DROP OUT Reduction Program ( DORP)

System and Mechanisms

I. Start-Up Stage

1. Identification of the school OHSP-DORP team to be initiated by the

school head. The team consists of

- School head
- Guidance Counselor / Designate
- Department Heads (Eng/Fil/Sci/Math/Makabayan)
- PTCA president
- SSC president (supreme student council)

2. Identification of clients. Advisers submit to the OHSP-DORP team

the results of the FICS Analysis Tool and other supporting
documents. Clients are categorically classified as SARDOs
(regular students who are at- risk of dropping out)

3. Administration of other Entry Assessments to be administered by the

Guidance Counselor/Designate.

4. In case of Informal Reading Inventory(IRI), the GC/D shall be

assisted by the English and Filipino teachers.

5. Recommendation of Appropriate Interventions based from results of

Entry Assessments ( OHSP for short term or long absences from
classes, IGP/Entrep for financial constraints of SARDOs, SII-academic
for academic related, etc,)

Suggested Templates

 Form 1 – FICS Analysis Tool

 Form 2 – ILRT (Independent Learning Readiness Test)
 Form 2A – Reading Comprehension Test
 Form 2B - Pagsubok sa Kakayahan ng Mag-aaral
 Form 2C – English Composition Examination
 Form 2D – Pagsasanay sa Pagsulat sa Filipino
 Form 2E – Exercise in Mathematics
 Form 2F – Summary of Scores
 Form 2G– Coping Scale (Sukatan ng Kakayahan ng Mag-aaral)
 Form 3 – PHIL-IRI (to be provided by the Division)
 Republic of the Philippines
Department of Education
Conduct/Behavior Information Family and Other Related
BUREAU Information
OF SECONDARY EDUCAT
Dropout Reduction Program (DO
School:______________________________Division:______________
(14) (21)
FICS Analysis Tool ______________________
(13) (19)
Suspensions
    (15) (17) (18) (20) Number Inform
Academic of
Reported (16) Living
and other Health If female, Previous Number people in the
conduct or (1) Abuse with (4)
disciplinary Problems (2) Enrolled at pregnant? (3)Pregnancies Reading of siblings
(5) household who
(6) No. of days
misbehavior Bridge candidate Bridge Non Bridge taker parents Repeated a absent during the
actions but did not opt Final grades Final grades in Grade VI Grade level,
year level
arepreceding
employed year
to enroll if known
   
No Names   Math English Science Math English Science      
                 
1                      
                 
2                      
                 
3                      
                 
4                      
                 
5                      
                 
6                      
                 
7                      
                 
8                      
                 
9                      
                 
10                      
                 
11                      
                 
12                      
                 
13                      
                 
14                      
                 
15                      
                 
16                      
                 
17                      
                 
18                      
                 
19                      
                 
20                      
                 
21                      
                 
22                      
23                      
24                      
25                      
PLEASE READ THE ATTACHED INSTRUCTIONS IN FILLING OUT THIS FORM
Instructions in filling out FICS Analysis Tool

1. Check if applicable
2. Indicate the final grades in Science, Math and English in Bridge Program
3. Indicate the final grades in Science, Math and English in Grade VI
4. Indicate the reading grade level
5. Write "yes" or "no"; if "yes", indicate number of times and year levels repeated
6/7. Number of days absent, late during the immediately preceeding school year
8. Indicate learning difficulty (i.e.,"dyslexia", ADHD) and write after it "D" if
formally diagnosed or "S" if suspected but not formally diagnosed
9. Indicate "yes" or "no". If yes, indicate how many times student had transferred schools
10. Indicate "yes" or "no".
11. Indicate "yes" if the student is NOT A MEMBER OF ANY SCHOOL/CAMPUS ORGANIZATION,
or "no" if he is a member of at least 1 organization
12. Indicate "yes" if student is regularly compliant, that is, brings to class requirements,
accomplished assignments and projects, "no if student is regularly non-compliant with school requirements
13. Indicate nature of conduct or behavior problems and frequency of occurrence
14. Write nature of disciplinary action and frequency of said action
15. Known health problems, including malnutrition, drug abuse. Specify.
16. Indicate if student shows signs of physical, emotional and other forms of abuse, like being beaten,
bullied, sexually abused and indicate where abuse might be taking place, for example, "bullied in school",
"beaten at home", regularly insulted by teachers", "regularly teased, called names by peers"
17. Indicate "yes" or "no"
18. Indicate "yes" or "no" and if "yes", number of children
19. Indicate "yes" or "no"
20. Indicate number (i.e., 4,5,6)
21. Indicate number
22. Indicate amount in pesos
23. Indicate highest attainment of parents
24. Write address and put an asterisk if living more than 1km. from the school

FORM 2

Independent Learning Readiness Test (ILRT)

Below is a list of competencies that you are expected to demonstrate. Encircle the number
in the scale that corresponds to your answer for every item where:

3 means that you demonstrate the competencies with least or no

supervision/assistance from the teacher;

2 means that you demonstrate the competencies with some

supervision/assistance from the teacher; and

1 means that you demonstrate the competencies with much

supervision/assistance from the teacher.

I am able to: SCALE

1. Get information from print and non-print materials 3 2 1

2. Recall details read/heard/seen from different types of media 3 2 1

3. Relay information heard over the telephone and from

 radio broadcasts 3 2 1

4. Interpret the information in graphics and billing

statements (electric, water, etc.) 3 2 1

5. Use the card catalogue to locate information 3 2 1

6. Follow signs and symbols to locate places or things 3 2 1

7. Follow directions using map 3 2 1

8. Fill out forms (schools, banks, etc.) 3 2 1

9. Follow instructions/steps in doing a task 3 2 1

10. Write personal letters and diaries 3 2 1

11. Solve simple mathematical problems 3 2 1

12. Interview people 3 2 1

Interpretation of the total rating:

29 – 36 Independent level
20 – 28 Instructional level
12 – 19 Beginning level

FORM 2A

READING COMPREHENSION TEST

Read the selection below silently. Then answer the short test that
follows. Write only the letter of your answer on your answer sheet.

When a person’s temperature rises above the normal 37°C,

whether it is a reaction to an infection or the manifestation of distress, his first
impulse is to take an antipyretic like Aspirin or Medicol for relief.

But this is not the only way to bring the fever down. There are other ways
which are economical but equally effective. One is a sponge bath—the simplest
techniques. Care must be taken; however, to do it as quickly as possible to avoid
chilling. After the refreshing sponge bath, the thermometer will register a normal
temperature and the patient will feel relieved.

The other way is the inducing of perspiration, which is done by wrapping the
patient with layers of bankers and inhibiting ventilation. This may involve much
discomfort to the patient but the moment he perspires, his temperature goes down
and he is relieved of the restlessness and pain.

When none of these methods succeed in bringing down a persistently high

temperature, it is best to see a doctor and following his advice.
 1. According to the selection, one is restless when his temperature is

a. High c. low
b. Normal d. unknown
.
2. Why does the author give alternatives to the antipyretic Aspirin or Medicol?

a. To avoid infection c. To induce perspiration

b. To reduce pain d. To save money

3. A persistently high temperature one that

a. goes up c. goes down

b. won’t go down d. rises and falls

4. A sponge bath helps to

a. make temperature rise c. bringing temperature down

b. prevent chilling d. induce perspiration
5. One has a fever if his temperature is
a. 39°C c. 37°C
b. 36°C d. 36.5°C

6. What should you do if all the methods described in the selection fail to lower
your fever?

a. Have a sponge bath c. Drink plenty of water

b. See a doctor d. Wrap yourself with blankets

7. Which of these should be done as quickly as possible according to the

selection?

a. Measuring ones’ temperature c. Taking a sponge bath

b. Inducing perspiration d. Seeing a doctor

8. When body perspires, its temperature

a. goes up c. remains the same

b. goes down d. unknown

9. The purpose of covering the patient with blanket is to make him

a. feel cold c. comfortable

b. sweat d. chilled

10. This selection tells us how to

a. prevent sickness c. bring temperature down

b. avoid fever d. reduce pain
 Form 2B

Pagsubok sa Kakayahan sa Pagbasa

Panuto: Basahing mabuti ang sanaysay at sagutin ang mga

sumusunod na tanong . Titik lamang ng tamang sagot ang isusulat sa iyong
sagutang papel.

Nagkaroon ng sibilisasyon ang mga tao. Umunlad ang kanyang

kaalaman sa larangan ng agham at teknolohiya. Dumami nang dumami
ang iba’t ibang uri ng makinaryang ginagamit niya sa kanyang pang-araw-
araw na buhay. Nagdagsaan ang iba’t ibang uri ng sasakyang panlupa,
pandagat at panghimpapawid. Naging lungsod ang dating mayaman at
makahoy na kabundukan. Makikita ang iba’t ibang uri ng pabrika na
nagtatapon ng mga dumi sa mga ilog at dagat. Nagbubuga rin ang mga
ito ng mga nakakalason na usok sa ating papawirin. Nahiya ang hanging
maghatid ng lamig. Nahiya rin ang mga punong kahoy na magbigay-
buhay sa buong kalupaan. Sumisid na ang tubig sa kanyang lagusan
matapos na ang kanilang daluyan ay tambakan ng mga gabundok na
basura. Nawalan na ng puwang ang paglinis at paghahalaman. Tuluyan
nang nilimot ng tao ang kanyang tungkulin sa kanyang kapaligiran.

1. Ang kaisipang nais ipahatid ng buong talata ay .

A. May tungkulin ang tao sa kanyang kapaligiran.

B. Dumami ang suliranin sa kapaligiran dahil sa tao.
C. Sa kabila ng pag-unlad ng tao at ng kanyang paligid ay nakalimot siya sa
kanyang tungkulin.
D. Lumaganap ang suliranin sa polusyon bunga ng pag-unlad ng agham at
teknolohiya.

2. Ang nais ipahatid ng pangungusap na “Nawalan na ng puwang ang paglilinis

at paghahalaman”

A. Nakalimot na ang tao sa kanyang tungkulin sa paglilinis at paghahalaman.

B. Laganap na ang polusyon sa kapaligiran.
C. Marumi ang paligid at kakaunti na lamang ang mga halaman sa
kapaligiran.
D. Ang ibang tao’y hindi na marunong magpahalaga sa kagandhan at
kasaganahan dulot ng kalikasan.
3. Sa pangungusap na “Tinayuan ito ang mga nagtataasang gusali na para bang
gusting sungkutin ang araw sa katayugan” nais ilarawan ng may akda ang
kaisipang ,

A. Higit na mataas ang araw kaysa sa mga nagtataasang gusali.

B. Araw-araw ang mga nagtataasang gusali ay nasisikatan ng araw.
C. Nakikipag-unahan ang mga mayaman sa pagpapatayo ng mga
nagtatayugang mga gusali.
D. Nagtataasan ang mga gusaling itinayo na halos ay abutin na ang araw.

4. Ang kaisipang nais tukuyin ng may akda sa huling pangungusap ay

.

A. Wala nang pag-asa pang malutas ang suliranin sa polusyon.

B. Ang tao ay ma’y iba’t ibang tungkulin ginagampanan sa lipunan.
C. Ang tungkulin ng tao ay kanyang nalilimutan bunga ng suliraning laganap
sa kanyang kapaligiran
D. Ipinagwawalang bahala ng mga tao ang mga bagay na nais niyang gawin
para sa kapakanan ng kanyang lipunan.
 Form 2C

English Composition Examination

Name: Year _ Section_

School: _

Below are suggested topics, student like you often think and talk about.

a. My Family
b. What I Want To Be
c. My Favorite Teacher
d. My Hobby
e. My Unforgettable Experience

Select one topic which interest you, and write two or three paragraphs
about it in English in the space below. If the space below is not enough, you
may continue your essay at the back of this paper.

Title:
 Form 2D

Pagsasanay sa Pagsulat sa Filipino

Pangalan
Paaralan
Taon at Pangkat

Panuto: Basahin at unawaing mabuti ang sitwasyon inilahad sa ibaba.

Sitwasyon

Pagkatapos ng isang mahabang oras ng pagbibiyahe sa bus, narating mo rin

ang bahay ng inyong pinsan na titigilan mo ng ilang araw para sa isang maikling
bakasyon. Nabigla ka ng ibaba mo ang bitbit na traveling bag dahil hindi ito sa iyo.

Sumulat ng isang salaysay tungkol san mga posibleng pangyayari. Gamitin

ang mga patnubay na tala sa ibaba at magdagdag pa ng sarili mong mga ideya.

Paano mo at kailan mo natuklasan na hindi iyo ang bitbit na traveling bag?

Ano ang ginawa mo?

Ano ang nasa loob ng bag?

Ano ang naramdaman mo?

Sino pa ang posibleng kasangkot sa mga pangyayari?

Paano naapektuhan ng mga pangyayari ang inyong bakasyon?

Ano ang huling pangyayari?

Gawing kawili-wili ang iyong salaysay. Tiyaking hindi kukulangin sa 150 mga
salita ang iyong komposisyon. Umisip rin ng sariling pamagat.

Pamagat
 Form 2E

Exercise in Mathematics

Perform the indicated operations:

A. Addition:

1) 8 2) 37 3) 72 4) 513 5) 6369
9 26 99 748 54

B. Subtraction:

1) 7 2) 19 3) 51 4) 832 5) 1000
5 12 36 218 846

C. Multiplication:

1) 8 2) 15 3) 48 4) 143 5) 75
6 7 9 4 25

D. Division:

1) 36 ÷ 4 =
2) 75 ÷ 5 =
3) 123 ÷ 3 =
4) 100 ÷ 25 =
5) 960 ÷ 12 =
 Summary of Scores

I. English

Reading Composition

II. Filipino

Pagbasa Pagsulat

III. Mathematics

Interpretation:

__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
 Form 3
Coping Scale
(Sukatan ng Kakayahan ng Mag-aaral)

Magandang araw sa iyo…

Ang mga pangungusap na nakatala sa ibaba ay nagsasaad ng mga

paniniwala, opinyon at damdamin ng mga karaniwang estudyante ukol sa pag-aaral.
Kasama rin dito ang ilan sa kanilang mga nakasanayang pag-uugali sa pag-aaral o
study habits.

Basahing mabuti at intindihin ang bawat pangungusap. Para sa iyo, ang

sinasabi ba nito ay totoo o hindi? Kung totoo, lagyan ng tsek (√ ) sa hanay na
Totoo. Kung hindi naman, maglagay ng tsek (√ ) sa hanay na Hindi Totoo at kung
hindi nakatitiyak, lagyan ng tsek (√ ) sa hanay na Hindi Sigurado.

Inaasahang magiging tapat ka sa sagot sa bawat aytem. Alalahanin mong

hindi ito isang pagsusulit na may mga natatanging tamang sagot. Sa coping scale na
ito, ang iyong pakiramdam o palagay, ay siyang tamang sagot.

Simulan mo na ang pagsagot!

Hindi Hindi
Totoo
Totoo Sigurado
1. Pumapasa ako sa lahat ng subjects ko.

2. Hindi ako mahilig mag-aral tuwing gabi.

3. Wala akong hilig gumawa ng mahabang takdang
aralin.
4. Naiinis ako sa guro na may paboritong estudyante
na hindi naman dapat.
5. Naiinip ako sa haba ng mga class period.
6. Sabik akong matutunan sa klase ang mga bagay-
bagay na hindi ko pa nalalaman.
7. Naiinis ako kapag ang isang kamag-aral ay
nakakuha ng mas mataas na grado kaysa akin.
8. Ayaw ko sa guro na namimintas ng mga mali kong
gawain.
9. Naiinis ako sa guro kung tinatawag ako upang
sumagot ng tanong.
 21

10. Hindi ko palaging naipapasa ang mga takdang

aralin at proyekto na ibinibigay ng guro.
11. Naiinis ako sa guro na nahuhuli sa pagpasok sa
klase.
12. Mahirap mag-aral ng mag-isa sa bahay dahil
walang nagtuturo sa akin.
13. Masipag akong mag-aral at gumawa ng mga
takdang aralin at proyekto.
14. Gusto ko ang guro na nagbibigay halaga at pansin
kahit sa mga maling sagot ko.
15. Gustong-gusto kong matuto ng mga aralin.

16. Naiinis ako sa sobrang pala-absent na guro.

17. Wala akong hilig magbasa.

18. Sa bahay ay napag-uusapan din namin ng
magulang o kapatid ko ang itinuro ng guro.
19. Naiinis ako sa guro na palaging nagbibigay ng
pagsusulit.
20. Makatatapos ako ng high school kahit papaano.
21. Pumapasok ako kahit may sakit, dahil ayaw kong
mahuli sa mga aralin.
22. Ayaw ko sa guro na masungit.
23. Hindi ako nahuhuli sa pagpasa ng mga takdang
aralin at proyekto.
24. Sa tingin ko ay wala ring kwenta kahit nakatapos
ako ng high school.

Maraming salamat sa iyong kooperasyon!

 Scoring the Coping Scale

There are 24 items in the Coping Scale (Sukatan ng Kakayahan ng

Mag-aaral). There are equal numbers of positive and negative items.

1. To score items 1,6,8,11,13,14,15,16,18,20,21, 22 assign the following points to

the response:
Totoo - 2
Hindi Sigurado- 1
Hindi Tototo - 0

2. To score items 2,3,4,5,7,9,10,12,17,19, 23, 24 assign the following points to the

response:
Totoo - 0
Hindi Sigurado- 1
Hindi Totoo - 2

3. Find the total score by adding the points of all the 24 items.

4. - A total score of 38 and above indicates a high probability that the student
can cope with the EASE Program.
- a total score between 30 and 37 indicates a moderate probability that the
student can cope with the program.
- A total score below 30 indicates a low probability that the student can
cope with the program.
 Form 3

Informal Reading Inventory (IRI)

The reading ability of a learner is crucial to the Open High school Program (OHSP) because
most of the time the learner works independently.

The use of the IRI shall help the teacher determine a learner’s reading level. The independent
level is the stage in which the learner can read successfully with little or no aid because fluency
and comprehension are developed well enough. The learner’s instructional level signals an area
of difficulty. It may mean that the book or reading material is too difficult for the learner. The
learner’s beginning/frustration level may mean frequent face-to-face session from the subject
area teacher.

The results of the IRI shall help the school in determining ۸ prospective enrollees. Thus, an oral
and silent test must be likewise conducted before a learner is officially accepted.

A. Administration of an Oral Reading Test

1. Select a 100 word passage from a material you wish the learner to read
2. The learner is asked to read the passage orally
3. The teacher records the errors.

Types of Errors

Mispronunciation : Record the incorrect response above the word missed

Substitution : Record the substituted word above the one missed

Omission : Circle the omitted word or words

Insertion : Caret ۸ in the extra word

Hesitations : Supply the needed word and write H if the learner pauses
Pauses for longer than five minutes

Repetitions : Draw a wavy line under repeated words

B. Administration of a Silent Reading Test

1. Prepare questions that determine the learner’s ability to use various parts of the text.

Ex. On what part of the text will you find information on ________?
2. Prepare questions that measure both vocabulary and comprehension.
 3. When preparing the questions, be careful to provide items that assess the many
operations of comprehension skills (recognition or recall of facts, concepts,
information; convergence or divergence of concepts; evaluation of facts, information,
concepts and situation).

4. Direct the learner to read the selection.

5. The learner can be timed if you are interested in his/her reading rate.

C. Interpretation

Informal Reading Inventory Standards

Level Oral reading Comprehension

Independent 99 – 100% 99 – 100%

Instructional 95 – 98% 70 – 94%

Beginning 94% and below 69% and below

On the silent reading test, if a learner is able to answer correctly 91 – 100% of the questions,
he/she is at the independent level, if he/she answered 70 – 90% correctly, he/she is at the
instructional level. A learner is at the beginning level if the correct answer is 69% or below.
 Sample Reading Passage

BACK TO SCHOOL

Welcome to Bonifacio High school! Today, you begin another chapter in your life.

High school years are very important years. You learn to get along with others; you can
learn to observe the rules of simple courtesy and good sportsmanship whether on the athletic
field, in the classroom, or at a party. You will think seriously about your future and seek
guidance in choosing your courses.

Each of your teachers assigns homework and expects it to be submitted on time. You
will be asked to read books and references, solve problems, and write compositions. You are
strongly advised then, to develop good study habits. Schedule your activities and use your time
wisely.

Every subject in your curriculum is planned to make you live a fruitful life, prepare you
for the future, make you useful, reliable and responsible citizens. You, the students of today,
are the teachers, parents, decionmakers, and leaders of tomorrow. How you spend these years
in high school will determine to a great extent the kind of nation and world you will help shape
in the future. (Flores, Ladera and dela Cruz, New Horizons in Learning English)
II. Implementation Stage

1. SARDOs who pass the entry assessments sign the learning contract or
agreement (Form 1)

2. Parents or guardian sign the contract (Form 1A)

3. Subject teachers are informed of the present status of the SARDO/s for
appropriate teaching-learning scaffolds.

4. SARDOs are oriented by individual subject teachers on the utilization of print

learning materials(modules), non-print materials and/or online lessons

5. Learners fill up Form 2

6. In cases when the SARDO has to extend the use of module/s, he/she informs
concerned subject teacher and adviser (Form 3)

