This Form Should Be Accomplished by The LAC Facilitator and Its Members at The First LAC Session

Republic of the Philippines
Department of Education
Region VIII
Schools Division of Leyte
BATO NATIONAL HIGH SCHOOL

Bato, Leyte
FORM 1: LAC PROFILE
This form should be accomplished by the LAC Facilitator and its members at the first LAC
session.
REGION: VIII
LAC ID (name or number): Number of LAC members:
Name of LAC Facilitator: PAZ S. DELEN Designation/Position: Master Teacher II
LAC Members
Male/ DESIGNATION/ DIVISION/S Contact details Preferred contact
NAME Female POSITION (email, mobile mode (email, phone,
number) Skype, Zoom, Google
Meet, Viber, FB)

Region VIII
A. Ma b ini St. Brg y. Ba g o n g b a ya n , Ba Schools
to , Le yte Division of Leyte
Te l. No . 053-568-0204 I b nh s_b a to @ya h o o .c o m
Yo u r Fu ture … O u r Fo c us…
Bato, Leyte
FORM 2: LAC Facilitator Information Sheet
This form should be accomplished by the designated LAC Facilitator on or before the first LAC
session.
Region:
Division:
NAME: Male/Female: Date of Birth: Age:
Contact details: Email: Mobile Number: Facebook Name:
Preferred contact mode: (Indicate all: email, phone, Skype, Viber, WhatsApp, Zoom, Googlemeet, FB,
Messenger, etc.)
A. Ma b in i St. Brg y. Ba g o ng b a ya n, Ba to , Le yte

Yo u r Futu re … O ur Fo c u s…

Region VIII
Schools Division of Leyte
A. Ma b ini St. Brg y. Ba g o n g b a ya n , Ba to , Le yte
Yo u r Fu ture … O u r Fo c us…
Bato, Leyte
FORM 3: LAC Session Report
This form should be accomplished by the LAC Facilitator at the end of every LAC session.
LAC ID: REGION
LAC FACILITATOR: LAC SESSION NO.:
DATE AND TIME OF SESSION: VENUE/PLATFORM OF SESSION:
Number of members present (attach attendance document):
Materials and resources:
___ Self-Learning Module

___ Activity sheets
___ Digital resources
___ Online resources
___ Smartphone
___ PC
___ LAC session guide
___ Others. Please specify:
_______________________________________
Part A
Please indicate the extent to which you agree with each of the following statements by ticking the
appropriate box.
(SD = Strongly Disagree; D = Disagree; N = Neutral; A = Agree; SA = Strongly agree)
Comments / Remarks
(For example, if you disagree or strongly
SD D N A SA disagree, please indicate why.)
MEMBER PARTICIPATION
1. All of the members came

prepared for the LAC
session
2. All of the members had an

opportunity to share and
discuss their assignment,
insights, and ideas
3. Members listened to each

other’s insights and ideas.
4. The members’ assignments

showed an understanding
of the lessons in the SLM.
5. The members
demonstrated
engagement in and/or
enthusiasm for the learning
tasks during the session
(including providing
feedback
on each other’s
assignment).
FACILITATION
6. I managed the sharing and

discussion during the LAC
session by keeping the
discussion focused on the
lesson or topic.
7. I encouraged all the

members to actively
participate in the LAC
session (i.e., for the
teachers to share their work
and ideas/ insights).
8. I provided useful feedback

on the teachers’
assignments.
Part B
Please provide the information requested.
1. The best part of the session (i.e. what went well):
2. Problems or challenges encountered and how they were resolved:
3. Other topics discussed apart from the recommended topics, if any:
4. Recommendations/Plans for next LAC session:
A. Ma b ini St. Brg y. Ba g o n g b a ya n, Ba to , Le yte

