Republic of the Philippines
Department of Education
REGION X – NORTHERN MINDANAO
SCHOOLS DIVISION OF OZAMIZ CITY
OZAMIZ CITY NATIONAL HIGH SCHOOL
BERNAD ST., LAM-AN, OZAMIZ CITY
HOME VISITATION FORM
Name of Student _________________________ LRN __________________ Grade/Section __________
Address ___________________________ Birthday ________________ Gender ________ Age _______
Name of Father ________________________________ Contact Number _________________________
Name of Mother _______________________________ Contact Number _________________________
REASON FOR HOME VISITATION:
_____________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
REMARKS/AGREEMENT:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
___________________________________
___________________________________
PARENT’S SIGNATURE OVER PRINTED NAME
STUDENT’S SIGNATURE OVER PRINTED NAME
Prepared:
____________________________________
Class Adviser
Noted:
DANI LYNE D. HOMECILLO, RGC
Guidance Coordinator III
Attested:
LILIBETH Y. ABAMONGA
Secondary School Principal II
Address: Bernad Street, Lam-an, Ozamiz City
Telephone No: (088) 521-3385
Telefax: (088) 545-2821
Email Address: 304167@deped.gov.ph
Republic of the Philippines
Department of Education
REGION X – NORTHERN MINDANAO
SCHOOLS DIVISION OF OZAMIZ CITY
OZAMIZ CITY NATIONAL HIGH SCHOOL
BERNAD ST., LAM-AN, OZAMIZ CITY
HOME VISITATION RECORD
Name of the Student: ______________________________________________
Section: ________________________________
Date of Home Visitation: ___________________________________________
REASONS:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
ACTION TAKEN:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
___________________________________
PARENT’S SIGNATURE OVER PRINTED NAME
______________________________________
Class Adviser
Address: Bernad Street, Lam-an, Ozamiz City
Telephone No: (088) 521-3385
Telefax: (088) 545-2821
Email Address: 304167@deped.gov.ph
Republic of the Philippines
Department of Education
REGION X – NORTHERN MINDANAO
SCHOOLS DIVISION OF OZAMIZ CITY
OZAMIZ CITY NATIONAL HIGH SCHOOL
BERNAD ST., LAM-AN, OZAMIZ CITY
LETTER FROM THE PARENT/GUARDIAN
_______________________
Date
Ma’am/Sir:
Maayong adlaw!
Ako si ______________________________________________________. Anak nako si
(Pangalan sa Ginikanan)
___________________________________. Naghimo ani nga sulat og nagpahibalo nga ang
(Pangalan sa Estudyante)
akong anak mo-undang na sa pag eskwela kay _______________________________________
(Rason)
______________________________________________________.
Daghang salamat!
Kanimo Matinahuron,
____________________________________
Signature Over Printed Name of Parent/Guardian
____________________________________
Signature Over Printed Name of Parent/Guardian
Address: Bernad Street, Lam-an, Ozamiz City
Telephone No: (088) 521-3385
Telefax: (088) 545-2821
Email Address: 304167@deped.gov.ph