LEARNER ACTIVITY SHEET in ENGLISH 5

Name of Learner: ____________________________

Grade & Section :____________________
WEEK 1 (August.24-28,2020)
Quarter 1: Fill- out forms accurately (school forms, deposit and withdrawal
slips, etc.) (CG Code: EN5WC-IIj-3.7)
Learning Objectives:
1. Follow printed directions in completing school forms such as information sheet.
(Competency 2, Reading)
2. Fill out school forms correctly using Bank deposit and withdrawal slip.
(Competency 2, Writing)

Filling Out Forms

A from is a printed or typed document with blank spaces for insertion of required
information such as a full name ( surname, first name, middle name), birthdate, and address.

Let’s study the example below:

Application For Club Membership
Tandag Central Elementary School
Tandag City
Date: August 24,2020

First Name: CHRISTIAN CARLOS Complete Address: Purok.Kalipayan,Barangay Bongtod Tandag City
Middle Name: RAMIREZ Contact Number: 09956028443
Last Name: PARAJES Date of Birth: 09-10-2007(mm/dd/yy)
Grade & Section: Grade V Yakal
Age: 12 years old
xGender:

Signature over Printed Name

Here are some helpful tips for filling out forms.

 Directions: Fill out the sample Science Club membership form below.

Exercise A

Name: ________________________ ______________________

Last Name First Name Middle Name
Grade & Section: _______________________
Birthday: ________________________
Month/Date/Year
Sex: __________ ____________ Age: ______________
Male Female
Color of Eyes: ___________
Color of Hair: ___________
Complexion: ___________
Height: ___________ Weight: ___________
Address: ____________________________________________________________
No. Street Barangay Town Province
Citizenship: ___________
Person to contact in case of Emergency:
Name _______________________________________
Relationship ______________
Address _____________________
Telephone Number ___________

Signature of the Member

Exercise B

Directions: Next year, you will be in Grade VI and old enough to enrol by yourself. Fill
out the enrolment form below.

Name: ________________________ ______________________ _____

Last Name First Name M.I

Grade this school year: ______________

Final Rating in Grade V: _____________

Birthday: ________________________ Age: ______________

Month/Date/Year

Place of Birth:

__________________________________________________________ No.

Street Barangay Town Province City

Sex: _________ Nationality: ____________ Religion: ______________

Name of Father: _______________________ Occupation: _____________

Name of Mother: _______________________Occupation: _____________

Name of Guardian: ____________________________

Address: ________________________Telephone Number: ___________

Exercise C
Directions: Fill out each form correctly using the data given.
Amor Lopez went to BPI Bank last November 26, 2005 and deposited One Thousand
Fifty pesos (Php 1,050.00) in her account number 0916-2621-13 on August 27, 2005.
She withdraw seven hundred pesos (Php 700.00) to buy her school supplies.
Deposit Slip
Account No.
Date: _________________
Depositor:
Bank Initial: 1. _________________
2. _________________
3. _________________
Total Checks: ______________________
Cash ____________________________
Total Deposits _____________________
Amount in Words ___________________
Withdrawal Slip
Account No. Date: _______________
Received from BPI Bank Savings and Association the sum of
pesos (Php ___________) which amount is withdrawn
from my/our savings account above numbered.

Signature of Depositor
 Let’s Enrich Ourselves

Exercise D

Directions: Fill out each form correctly using the data given.

Amanda Lopez went to BPI Bank last November 26, 2005 and deposited One Thousand
Fifty pesos (Php 1,050.00) in her account number 0916-2621-13 on August 27, 2005.
She withdraw seven hundred pesos (Php 700.00) to buy her school supplies.

Deposit Slip
Account No. Date:

Depositor:

Bank Initial 1.

2.

3.

Total Checks:

Cash

Total Deposits

Amount in Words:

Withdrawal Slip
Account No. Date:

Received form BPI Bank Savings and Association the sum of

(words)

Pesos (Php ) which amount is withdrawn from my/our savings account above
numbered.

Signature of Depositor
 Poor Fair Good Excellent
2 pts 3 pts 4 pts 5 pts
Holistic
Student is not able to Student is able to Student is able to Student is able to
complete the task. complete the task complete the task complete the task
with some errors or with few errors. successfully with no
difficulty. errors.
Required Student does not Student provides Student provides Student provides all
provide the required some of the required most of the required required information.
Information information. information. information.

Mechanics Student's writing is Student's writing is Student's writing is Student's writing is

illegible, and many somewhat neat and mostly neat and neat and legible.
errors are present. legible. Some errors legible. Student Student writes on lines
present. writes on lines and and follows form
follows form instructions.
instructions with few
errors.

Perfect Score: 15points each exercise.

Materials:
References/Book: Joy in Learning English 5 pp.187-188
Authors: Kristine Erika C. Castillo
Evelyn B. Angeles

Prepared by:

ARAN EVE D. NAPAL

Teacher