ALS Assessment Form 1

INDIVIDUAL LEARNING AGREEMENT

Name of Learner: Community Learning Center:

Level: BLP LE AE JHS SHS Name of Learning Facilitator:

Direction: Write your learning goals, your learning activities or strategies in order to attain these goals, and the timeline.
General Learning Goal: Finish Elementary/JHS/SHS Others (Pls. specify):
Delivery Mode Review of Learning Goals (Pagsusuri
(Mga Timeline sa Kasanayang Natutunan) Learning
Learning Goals Pamamaraan sa (Kailan mo ito Not Facilitator’s Advice
(Kasanayang Gusto at Kailangan Kong Pagkatuto) Date of Review
gustong Achieved Achieved (Payo ng Learning
Matutunan) (Face-to-face, (Petsa ng
matutunan) (Nakamtan) (Hindi Facilitator)
Independent Learning, Pagsusuri)
RBI, eLearning/eSkwela) Nakamtan)

(Learner’s Signature over Printed Name) (Learning Facilitator’s Signature over Printed Name)

Date: Date:
 ALS Assessment Form 2
RECORD OF MODULE USE AND MONITORING OF LEARNER’S PROGRESS

Name of Learner: Community Learning Center:

Level: BLP LE AE JHS SHS Name of Learning Facilitator:
Directions: Write the title of each learning module you accomplished along with the learning strand, results in the pre-test and post-test,
other activity/ies you have completed, and your own assessment.
Learning Facilitator’s Learning
Assessment Facilitator’s
Date (Petsa) Learner’s Self
Pre-Test Post-Test Result Other Related (Pagtataya ng Learning Remarks
Title of Learning Module Activities Assessment of (Puna ng Learning
LS Result (Resulta (Resulta ng
Performance Facilitator)
(Pamagat ng Modyul) ng Panimulang Pagtatapos na Accomplished (Iba Facilitator)
Pagtataya) (Pagtataya sa Sarili sa
Pagtataya) pang Gawaing Natapos)
Started Finished Pagganap) Mastered Not Mastered
(Simula) (Pagtapos) (Natuto) (Hindi Natuto)

(Learner’s Signature over Printed Name) (Learning Facilitator’s Signature over Printed Name)

Date: Date: