Form 4. Teacher LAC Engagement Report

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Republic of the Philippines

Department of Education
MIMAROPA REGION
SCHOOLS DIVISION OF OCCIDENTAL MINDORO

____________(School)____________

FORM 4 - Teacher LAC Engagement Report

General Directions: Fill in one copy of this form immediately after each LAC session.

Name of Teacher: Grade Level Taught:

Date of LAC Session: Topic:

School: District:

Part A
Please indicate the extent to which you agree with each of the following statements by ticking the
appropriate box. (SA = Strongly Agree; A = Agree; N = Neutral; D = Disagree; SD = Strongly Disagree)

Comments/Remarks (For example, if


Components SD D N A SA you disagree or strongly disagree,
please indicate why.

The Session Guide and the


Topic

1. The session guide covered the


lesson/topic clearly.

2. The topic was relevant to my


needs as a teacher.

3. I learned a lot from the topic.

The LAC Session

4. I learned a lot from my


colleagues in this LAC session.

5. The LAC session helped me


understand the topic/content.

6. My perspective on the topic/s


covered has changed as a result
of the LAC session.

7. I participated actively in the


LAC session by sharing my
assignment and insights, asking
questions, and giving feedback on
what colleagues shared

8. I interacted with different


people during the LAC session.

Plan of Action

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9. I feel motivated to apply in my
classroom what I have learned in
this lesson.

10. I intend to apply what I have


learned from the lesson in my
classroom.

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:

Prepared by:

___________________________
LAC Member

Noted:
__________________________________
LAC Facilitator

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