Year & SEM: _____________________ Name of counselor: ___________ counselor ph.

No:____________________

S.No Roll No Name of the Dates of the Attendance No of Active Backlogs Whether the What Action plan Student
Student counseling (%) in the cumulative year information of backlogs taken by the Signature
conducted with subjects is conveyed to parents counselor regarding
(1&2) through message/Call/ backlogs
Letter/ E-Mail
Yes/No
1

Signature:
 Year & SEM: _____________________ Name of counselor: ___________ counselor ph.No:____________________

S.No Roll No Name of the Dates of the Attendance No of Active Whether the information What Action plan Student
Student counseling (%) Backlogs in the of backlogs is conveyed taken by the Signature
conducted cumulative year to parents through counselor regarding
(1&2) with subjects message/Call/ Letter/ backlogs
E-Mail
Yes/No
9

10

11

12

13

14

15

16

Signature:
 Year & SEM: _____________________ Name of counselor: ___________ counselor ph.No:____________________

S.No Roll No Name of the Dates of the Attendance No of Active Whether the information of What Action Student
Student counseling (%) Backlogs in the backlogs is conveyed to parents plan taken by the Signature
conducted cumulative year through message/Call/ Letter/ counselor
with subjects E-Mail regarding
Yes/No backlogs
17

18

19

20

Signature: