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Monitoring and Evaluation Form

The document is a Work Immersion Monitoring Form for supervisors, detailing student information, tasks, and performance evaluation criteria. It includes sections for task tracking, supervisor evaluation of student performance across various criteria, and a grading system. The evaluation contributes 40% to the overall grade, emphasizing job knowledge, commitment to quality, self-motivation, teamwork, and initiative.

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20 views2 pages

Monitoring and Evaluation Form

The document is a Work Immersion Monitoring Form for supervisors, detailing student information, tasks, and performance evaluation criteria. It includes sections for task tracking, supervisor evaluation of student performance across various criteria, and a grading system. The evaluation contributes 40% to the overall grade, emphasizing job knowledge, commitment to quality, self-motivation, teamwork, and initiative.

Uploaded by

lkinggaming0
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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WORK IMMERSION MONITORING FORM FOR SUPERVISOR

Adopted from Annex C of DepEd Order No. 30, series of 2017

Name of Student Grade and Section


Name of School Track/ Strand
Duration of Work
Company and Department
Immersion

Name of Supervisor Contact Number


Name of Work Immersion
Contact Number
Teacher

LIST OF TASKS/ ACTIVITIES

TASKS/ TIME REMARKS OR


DATE STATUS
ACTIVITIES ALLOTMENT COMMENTS

Certified true and correct:

Supervisor’s Signature Over Printed Name

WORK IMMERSION STUDENT’S PERFORMANCE EVALUATION

Record Code: SHS-SSD-5.9

Page 1 of 2

Date: May 6, 2025


Name of Student Grade and Section
Name of School Track/ Strand
Company and Duration of Work
Department Immersion

Name of Contact
Supervisor Number
Name of Work Contact
Immersion Teacher Number

Direction: Check the column which corresponds to your rating.

LEGEND: 5 - excellent 4 - very satisfactory 3 - satisfactory 2 – fair 1- poor

Criteria 5 4 3 2 1
JOB KNOWLEDGE
A. Requires minimum to no support from the supervisor.
B. Demonstrates a thorough or proficient knowledge of job duties.
C. Makes minimal to no errors or omissions in assigned tasks
Total: ___________________
COMMITMENT TO QUALITY
A. Participates in all aspects of the job requirements.
B. Consistently completes assignments in a reasonable amount of time.
C. Follows all written and oral instructions.
Total: ___________________
SELF-MOTIVATION/ ATTENDANCE/ TIME MANAGEMENT
A. Self-directed, recognizes tasks to be done
B. Consistently reflects on work done and its values
C. Attend remote/ online sessions when scheduled.
D. Consistently attend online sessions in a timely manner.
Total: ___________________
TEAM WORK/ COMMUNICATION AND SOCIAL SKILLS
A. With pleasant and positive attitude, easy to get along with.
B. Shows willingness to benefit from training
C. Shares in the work distribution
D. Frequently contributes ideas to improve the organization
E. Develops strong relationships with staffs and other trainees
F. Dress and appearance present a positive image
Total: ___________________
INITIATIVE AND INNOVATION
A. Encourages brainstorming of new ideas
B. Accept feedbacks and constructive comments
C. Readily collaborates to solve problems
D. Leads improvement initiatives
Total: ___________________
Grand Total: ___________________
* Note: The students performance evaluation constitutes to 40% of the over-all grade.

Evaluated by:
__________________________________
Supervisor’s Signature Over Printed Name

Record Code: SHS-SSD-5.9

Page 2 of 2

Date: May 6, 2025

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