Guidance forms

1. FORM 1:
__________________________________________________________________________________________________
Pupil’s Profile
Name : ____________________________________________________________________________
(Last Name, First Name, Middle Name, Extension Name)
Birthday : __________________________________________________ Age : _______________
Birthplace: __________________________________________________________________________
Religion : ___________________________________________________________________________
Address : __________________________________________ _________________________________
Barangay : ___________________________________________________________________________
Father’s name : ______________________________________________________________________
(Last Name, First Name, Middle Name, Extension Name)
Educational Attainment: (Please check) ______Elementary ______ High School _______ College
Occupation : __________________________________ Contact no. : ___________________________
Mother’s name (before marriage) : ____________________________________ ____________________
(Last Name, First Name, Middle Name, Extension Name)
Educational Attainment: (Please check) ______Elementary ______ High School ___/___ College
Occupation : ________________________________Contact no. : _____________________________
Guardian’s name : _____________________________________________________________________
(If not with parents) (Last Name, First Name, Middle Name, Extension Name)
Contact no. : _______________________________________________
Date of entry (Grade IV) : ___________________________________________________________________
4Ps / CCT recipient - Yes _______ No __________
Pasolo Road, Pasolo
Valenzuela City
Telefax: 293-30-83
Email:pasolo.elementaryschool@gmail.com
Division of City Schools – Valenzuela
Valenzuela North District
PASOLO ELEMENTARY SCHOOL

2. FORM 2:
__________________________________________________________________________________________________
ANECDOTAL RECORDS
Teacher/Observer:__________________________________________ ObservationTime:_______________________
ObservationDate:________________________
StudentName:________________________________________________
Descriptionof the incident:____________________________________________________________________________
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Descriptionof the location/setting:___________________________________________________________________
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Recommendation/Actions: ____________________________________________________________________________
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__________________________________________________________________________________________________
_________ __________________
Guidance Coordinator
Pasolo Road, Pasolo
Valenzuela City
Telefax: 293-30-83
Email:pasolo.elementaryschool@gmail.com
Division of City Schools – Valenzuela
Valenzuela North District
PASOLO ELEMENTARY SCHOOL

3. FORM 2:
__________________________________________________________________________________________________
ANECDOTAL RECORDS
Guro/Observer:____________________________________________ Oras:____________ ______________________
Petsa:__________________________________
Pangalanng Mag-aaral:________________________________________________
Mga Pangyayari:____________________________________________________________________________
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Paglalarawan saLugar at Tagpuan:___________________________________________________________________
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RekomendasyonatAksyon: ___________________________________________________________________________
__________________________________________________________________________________________________
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__________________________________________________________________________________________________
__________________________________________________________________________________________________
_________ __________________
Guidance Coordinator
Pasolo Road, Pasolo
Valenzuela City
Telefax: 293-30-83
Email:pasolo.elementaryschool@gmail.com
Division of City Schools – Valenzuela
Valenzuela North District
PASOLO ELEMENTARY SCHOOL

4. FORM 4:
________________________________________________________________________
HOME VISITATION FORM
Name of Student___________________________. LRN ___________________Grade/Section _____________
Address____________________________________Birthday________________Gender___________ Age _______
Name of Father________________________________ Contact Number___________________________________
Name of Mother ______________________________ ContactNumber___________________________________
REASON FOR HOME VISITATION:
___________________________________________________________________________________________
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REMARKS/AGREEMENT:
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_________________________________________________________________________________________
_________________________________ ________________________________
PARENT’S SIGNATURE OVER PRINTED NAME STUDENT’S SIGNATURE OVER PRINTED NAME
Notedby:
_________________________
Guidance Teacher
Preparedby:
_____________________
Adviser
APPROVED:
________________________________
Guidance Coordinator
Division of City Schools – Valenzuela
Valenzuela North District
PASOLO ELEMENTARY SCHOOL
Pasolo Road, Pasolo
Valenzuela City
Telefax: 293-30-83
Email:pasolo.elementaryschool@gmail.com

5. FORM 4:
________________________________________________________________________
HOME VISITATION FORM
Pangalanng Mag-aaral_________________________. LRN ___________________Baitang/Pangkat:_____________
Tirahan____________________________________Kaarawan_______________Kasarian______________Edad _______
Pangalanng Ama________________________________ Contact Number___________________________________
Pangalanng Ina__________________________________Contact Number___________________________________
MGAKADAHILAN NG PAGBISITA SA MAG-AARAL:
___________________________________________________________________________________________
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KASUNDUANNG MGA MAGULANG NG MAG-AARAL AT GURONG TAGAPAMATNUBAY:
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_________________________________ ________________________________
PANGALAN NG MAGULANG/LAGDA PANGALAN NG BATA
Inihandani:
___________________________
Gurong Tagapayo
BinigyangPansin:
____________________________________
Guidance Coordinator
Division of City Schools – Valenzuela
Valenzuela North District
PASOLO ELEMENTARY SCHOOL
Pasolo Road, Pasolo
Valenzuela City
Telefax: 293-30-83
Email:pasolo.elementaryschool@gmail.com

6. FORM 5:
________________________________________________________________________
PROMISSORY NOTE
__________________
Petsa
Sa Kinauukulan,
Akosi _____________________________________, Baitang______ Pangkat____________________ na
(Pangalan ng Mag-aaral)
nasa ilalimngpamamahalani _____________________________________________ ay nangangakona hindi namuling
( Guro)
__________________________________________________________________________________________________
__________________________________________________________________________________________________
(Mga Pagkakamaling Nagawa / Kahinaan ng Bata)
at ________________________________________________________________________________________________
__________________________________________________________________________________________________
(Mga pangakong gagawin/Mga pagbabago)
___________________ ______________________
Pangalanng Magulang Pangalan ng Mag-aaral
_____________________
Gurong Tagapamatnubay
Binigyang – pansin:
___________________________
Guidance Coordinator
Division of City Schools – Valenzuela
Valenzuela North District
PASOLO ELEMENTARY SCHOOL
Pasolo Road, Pasolo
Valenzuela City
Telefax: 293-30-83
Email:pasolo.elementaryschool@gmail.com

7. FORM 6:
_____________________________________________________________________
REFERRAL SLIP
___ ______________
Date
To the Guidance Coordinator,
Please interview _____________________________________________Grade_____ Section____________.
Chief reason/s for interview_______________________________________________________________________.
Interviewrequested by:
__________________________
Adviser
FORM 6:
_____________________________________________________________________
RETURN SLIP
_______________
Date
____________________________,
Interview with __________________________________________ will be on ________________________ at
__________________.Please send the above child with his/her parent/s to the Guidance Office on time.
__________________________
School Guidance Coordinator
Division of City Schools – Valenzuela
Valenzuela North District
PASOLO ELEMENTARY SCHOOL
Pasolo Road, Pasolo
Valenzuela City
Telefax: 293-30-83
Email:pasolo.elementaryschool@gmail.com
Division of City Schools – Valenzuela
Valenzuela North District
PASOLO ELEMENTARY SCHOOL
Pasolo Road, Pasolo
Valenzuela City
Telefax: 293-30-83
Email:pasolo.elementaryschool@gmail.com