL

ANECDOTAL REPORT

Name Student Observed:___________________________________Grade & Section: ________

Teacher-Observer: __________________________ Adviser: ____________________________
Date Observed: _______________ Time: _____________ Place: _________________________

What behaviour was manifested/observed?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________

How did the observer/others responded/reacted to the manifested behaviour?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How did the person being observed responded/reacted to others?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Recommendation:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

__________________________
Name and Signature of Observer

Guidance and Counseling Office

Miagao National High School
Address: Brgy. Igtuba, Miagao, Iloilo
Telephone No.: (033) 315-9477; 327-1865
E-mail: 302531@deped.gov.phꟾ mnhs.mail@gmail.com