Republic of the Philippines

Department of Education
Region III – Central Luzon
Schools Division of City of Balanga
M.DELOS REYES MEMORIAL ELEMENTARY SCHOOL

Form 1: LAC Profile

School Division: City of Balanga District: District I

School: M. delos Reyes Mem. ES School Head: Eleonor G. Sioson
LAC ID: 104561 Number of LAC Members:
LAC Facilitator: Designation/Position:
LAC Members:

Male/ Designation/ Division Contact Details Preferred

Name Female Position (email, mobile Contact
number) Mode
(email,phone,
Skype,
Zoom,
Google Meet,
Viber, FB
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

M. DELOS REYES MEMORIAL ELEMENTARY SCHOOL

Address: Brgy. Puerto Rivas Itaas, City of Balanga, Bataan
Telephone No: (047) 240-4536
E-mail: mrmes0205@yahoo.com
 Republic of the Philippines
Department of Education
Region III – Central Luzon
Schools Division of City of Balanga
M.DELOS REYES MEMORIAL ELEMENTARY SCHOOL

Form 2 : LAC Facilitator Information Sheet (to be accomplished by the LacF)

Schools Division:City of Balanga District: I

School: M. Delos Reyes Mem. Elementary School School Head: Eleonor G. Sioson
LAC Facilitator: Gender:

Date of Birth: Age:

Contact Details: Email address:

Phone Number: N/A

Facebook name:
Mobile Number:

Home Address

M. DELOS REYES MEMORIAL ELEMENTARY SCHOOL

Address: Brgy. Puerto Rivas Itaas, City of Balanga, Bataan
Telephone No: (047) 240-4536
E-mail: mrmes0205@yahoo.com
 Republic of the Philippines
Department of Education
Region III – Central Luzon
Schools Division of City of Balanga
M.DELOS REYES MEMORIAL ELEMENTARY SCHOOL

Form 3 : LAC Session Report

General Directions: Complete on copy of this form immediately after each LAC session.

LAC ID: Region : III

LAC Facilitaor : LAC Session No.:
Date and Time of Session : Venue: Platform of Session
Webinar
Number of members present (attached attendance document):
Materials and Resources:
_______ Self Learning Modules
_______ Activity Sheets
_______ Digital Resources
_______ Online Resources
_______ Smartphone
_______ PC
_______ LAC Session Guide
_______ Others . Please specify :
__________________
Part A : Please indicate the extent to which you agree with each of the following statements by ticking the
appropriate box. (SD= Strongly Agree; D=Disagree; N= Nuetral; A = Agree; SA= Strongly Agree)

SD D N A SA Comments / Remarks (for

example, if you disagree,
please indicate why.)
Member Participation
1. I learned a lot from my colleagues
in this LAC session.
2. The LAC session deepened my
understanding of the courseware
content.
3. My perspective on the topic / s
covered has changed as a result of
the LAC session
4. I participated actively in the LAC
session by sharing my assignments
and insights, asking questions, and
giving feedback on what colleagues
shared.
5. I interacted with different people
during the LAC session.
Action Plan
6. I feel motivated to apply in my
classroom what I have learned in
this lesson.
7. I intend to apply what I have
learned from the lesson in my
classroom.
Part B.
Please provide the information requested.

1. I need further clarification and/or resources on the following topics:

M. DELOS REYES MEMORIAL ELEMENTARY SCHOOL

Address: Brgy. Puerto Rivas Itaas, City of Balanga, Bataan
Telephone No: (047) 240-4536
E-mail: mrmes0205@yahoo.com
 Republic of the Philippines
Department of Education
Region III – Central Luzon
Schools Division of City of Balanga
M.DELOS REYES MEMORIAL ELEMENTARY SCHOOL

2. I encountered the following problems or challenges:

3. Other comments and suggestions:

4. Reflection:

Prepared by:

Noted :

M. DELOS REYES MEMORIAL ELEMENTARY SCHOOL

Address: Brgy. Puerto Rivas Itaas, City of Balanga, Bataan
Telephone No: (047) 240-4536
E-mail: mrmes0205@yahoo.com