7. In cases when SARDO has to temporary stop or incur temporary absences,

he/she fills up Form 4

8. Parents/guardian sign Form 4A (Parents/Guardians’ Approval)

9. In cases when medical attention and/or psycho-social and emotional assessment

is needed by the learners, class adviser recommends him/her to the person-in-
authority (Form 5)
 Form 1
(English Version)
B. Implementation Stage

LEARNER’S AGREEMENT

I ____________________________ is currently receiving intervention through the

(Name of Learner)

DORP( Drop out Reduction Program) at ________________________ as

________________________
(Name of School) (Year Level)

As a learner, I am expected to undertake the following:

● to act responsibly in all learning activities/task assigned to me;

● to be honest and open by contacting/reporting to my teacher the learning activities/task

which I find difficult

● to exercise time management so as to finish on time any learning activity/task required

in each subject

● to try my best so as not to abuse the “freedom of self-pacing”; and

● to finish my course with the support of my family/guardian/patron

With the above-mentioned expectations, I hereby agree that with all the opportunities
offered by the Open High School System, I will do my best to SUCCEED.

_________________________ _______________________
Parent/guardian/patron Learner

Noted:

________________________
Adviser

_______________________
 Principal

Form 1
(Filipino Version)
KASUNDUAN

Ako si __________________________ay isang mag-aaral sa ilalim ng DROP OUT

(Pangalan)

REDUCTION PROGRAM ng paaralang ____________________________ na

nabibilang sa ___________________.
(Antas)

Bilang mag-aaral, ako’y inaasahang gagawin ang mga sumusunod:

 pangangatawanan ang lahat ng gawaing pampagkatuto na ipinagkatiwala sa

akin;
 magiging bukas at matapat na ipaaalam sa aking mga guro ang mga gawaing
mahirap para sa akin
 susundin ang panahon o palugit na ibibigay sa akin upang matapos sa oras ang
bawat gawaing pampagkatuto
 hindi aabusuhin o sasamantalahin ang esensya ng freedom of self-pacing; at
 tatapusin ang kursong pangsekondarya anumang balakid ang makaharap sa
tulong ng aking pamilya/nangangalaga/pinaglilingkuran.

Sapagkat ito ang mga inaasahan sa a akin, ipinangangako ko na sasamantalahin

ang lahat ng mga pagkakataong ipagkaloob ng Open High School System upang ako
ay magtagumpay.

Saksi: Lagda:

_____________________________ ____________________________
Magulang/Tagapangalan Mag-aaral
Pinaglilingkuran

Binigyang Pansin

__________________________
Tagapayo
__________________________
Guidance Counselor

__________________________
Principal
Form 1A

KASUNDUAN

Ako si G/Gng./Bb. ___________________________________________________________

magulang/tagapangalaga ni
________________________________________________________
mag-aaral sa ilalim ng Open High School System ng paaralang
__________________________________ ay nahahandang sumuporta sa mga sumusunod:

● magbibigay ng tulong sa paraang pinansyal o materyal ng gagamitin sa mga gawaing

pampagkatuto;

● magiging bukas at matapat sa pagpapaalala ng kanyang mga gawaing pampagkatuto at

ang pagsusumite nito sa tamang panahon;

● magiging bukas at matapat sa mga guro ng paaralan at sa mga taong tumutulong sa

pamayanan ng iparating sa kanila ang mga pangangailangan ng aking mag-aaral at;

● susubaybayan siya nang buong katapatan hanggang sa matapos ang kursong pang
sekondari.

Lagda:

________________________ ___________________________
Mag-aaral Magulang/Tagapangalaga

Binigyang Pansin:

_____________________________
Tagapayo

_____________________________
Guidance Counselor

____________________________
Principal
 Form 2

Receipt/Acceptance Form

Date Received:______________

Learning
Area/Subject :_________________________
Learner’s
Name :_________________________
Year Level :_________________________

Allotment
No. of Period per Initial Evaluation by
Quarter Modules Title of Modules Module the subject teacher
Received (To be agreed Returned on after returned of the
upon by learner
and subject module
teacher)
Modules
Nos.
_______
_______
_______
_______
_______
 Form 3

Request for Extension of Submission of Module

Dear_______________,

This is to request for the extension of submission of module from_____________

to________________________________.

