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INDIVIDUAL WORK PLAN AND ACCOMPLISHMENT REPORT

Name of Activity: Legal Basis


Name of Teacher: School:
Position: District:
Date: Day:

Actual
Time Activity Physical Target
Accomplishment

Prepared by:

SIGNATURE OF TEACHER OVER PRINTED NAME


Position
Certified True and Correct:

NAME OF SCHOOL HEAD AND SIGNATURE


Position
PHOTO DOCUMENTATION

DAY 1 DAY 2 DAY 3

DAY 4 DAY 5 DAY 6

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