Republic of the Philippines

Department of Education
Region XI – Davao Region
Schools Division of Davao City
MAHAYAG NATIONAL HIGH SCHOOL
Purok 1 Barangay Mahayag, Davao City
READING PROGRAM/REMEDIATION EVALUATION FORM
Venue: ___________________________________ Date: _________________

Instructions: Please answer each item to how you would honestly and
objectively assess the activity by using 4-point rating scale to indicate the
extent to which you agree or disagree with each statement. Kindly check the
blank space below the appropriate number.

4 3 2 1
Indicators Strongly Agree Disagree Strongly
Agree Disagree
A. Venue
1. The venue was well lighted and
ventilated.
2. The venue was comfortable with
sufficient space for the tutorial/
distribution and retrieval.
3. The venue for the tutorial/
distribution and retrieval had
sanitary and hygienic conditions.
4. The venue was accessible convenient.
B. Program/Materials
5. The reading program objectives were
achievable and in congruence with
the curriculum.
6. The reading program activities were
in line with its objectives and doable.
7. The reading materials: content and
exercises given can be accomplished
in the time duration.
8. The reading materials were adequate
and appropriate for the recipient’s
needs.
9. The reading materials were clear and

Address: Purok 1 Barangay Mahayag, Davao City

227-7361
 readable.
10. The reading materials were free
from errors.
11. The reading materials were
complete in pages.
12. The reading materials were
presentable and durable.
C. Process Distribution and Retrieval of
Reading Materials
13. The process of the distribution
and retrieval were systematic.
14. The process of the distribution
and retrieval were logical.
15. The process of the distribution
and retrieval were clearly stated and
comprehensible.
16. The process of the distribution
and retrieval were clear and posted in
a strategic area.
17. The distribution and retrieval
schedule were announce ahead of
time.
18. The distribution and retrieval
schedule were disseminated
appropriately and in multi-way.
19. The health protocols were given
high regards during the distribution
and retrieval of SLMs.
D. Personnel/Tutor/In-charge
20. The distribution and retrieval
personnel were courteous and polite.
21. The distribution and retrieval
personnel were efficient.
22. The distribution and retrieval
personnel were responsive to the
needs of the recipient.
23. The tutor/in-charge attended
regularly the tutee/ reading program
recipient.
24. The tutor/in-charge made regular
follow-up to his/her the tutee/
reading program recipient.
25. The tutor/in-charge assessed
regularly the tutee/ reading program

Address: Purok 1 Barangay Mahayag, Davao City

227-7361
 recipient.

Evaluator: ________________________________

Address: Purok 1 Barangay Mahayag, Davao City

227-7361