I am making this request because:_____________________________________

_______________________________________________________________________
_______________________________________________________________________
____________________________________________________________________

Truly yours,

_____________________
Student

Noted:

_____________________
Parent/Guardian

Approved by:

_______________________
Subject Teacher
 Form 4

Application for Open High School (Temporary Absences)

_________________
Date

Sir/Madam:

I am applying for OHSP (Temporary Absences)

I want to be in the program from

_____________________________________to
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_________________________________________________________________.

Thank you.

Sincerely yours,

_____________________
Student

Year_____Section______
 Form 4A

Pahintulot ng Magulang at Tagapag-Alaga

(Parent/Guardian’s Approval)

Pinahihintulutan ko ang pag-aaplay ni________________________________________

Sa Programang Open High School (Pansamantalang Pagliban) sa dahilang__________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
__________________________________________________________________.

G./Gng./Bb.__________________
(Pangalan at Lagda)

Petsa________________
 Form 5

Referral Slip

Date__________________

The Guidance Counselor/

Medical Officer

Sir/Madam:

Kindly assess_________________________of___________________________
(Name of Student) (Year and Section)

in terms of disadvantaged situations.

Respectfully yours,

_____________________
Class Adviser

Finding/Assessment
_______________________________________
_______________________________________

Suggestions/Recommendations
_______________________________________
_______________________________________

_____________________________
Guidance Counselor/Medical Officer

Noted by:

_____________________
Principal /School Head
 (To be fill up by the adviser and directly submitted to the person-in authority)

III. Mainstreaming Stage

1. Subject teachers fill-up Form 1 or Form 2

2. Homeroom PTA meeting is conducted by the adviser to update them of the

progress of their children.

3. In cases when the adviser needs to conduct a conference with the SARDO/s
and/or parent, Form 3 is sent to the concerned

4. In cases when the SARDO/s needs to go back to regular school program,

he/she request for Form 4

5. Adviser of the SARDO/s forwards an endorsement form to the Adviser and

subject teachers (Form 5)
 Form 1

Summary of Modules Accomplished by Quarter

Learning Area:_____________ Year Level:____________

Learner’s Name:______________________________ Quarter 1
SY:__________________

Modules 1 2 3 4 5 6 7 8 9 10 Other Requirements

Taken June 15
Returned June 17 Over-all Remark

Result per Kasiya-siya

Modules Nasunod
lahat ang
hinihingi ng
modyul.
Above-
average ang
mga
nakuhang
puntos sa
kabuuan ng
ebalwasyon
 (To be accomplished by subject teacher)

Form 2

Learning Area:_____________ Year Level:____________

Learner’s Name:______________________________ Date Taken:___________
Teacher:______________

1) No. of Desired Allotment Actual Initial Remarks

Modules Competencies/standa Period (To be Accomplishment Evaluation of
rd to be developed determined Period the subject
by the Teacher
learner)

Modules 6:  Give meaning of One week 2 weeks

Being idiomatic phrases
Responsible  Arrive at a
Steward of concensus
Nature  Transcode
information
obtained from a
listening text
 Write a text on
how one might
help in the
conservation of our
natural resources
(To be accomplished by the subject teacher)

Form 3

Letter of Invitation

Dear Sir/Madam:

This is to invite you and your child___________________________________,for

a brief conference on __________________at__________________.

Pertinent matters shall be discussed during the meeting.

Thank you.

_____________________
Adviser

Noted:

__________________________
Principal / School Head
 Form 4

Application for Reentry into Regular

School Program

Dear_____________,

This is request that I return to my regular classes on______________,20______.

I am making this request because:_____________________________________

_______________________________________________________________________
_______________________________________________________________________

Below is my performance rating as an EASE student for ___________________:

(Inclusive Dates)

Subject Module Class Standing Teacher’s

No. Quizzes Recitation Output/project Signature
Filipino
English
Mathematics
Science
Makabayan
Araling Panlipunan

Truly yours,
_____________________
Student
Noted:
_________________________
Parent/Guardian
 Approved:
_____________________
Principal/School Head

(Submit this form to your class adviser of OHSP)

Form 5

Endorsement

The Adviser
Section______________

The Subject Teacher

Subject______________

Dear Sir/Madam:

This is to endorse ______________________________________________to be

mainstreamed/returned to his her regular classes. Pertinent academic records and other
data have been evaluated by the OHSP-DORP team and found to be Satisfactory.

________________
Coordinator

Approved:

_____________________
Principal/School Head