GF - 02

Republic of the Philippines

Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407

GUIDANCE OFFICE
CALL SLIP

Date _______________

To: ______________________________________________________
Year and Section: __________________________________________

From: Guidance Counselor

Kindly report to the Guidance Office for conference.

_____ Before going home

_____ At once, if possible
_____ During your free time

_________________________________
SIGNATURE OVER PRINTED NAME

Issue: February 2011 Revision Code: 0

GF - 02
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407

GUIDANCE OFFICE
CALL SLIP

Date _______________

To: ______________________________________________________
Year and Section: __________________________________________

From: Guidance Counselor

Kindly report to the Guidance Office for conference.

 _____ Before going home
_____ At once, if possible
_____ During your free time
_________________________________
SIGNATURE OVER PRINTED NAME

Issue: February 2011 Revision Code:0

GF -03
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407
GUIDANCE OFFICE
TARDINESS / ABSENCES REPORT

DATE ______________________________
NAME OF STUDENT __________________________________________
YEAR AND SECTION _________________________________________

DATE ABSENT TARDY

______________ ____________ __________

_______________ _____________ ___________

_______________ _____________ ___________

_______________ ____________ ___________

_______________ ____________ ___________

_______________ _____________ ___________

________________________ ______________________
Date Submitted Teacher’s Signature
Issue: February 2011 Revision Code: 0
GF -03
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407

GUIDANCE OFFICE
TARDINESS / ABSENCES REPORT

DATE ______________________________
NAME OF STUDENT __________________________________________
YEAR AND SECTION _________________________________________
 DATE ABSENT TARDY
______________ ____________ ___________

_______________ _____________ ___________

_______________ _____________ ___________

_______________ _____________ ___________

_______________ _____________ ___________

_______________ _____________ ___________

________________________ ______________________
Date Submitted Teacher’s Signature
Issue: February 2011 Revision Code:0

GF –04
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407

GUIDANCE OFFICE
LETTER TO PARENT

Date __________________

Mr. and Mrs. _______________________

__________________________________

__________________________________

Dear Mr. and Mrs. ______________,

The Guidance Counselor invites you for a short conference to discuss matters pertaining to the

welfare of your son/ daughter who is enrolled in our school

The school is interested in the success of your son/ daughter in his/ her studies, so please try to
 come at your most convenient and earliest possible time.

Thank you.

Very truly yours,

____________________

Guidance Counselor

Name of Student: _______________________

Year and Section: _______________________

Noted:

__________________________

Principal

Issue: February 2011 Revision Code:0

GF -05
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407

GUIDANCE OFFICE
REFERRAL SLIP
Name of Student ___________________________________________
Year and Section ___________________________________________

School Problem (Pls. Check)

_____ Irregular Attendance _____ Illness

_____ Prolong Absence _____ Physical Handling

_____ Lack of Interest in school Work _____ Poor Personal Habit

_____ Lack of School Materials _____ Behavioral Problem

_____ No Breakfast/ Lunch ______ Other ( pls. specify)

By: _______________________________
 Name and Signature

Date: ___________________________
Issue: February 2011 Revision Code: 0

GF -05
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407

GUIDANCE OFFICE
REFERRAL SLIP
Name of Student ___________________________________________
Year and Section ___________________________________________

School Problem (Pls. Check)

_____ Irregular Attendance _____ Illness

_____ Prolong Absence _____ Physical Handling

_____ Lack of Interest in school Work _____ Poor Personal Habit

_____ Lack of School Materials _____ Behavioral Problem

_____ No Breakfast/ Lunch ______ Other ( pls. specify)

By: ______________________________
Name and Signature
Date: ___________________________
Issue: February 2011 Revision Code:0

GF-06
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407

GUIDANCE OFFICE
HOME VISITATION FORM
Date of Visit: ________________________________

Name of Student: _______________________________________________________________

Section: ______________________________________________________________________

Home Address: ________________________________________________________________

Person around during the visit: ____________________________________________________

Concern and details of the Visit:

Result of the Visit:

__________________________
Adviser/ Subject Teacher

CONFIRMATION OF ADVISER’S/ SUBJECT TEACHER’S HOME VISIT

________________________________
_____________________________

Signature of the Student Signature of the Parent/ Guardian

Issue: February 2011 revision Code: 0

GF -08
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
 GUIDANCE OFFICE

ANECDOTAL REPORT

Student Observed:
__________________________________________________________________________________
Observer:
_____________________________________________________________________________________
____
Date: ______________________________ Time: ________________ Place:
________________________________

Context: What was happening immediately before the behavior occurred?

____________________________________

Behavior: What behavior was manifested?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_______________________________________

Effect: How did observer/ others respond/ react to the manifested behavior?

Recommendation:_____________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_________
Source: Villar, Imelda V.G. (2009). Implementing a Comprehensive Guidance and Counseling Program in
the
Philippines.Makati City. Aligned Transformations.

Issued: February 2011 Revision Code:0

GF -09
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407

GUIDANCE OFFICE

ANECDOTAL RECORD

Student Observed:
__________________________________________________________________________________

Date/ Time Place Observer Behavior How Handled

Observed
SUMMARY:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________

Source: Villar, Imelda V.G. (2009). Implementing a Comprehensive Guidance and Counseling Program in
the
Philippines.Makati City. Aligned Transformations.

Issued: February 2011 Revision Code: 0

GF – 010
Republic of the Philippines
Department of Education
Region X
Division of Camiguin
MAMBAJAO NATIONAL HIGH SCHOOL
Balintawak St., Poblacion Mambajao, Camiguin
E-mail: [email protected]
Tel. No. (088) 387-0407

GUIDANCE OFFICE

OBSERVATION CHECKLIST
Characteristics Manifested in the Classroom

Date: ________________________________________________ Place:

_____________________________________
Name of Observed Student: ______________________________ Grade/ Year:
_______________________________
Name of Observer: _____________________________________ Position:
__________________________________
Period of Observation: From _____________________________ To
__________________________________________

Reason for Observation:

_____________________________________________________________________________
 Active Dependent on Others

Assertive Deceitful

Resourceful Belligerent

Conscientious Careless

Cooperative Critical

Influential Bullying

Initiating Unreliable

Creative Rude

Honest Impatient

Law-abiding Domineering

Productive Time-wasting

Effective Self-centered

Confident Aloof

Source: Villar, Imelda V.G. (2009). Implementing a Comprehensive Guidance and Counseling Program in
the
Philippines.Makati City. Aligned Transformations.

Issued: February 2011 Revision Code: 0

GF -011

GUIDANCE OFFICE

COUNSELING NOTES

Date: ______________________

Name of Student/ Counselee: _________________________________

Reason: (Presenting Problem)

Remarks: (What you did?)

What did you find out?

Course of Action:

Issued: February 2011 Revision Code: 0

GF -012

GUIDANCE OFFICE
COUNSELING REPORT

Date:___________________________________

Name:__________________________________

Presenting Problem:

Brief Background: How the person behaves?

Physical Appearance:

Synthesis:

Recommendation:

Issued: February 2011 Revision Code:0