FORM 1: LAC PROFILE

This form should be accomplished by the LAC Facilitator and its members at the first LAC session.
REGION: III
LAC ID (name or number): SBNHS-1LAC-06-006 Number of LAC members: 14
Name of LAC Facilitator: Joana Joy S. Canlas Designation/Position: Teacher II
LAC Members
Name Male/ Designation/ Division Contact Details ( email, Preferred
Female Position mobile number) contact
mode
(email,phone
,Skype,Zoom
JEHANNAH ANTIOQUIA Female T-1 Angeles jehannah.antioquia@dep All
ed.gov.ph
EDDIE DARCIA Male T- Angeles [email protected] All
.ph
GEMMA MANDAP Female T-1 Angeles gemma.mandap@deped All
.gov.ph
FRANCES VELASQUEZ Male T-1 Angeles frances.velasquez@dep All
ed.gov.ph
LADY YUMANG Female T-1 Angeles [email protected] All
v.ph
PATRICK RENZ MIRANDA Male T-1 Angeles patrick.miranda@deped. All
gov.ph
EROS PRINIEL Male T-1 Angeles [email protected]. All
ph
LON RELORCAZA Male T- 2 Angeles [email protected] All
v.ph
CHARLIEMAGNE FIEL Male T-2 Angeles charliemagne.fiel@depe All
d.gov.ph
LITHOS STO. DOMINGO Male T- 2 Angeles lithos.stodomingoa@dep All
ed.gov.ph
JOANA JOY CANLAS Female T- 2 Angeles [email protected] All
v.ph
ALEJANDRINA TORRES Female T-2 Angeles alejandrina.torres@depe All
d.gov.ph
JOYCE MUNDIA Female T-2 Angeles [email protected] All
v.ph
KENNETH BAUTISTA Male T-1 Angeles kenneth.bautista@deped All
.gov.ph
FORM 2: LAC Facilitator Information Sheet
This form should be accomplished by the designated LAC Facilitator on or before first LAC session.
REGION: III

DIVISION: ANGELES

Name Gender Date of Birth Age

Joana Joy S. Canlas Female April 22, 1990 30

Contact Details Email: Mobile Number Facebook Name

09952589623 [email protected] 09322133109 Joana Joy Soriano
Canlas
Preferred contact mode
Email, Phone, Google Meet, Facebook, Messenger, Zoom
From: 8:00-5:00

FORM 3: LAC Session Report

This form should be accomplished by the LAC Facilitator at the end of every LAC session.
LAC ID: SBNHS-1LAC-06-006 REGION: III
LAC FACILITATOR: JOANA JOY S. CANLAS LAC SESSION NO.: 1
DATE AND TIME OF SESSION: VENUE/ PLATFORM OF SESSION:
SEPTEMBER 14, 2020 / 1:00- 3:00 PM WORK FROM HOME/GOOGLE MEET
meet.google.com/vvx-wvig-kke
Number of members present ( attach attendance documents): 14

Materials and resources:

____ Self-Learning Module

____ Activity Sheets
____ Digital resources
____ Online resources
____ Smartphone
____ PC
____ LAC session guide
____ Others. Please specify:
____________________________________
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)

Comment/ Remarks
(for example, if you disagree or
strongly disagree, please indicate
SD D N A SA why.)
MEMBER PARTICIPATION
1. All of the members came prepared for 
the LAC session.
2. Opportunity to share and discuss their 
assignment, insights and ideas.
3. Members listened to each other’s 
insight and ideas.
4. The members’ assignment showed an 
understanding of the lessons in the
SLM.
5. The members demonstrated 
engagement in and / or enthusiasm for
the learning task during the session
( including proving feedback on each
other’s assignment ).

Comment/ Remarks
(for example, if you disagree or
strongly disagree, please indicate
SD D N A SA why.)
FACILITATION
6. I manage the sharing and discussion 
during the LAC session by keeping the
discussion focused on the lesson or
topic.
7. I encouraged all the members to 
actively participate in the LAC session
( i.e., for the teachers to share their
work and ideas/ insights).
8. I provide useful feedback on the 
teachers’ assignment.
Part B
Please provide the information requested.

1. The best part of the session (i.e. what went well):

Discussing the ways on how easily understand the LDM

2. Problems or challenges encountered and how they were resolved:

Not all of the members have enough knowledge when it comes to LDM.
We shared our all ideas and helped each other to solve the problem.

3. Other topics discussed apart from the recommended topic, if any;

None

4. Recommendations/ Plans for next LAC session.

None

Signed:
Date:
FORM 4: LAC ENGAGEMENT REPORT

This form should be accomplished by each LAC Member at the end of every LAC session.
NAME OF MEMBER: CHARLIEMAGNE Z. FIEL LAC SESSION ID: SBNHS I-LAC-06-006
REGION: III DATE OF LAC SESSION: SEPTEMBER 14, 2020
DIVISION: PAMPANGA NUMBER OF LAC SESSION: LAC1

Part A
Please indicate the extent to which you agree with each of the following statement by ticking the
appropriate box. (SD = Strongly Disagree; D = Disagree; N = Neutral; A = Agree; SA = Strongly Agree)

Comments/Remarks
SD D N A SA (For example, if you disagree or
strongly disagree, 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 results 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 integrated 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:

Answer: Everything is clear and properly explained.

2. I encountered the following problems or challenges:

Answer: I was challenged with the different activities and task assigned to us in module 1

3. Other comments/suggestions:
Answer: The LAC1 was clear and successfully delivered. Though there are some flaws
regarding the management of time, it was clear for us what tasks should we do. I suggest that
we will be having interactive activities so we can further understand the different forms. It would
also be nice if they would give us the materials beforehand so we can study the module before
the session.

Signed:
Date: