Senior High School

Physical and Health Education

HOPE 1 Exercise for Fitness – Green Form

AY 2022-2023

I. PROFILE

NAME STRAND & SECTION

FIRST NAME/S, MIDDLE NAME, LAST NAME

ADVISER/EMAIL ADDRESS ROOM NO.

FIRST NAME/S, MIDDLE NAME, LAST NAME
PERSON TO CONTACT IN CASE OF EMERGENCY NICKNAME
Name/Relation:
Email Address: Most Recent Photo
(REQUIRED)
Contact No: Insert Within The box Size

II. COURSE ASSESSMENTS / GRADING PERCENTAGE

FORMATIVE ASSESSMENTS
WRITTEN [Activity Title] [Activity Title] [Activity Title] [Activity Title] [Activity Title] Total Score
Date
Score
00/00/00
/
00/00/00
/
00/00/00
/
00/00/00
/
00/00/00
/
/ PARENT’S SIGNATURE OVER PRINTED NAME
Date: 00/00/00 Time: 00:00
PERFORMANCE [Activity Title] [Activity Title] [Activity Title] [Activity Title] [Activity Title] Total Score
Date
Score
00/00/00
/
00/00/00
/
00/00/00
/
00/00/00
/
00/00/00
/
/ To be SIGNED+SUBMITTED after recording the total SCORES.

Mx. Jemmar Azucena

HOPE 3 Curriculum Designer
 SUMMATIVE ASSESSMENTS
WRITTEN Knowledge & Understanding Test Core Values Reflections Total Score
Process Test (Guided Generalization) (Cinquain Poems)
PARENT’S SIGNATURE OVER PRINTED NAME
Date 00/00/00 00/00/00 00/00/00 20 % / Date: 00/00/00 Time: 00:00
Score 00/30 00/44 000/280
PERFORMANCE Performance Task 1 Performance Task 2 Performance Task 3 Total Score To be SIGNED+SUBMITTED after recording the total SCORES.
50%
Date
Score
00/00/00
00/20
00/00/00
00/20
00/00/00
00/20
/

TRIMESTRAL EXAM: 30% HOPE Fest 2023

Date: 12/07/22
Event Director’s Rating: 00/20 PARENT’S SIGNATURE OVER PRINTED NAME
Time: 02:00 pm Teacher’s Rating: 00/20 Date: 00/00/00 Time: 00:00
(Tentative) Total Rating: 00/40
To be SIGNED+SUBMITTED after recording the total SCORES.

NOTE THAT:
 You are to comply and/or submit this Green Form at the end of the session or sessions.
 This will help you self-assess, keep track, and reflect on your PERFORMANCE in the course.
 Your scores in the Formative Assessments are NOT part of the final grade. However, the acquisition of correct concepts is CRITICAL to your Written Summative Assessments, and the
mastery of skills is CRITICAL to Performance Summative Assessments.
 You are ENCOURAGED to aim for high scores and/or ace the assessments in the Summative Assessments. Given that, in the Formative Assessments, feedforward will be actualized
every session, to monitor your progress in improving your performance, and your goal of mastering the essentials before taking the Performance Summative Assessments.
 For the Parents/Guardians’ reference of your performance in the course, you are required to have this Green Form SIGNED/SUBMITTED thrice; (1) after taking the Formative
Assessments, (2) after taking the Summative Assessments, and (3) after successfully engaging to the Trimestral Exam.
 You can raise your concern/s directly/discreetly to the Teacher during In-Person sessions, and STRICTLY to the Class President and/or Vice-President in Asynchronous mode.
 Instances that violate Plagiarism, Data Privacy, Bullying, Cyberbullying, Academic Integrity (Cheating), and the like will be sanctioned and dealt with accordingly.
 In Basic Education, CHARACTER FORMATION is one of the most valuable learning outcomes in DLSU-IS SHS Manila and it is channeled through course reflections.

III. ATTENDANCE & REFLECTION

Mx. Jemmar Azucena

HOPE 3 Curriculum Designer
 Week 1 Week 2 Week 3 Week 4
CINQUAIN POETRY Topic: Topic: Topic: Topic:
WRITING Date: Date: Date: Date:

An unrhymed poem consisting of five Line 1 Line 1 Line 1 Line 1

lines arranged in a special way. Line 2 Line 2 Line 2 Line 2
Line 3 Line 3 Line 3 Line 3
LINE 1 Line 4 Line 4 Line 4 Line 4
One broad term that describes the Line 5 Line 5 Line 5 Line 5
topic.
Week 5 Week 6 Week 7 Week 8
Topic: Topic: Topic: Topic:
LINE 2 Date: Date: Date: Date:
Two vivid adjectives that describe
the topic. Line 1 Line 1 Line 1 Line 1
Line 2 Line 2 Line 2 Line 2
LINE 3 Line 3 Line 3 Line 3 Line 3
Three interesting gerunds “ing” Line 4 Line 4 Line 4 Line 4
or action verbs that fit the topic. Line 5 Line 5 Line 5 Line 5

Week 9 Week 10 Week 11 Week 12

LINE 4 Topic: Topic: Topic: Topic:
A four-word phrase that captures Date: Date: Date: Date:
the feeling or a reflection about
your EXPERIENCE that speaks of Line 1 Line 1 Line 1 Line 1
one Lasallian Values. Line 2 Line 2 Line 2 Line 2
(Faith, Service, Communion) Line 3 Line 3 Line 3 Line 3
Line 4 Line 4 Line 4 Line 4
LINE 5 Line 5 Line 5 Line 5 Line 5
A specific term that explains
Week 13 Week 14
LINE 1
Topic: Topic:
Date: Date:
______________________
Sample Cinquain Poem Line 1 Line 1
Darius Joseph Diamante Line 2 Line 2
1 St. Bellarmine I AY 2011-2012
Ateneo de Davao High School Line 3 Line 3
Line 4 Line 4
Topic: Sports Line 5 Line 5

Champion.
Dynamic, fair.
Encouraging, leading, teaching.
Work hard for honor.
Leader.

STRICTLY submit a 3-page PDF file.

Mx. Jemmar Azucena

HOPE 3 Curriculum Designer