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: mamnhs303994@gmail.com
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: mamnhs303994@gmail.com
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: mamnhs303994@gmail.com
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: mamnhs303994@gmail.com
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: mamnhs303994@gmail.com
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: mamnhs303994@gmail.com
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: mamnhs303994@gmail.com
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: mamnhs303994@gmail.com
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: mamnhs303994@gmail.com
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: mamnhs303994@gmail.com
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
