District of Liloan
JUBAY NIGHT HIGH SCHOOL
GF1
REFERRAL SLIP
NAME OF STUDENT: _____________________________________________________________________
GRADE & SECTION: ___________________________________________________________________
NAME OF TEACHER:__________________________________________________________________
CAUSE OR REASON FOR REFERRAL:______________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
REMARKS:
___________________________________________________________________________________
___________________________________________________________________________________
District of Liloan
JUBAY NIGHT HIGH SCHOOL
GF1
REFERRAL SLIP
NAME OF STUDENT: _____________________________________________________________________
GRADE & SECTION: ___________________________________________________________________
NAME OF TEACHER:__________________________________________________________________
CAUSE OR REASON FOR REFERRAL:______________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
REMARKS:
___________________________________________________________________________________
___________________________________________________________________________________
District of Liloan GF2
JUBAY NIGHT HIGH SCHOOL
__________________
Date
______________________________________
______________________________________
Tinahud nga Ginikanan:
Alang sa kaayohan sa imong anak ug sa atong tunghaan, gihangyo ko ikaw nga mo-
ari sa atong tunghaan karong _____________________ kay aduna kita'y pagasabutan. Sa ingon
niini, gipahibalo ko ikaw sa imong pagkaginikanan nga si _________________________________.
__________a.) Kanunay nga mopalta sa klase
__________b.) mosulod o moguwa sa tunghaan, dili molahutay.
__________c.) hisakpan nga mopakita ug mga buhat nga supak sa mga lagda sa atong tunghaan.
__________d.) nakig-away sa iyang isigkaingon
__________e.) kanunay nga maulahi sa klase
__________f.) wala motungha hangtud karong mga adlawa.
__________g.) _______________________________________________________________________
Malipayon ako ug daku kon imong hatagan ug pagtagad kining maong sulat.
By: Matinahuran,
_____________________________ ___________________________
Adviser Guidance Teacher
GF2
District of Liloan
JUBAY NIGHT HIGH SCHOOL
_____________________
Date
______________________________________
______________________________________
Tinahud nga Ginikanan:
Alang sa kaayohan sa imong anak ug sa atong tunghaan, gihangyo ko ikaw nga mo- `
ari sa atong tunghaan karong _____________________ kay aduna kita'y pagasabutan. Sa ingon
niini, gipahibalo ko ikaw sa imong pagkaginikanan nga si _________________________________.
__________a.) Kanunay nga mopalta sa klase
__________b.) mosulod o moguwa sa tunghaan, dili molahutay.
__________c.) hisakpan nga mopakita ug mga buhat nga supak sa mga lagda sa atong tunghaan.
__________d.) nakig-away sa iyang isigkaingon
__________e.) kanunay nga maulahi sa klase
__________f.) wala motungha hangtud karong mga adlawa.
__________g.) _______________________________________________________________________
Malipayon ako ug daku kon imong hatagan ug pagtagad kining maong sulat.
By: Matinahuran,
_____________________________ ___________________________
Adviser Guidance Teacher
District of Liloan GF3
JUBAY NIGHT HIGH SCHOOL
__________________
STUDENT APPOINTMENT TO SEE THE COUNSELOR
If it is convenient _______________________________, would like him/her to see me at
(Name of Pupil)
___________________ on ____________________ for a conference/another conference.
(Time) (Date)
If this date is satisfactory, he/she may see me at another time. ___________________________
Guidance Teacher
GF2
District of Liloan
JUBAY NIGHT HIGH SCHOOL
STUDENT APPOINTMENT TO SEE THE COUNSELOR
If it is convenient _______________________________, would like him/her to see me at
(Name of Pupil)
___________________ on ____________________ for a conference/another conference.
(Time) (Date)
If this date is satisfactory, he/she may see me at another time. ___________________________
Guidance Teacher
`
District of Liloan GF4
JUBAY NIGHT HIGH SCHOOL
__________________
ANECDOTAL RECORD
Name of Student:________________________________ Grade & Section: ____________________
DATE PLACE TIME INCIDENT COMMENT
GF4
District of Liloan
JUBAY NIGHT HIG SCHOOL
ANECDOTAL RECORD
Name of Student:________________________________ Grade & Section: ____________________
DATE PLACE TIME INCIDENT COMMENT
`
District of Liloan GF5
JUBAY NIGHT HIGH SCHOOL
__________________
ACCOUNT OF COUNSELING INTERVIEW
Counselee __________________________________________ Grade & Section: ____________
Date of Interview ______________________ Length of Interview: _______________________
Problem:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Comments, Reaction, and Action Taken:
___________________________________________________________________________________
___________________________________________________________________________________
Schedule for next interview: _________________________________________________
Reported vountarily for interview: __________ ____________
Yes No
Referred By: ___________________________________
Guidance Teacher
GF5
District of Liloan
JUBAY NIGHT HIGH SCHOOL
ACCOUNT OF COUNSELING INTERVIEW
Counselee __________________________________________ Grade & Section: ____________
Date of Interview ______________________ Length of Interview: _______________________
Problem:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Comments, Reaction, and Action Taken:
___________________________________________________________________________________
___________________________________________________________________________________
Schedule for next interview: _________________________________________________
Reported vountarily for interview: __________ ____________
Yes No
Referred By: ___________________________________
Guidance Teacher
`
District of Liloan GF7
JUBAY NIGHT HIGH SCHOOL
__________________
FLOW SHEET
Name: __________________________________________ Sex: ____________
Grade & Section ______________________Teacher in Charge: _______________________
Description of the Child:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________
Subject Teacher/Teacher in Charge
Notes:
Make your observation about the child very accurate. Observe not only your own pupils but
all the pupils in school. This observation sheet giving the description about the child should be
given to the teacher to be put inside the cumulative folder. The material fund inside the
individual folder will be a good source for case study.
GF7
District of Liloan
JUBAY NIGHT HIGH SCHOOL
FLOW SHEET
Name: __________________________________________ Sex: ____________
Grade & Section ______________________Teacher in Charge: _______________________
Description of the Child:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
__________________________________
Subject Teacher/Teacher in Charge
Notes:
Make your observation about the child very accurate. Observe not only your own pupils but
all the pupils in school. This observation sheet giving the description about the child should be
given to the teacher to be put inside the cumulative folder. The material fund inside the
individual folder will be a good source for case study.
`
District of Liloan GF9
JUBAY NIGHT HIGH SCHOOL
RATING OF PERSONALITY TRAITS OF STUDENTS
Student's Name____________________________________________
Please place a check mark on each horizontal line at the point which represents
your estimate of this student.
HONESTY
___________________ __________________ __________________ __________________
Early Tempted, must Generally Trustworthy
Cannot be trusted at all be watched Trustworthy
`