Yo u r Fu ture … O ur Fo c us…

Region VIII
Schools
Te l. No . 053-568-0204 I b nh s_b a to @ya Division
h o o .c oof
m Leyte
Yo u r Futu re … O ur Fo cBATO
u s… NATIONAL HIGH SCHOOL
Yo u r Futu re … O ur Fo c u s… Bato, Leyte
FORM 4: LAC ENGAGEMENT REPORT
This form should be accomplished by each LAC Member at the end of every LAC session.
NAME OF MEMBER: LAC SESSION ID.:
REGION: DATE OF LAC SESSION:
DIVISION: NUMBER OF LAC SESSION:
Part A
Please indicate the extent to which you agree with each of the following statements by ticking
the appropriate box. (SD = Strongly Disagree; D = Disagree; N = Neutral; A = Agree; SA =
Strongly agree)
Comments / Remarks (For example, if

you disagree or strongly disagree, please
SD D N A SA indicate why.)
THE LAC SESSION
1. I learned a lot from my

colleagues in this LAC session.
2. The LAC session deepened

my understanding of the SLM
content.
3. My perspective on the topic/s

covered has changed as a
result of the LAC session.
4. I participated actively in the

LAC session by sharing my
assignment and insights,
asking questions, and giving
feedback on what colleagues
shared.
5. I interacted with different

people during the LAC
session.
ACTION PLAN
6. I feel motivated to apply in

my region/division/district
what I have learned in this
lesson.
7. I intend to apply what I have

learned from the lesson in my
region/division/district
Part B
Please provide the information requested.
1. I need further clarification and/or resources on the following topics:
2. I encountered the following problems or challenges:
3. Other comments/suggestions:
A. Ma b ini St. Brg y. Ba g o n g b a ya n, Ba to , Le yte

Yo u r Fu ture … O ur Fo c us…

This Form Should Be Accomplished by The LAC Facilitator and Its Members at The First LAC Session

Uploaded by

Copyright:

Available Formats

This Form Should Be Accomplished by The LAC Facilitator and Its Members at The First LAC Session

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

This Form Should Be Accomplished by The LAC Facilitator and Its Members at The First LAC Session

Uploaded by

Copyright:

Available Formats

Republic of the Philippines

BATO NATIONAL HIGH SCHOOL

LAC ID (name or number): Number of LAC members:

Name of LAC Facilitator: PAZ S. DELEN Designation/Position: Master Teacher II

Republic of the Philippines

NAME: Male/Female: Date of Birth: Age:

Contact details: Email: Mobile Number: Facebook Name:

A. Ma b in i St. Brg y. Ba g o ng b a ya n, Ba to , Le yte

Republic of the Philippines

LAC ID: REGION

LAC FACILITATOR: LAC SESSION NO.:

DATE AND TIME OF SESSION: VENUE/PLATFORM OF SESSION:

Number of members present (attach attendance document):

Materials and resources:

___ Self-Learning Module

(SD = Strongly Disagree; D = Disagree; N = Neutral; A = Agree; SA = Strongly agree)

1. All of the members came

2. All of the members had an

3. Members listened to each

4. The members’ assignments

6. I managed the sharing and

7. I encouraged all the

8. I provided useful feedback

1. The best part of the session (i.e. what went well):

2. Problems or challenges encountered and how they were resolved:

3. Other topics discussed apart from the recommended topics, if any:

4. Recommendations/Plans for next LAC session:

A. Ma b ini St. Brg y. Ba g o n g b a ya n, Ba to , Le yte

Republic of the Philippines

NAME OF MEMBER: LAC SESSION ID.:

REGION: DATE OF LAC SESSION:

DIVISION: NUMBER OF LAC SESSION:

Comments / Remarks (For example, if

THE LAC SESSION

1. I learned a lot from my

2. The LAC session deepened

3. My perspective on the topic/s

4. I participated actively in the

5. I interacted with different

6. I feel motivated to apply in

7. I intend to apply what I have

2. I encountered the following problems or challenges:

A. Ma b ini St. Brg y. Ba g o n g b a ya n, Ba to , Le yte

You might also like