Eap School Visit Form

Families and Children for Empowerment Development Foundation Inc. 2290 Pres. Quirino Ave. Paco Manila School Visit Report Date of Visit : ___________________________________________________________ Name of the Student : _____________________________________________________ Name of School : _________________________________________________________ Name of Teacher /Adviser : _________________________________________________ Purpose of Visit ( Dahilan ng Pagbisita sa Paaralan ) _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ ___ Observations ( Mga Obserbasyon sa Bata sa Loob ng Paaralan ) _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _____ Plan of Action /Recommendation/ Teachers Assessment _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _____

Prepared by :

Noted by :

__________________________ BCPC Educ.Commitee Assigned

______________________________ FCED-EAP Social Worker

______________________________ Ms. Marilyn C. Gamboa FCED-EAP Supervisor