Scribd
Upload
2 views2 pages

Routine Interview Form

The document is a Routine Interview Form from the Center for Guidance Services at Camarines Sur Polytechnic Colleges, aimed at gathering students' evaluations of themselves, their teachers, and the institution. It includes personal information sections, informed consent regarding data privacy, and topics for discussion related to academic and social adjustment, goals, concerns, and peer relationships. The responses will be confidential and used to improve guidance services.

Uploaded by

KIEM DICHOSO
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
2 views2 pages

Routine Interview Form

The document is a Routine Interview Form from the Center for Guidance Services at Camarines Sur Polytechnic Colleges, aimed at gathering students' evaluations of themselves, their teachers, and the institution. It includes personal information sections, informed consent regarding data privacy, and topics for discussion related to academic and social adjustment, goals, concerns, and peer relationships. The responses will be confidential and used to improve guidance services.

Uploaded by

KIEM DICHOSO
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

Republic of the Philippines

Camarines Sur Polytechnic Colleges


Nabua, Camarines Sur
CENTER FOR GUIDANCE SERVICES
Tel. No. (054) 288 – 4421 to 23 loc. 125 | Contact No. 09177019981
E-mail: guidancecenter@[Link]
CSPC-F-GUID-77

ROUTINE INTERVIEW FORM


Dear Students,

Good Day! The purpose of this interview is to obtain your honest, objective, and sincere appraisal for yourself, your teachers, and your
alma mater. Moreover, this also serves as a stepping stone to find out how our services be improved. This is conducted to help us know
in what way we can best serve you. Your response on this evaluation will be kept confidential.

Thank you so much and God bless you!


- Guidance Counselors and Staff -
PERSONAL INFORMATION
Family Name Given Name Middle Name
NAME

BLOCK SECTION YEAR COURSE

LEVEL

DATE TIME

INFORMED CONSENT
By completing this form, I am giving my consent that the information shared is a part of the assessment
service of the Guidance Center that may be used for research purposes.

I am aware that any information shared shall be treated with utmost confidentiality, in compliance with the
provisions of the Data Privacy Act of 2012. I hereby certify that the above information given is true and
correct.

_______________________________________________________________________
SIGNATURE OVER PRINTED NAME

TOPICS FOR DISCUSSION


1. How are you? (Kumusta ka?)

2. How well-adjusted are you in the following areas? (Scale of 1-10: 1 – Poor; 5 – Average; 10 –
Excellent)

________ Academically ________ Socially ________ Spiritually


________ Financially ________ Emotionally ________ Physically

3. Your academic goals


v Do you like your
course/program?
Yes No
Why?
______________________________________________________________________________

v Are you determined to finish your course?

Effectivity date: February 2025 Rev. 0 Page 1 of 2

Republic of the Philippines


Camarines Sur Polytechnic Colleges
Nabua, Camarines Sur
CENTER FOR GUIDANCE SERVICES
Tel. No. (054) 288 – 4421 to 23 loc. 125 | Contact No. 09177019981
E-mail: guidancecenter@[Link]
CSPC-F-GUID-77
Yes No
Why?
______________________________________________________________________________

4. Your issues/concerns right now.

v Do you have any concern/s that need/s special attention?

v How do you handle your concerns?

5. Do you have any barkada/peer group?

v How is your social relationship with them?

v What activities do you like to do with them?

6. What other activities or organizations have you joined in or out of school?

ACCOMPLISHED BY: DATE

NAME AND SIGNATURE OF THE STUDENT

Effectivity date: February 2025 Rev. 0 Page 2 of 2

You might also like