Republic of the Philippines

DEPARTMENT OF EDUCATION
Region IX, Zamboanga Peninsula
Division of Zamboanga City
RAMON ENRIQUEZ HIGH SCHOOL
Labuan District
Labuan, Zamboanga City

FORM 4: LAC ENGAGEMENT REPORT

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

NAME OF MEMBER: LAC SESSION ID.:

REGION: DATE OF LAC SESSION:

DIVISION: NUMBER OF LAC SESSION:

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,
SD D N A SA please indicate why.)

THE LAC SESSION

1. I learned a lot from my colleagues in

this LAC session.

2. The LAC session deepened my

understanding of the SLM content.

3. My perspective on the topic/s covered

has changed as a result of the LAC
session.

4. I participated actively in the LAC session

by sharing my assignment and insights,
asking questions, and giving
feedback on what colleagues shared.

5. I interacted with different

people during the LAC
session.

ACTION PLAN

6. I feel motivated to apply in my

region/division/district what I have
learned in this lesson.

7. I intend to apply what I have learned

from the lesson in my
region/division/district
Part B
Please provide the information requested.
1. I need further clarification and/or resources on the following topics:

2. I encountered the following problems or challenges:

3. Other comments/suggestions: