R epublic of the P hilippines

D epartment of E ducation
REG I O N I I I - C EN TRAL LUZO N
SC H O O LS D I VI SI O N O FFI C E- SC I EN C E C I TY O F M U N O Z
M U N O Z N ATI O N AL H I G H SC H O O L (AN N EX)

FORM 3: LAC Session Report

This form should be accomplished by the LAC Facilitator at the end of every LAC
session.

LAC ID: SCHOOL:

LAC FACILITATOR: LAC SESSION NO.:

DATE AND TIME OF SESSION: VENUE/PLATFORM OF SESSION:

Number of members present (attach attendance document):

Materials and resources:

___ Self-Learning Module

___ 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 Disagree; D = Disagree; N = Neutral; A = Agree; SA = Strongly agree)

Comments / Remarks
(For example, if you
disagree or strongly
disagree, please
SD D N A SA indicate why.)

School Address: Brgy. Rizal, Science City of Muñoz, Nueva Ecija

School ID: 322801
Contact Number: 0966-385-4558
E-mail Address: 322801@deped.gov.ph
 R epublic of the P hilippines
D epartment of E ducation
REG I O N I I I - C EN TRAL LUZO N
SC H O O LS D I VI SI O N O FFI C E- SC I EN C E C I TY O F M U N O Z
M U N O Z N ATI O N AL H I G H SC H O O L (AN N EX)

MEMBER PARTICIPATION

1. All of the members came

prepared for the LAC
session

2. All of the members had

an opportunity to share
and discuss their
assignment, insights,
and ideas

3. Members listened to
each other’s insights and
ideas.

4. The members’
assignments showed an
understanding of the
lessons in the SLM.

5. The members
demonstrated
engagement in and/or
enthusiasm for the
learning tasks during
the session (including
providing feedback
on each other’s
assignment).

FACILITATION

6. I managed the sharing

and discussion during
the LAC session by
keeping the discussion
focused on the lesson or
topic.

School Address: Brgy. Rizal, Science City of Muñoz, Nueva Ecija

School ID: 322801
Contact Number: 0966-385-4558
E-mail Address: 322801@deped.gov.ph
 R epublic of the P hilippines
D epartment of E ducation
REG I O N I I I - C EN TRAL LUZO N
SC H O O LS D I VI SI O N O FFI C E- SC I EN C E C I TY O F M U N O Z
M U N O Z N ATI O N AL H I G H SC H O O L (AN N EX)

7. I encouraged all the

members to actively
participate in the LAC
session (i.e., for the
teachers to share their
work and ideas/
insights).

8. I provided useful
feedback on the
teachers’ assignments.

Part B
Please provide the information requested.

1. The best part of the session (i.e. what went well):

2. Problems or challenges encountered and how they were resolved:

3. Other topics discussed apart from the recommended topics, if any:

None.

4. Recommendations/Plans for next LAC session:

School Address: Brgy. Rizal, Science City of Muñoz, Nueva Ecija

School ID: 322801
Contact Number: 0966-385-4558
E-mail Address: 322801@deped.gov.ph