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The document is a consent form for parents allowing their child to participate in a literacy tutoring program at Camiguin Polytechnic State College. It includes profiles of both the tutee and the tutor, as well as sections for weekly monitoring and reflections on the tutoring experience. The program aims to support children's education during the pandemic and beyond.

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colleenjadeko17
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0% found this document useful (0 votes)
6 views13 pages

Tutorial Templates

The document is a consent form for parents allowing their child to participate in a literacy tutoring program at Camiguin Polytechnic State College. It includes profiles of both the tutee and the tutor, as well as sections for weekly monitoring and reflections on the tutoring experience. The program aims to support children's education during the pandemic and beyond.

Uploaded by

colleenjadeko17
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

CAMIGUIN POLYTECHNIC STATE COLLEGE


Balbagon, Mambajao, Camiguin
Institute of Teacher Education

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA AND BEYOND YEAR 5


January 2, 2026

DR. JENELYN G. SABELLINA


Dean, Institute of Teacher Education
Camiguin Polytechnic State College
Balbagon, Mambajao, Camiguin

Subject: Consent to allow my son/daughter as literacy recipient of the Extension Program of The
Institute of Education of Camiguin Polytechnic State College

Dear Ma’am:

I am _________________________________, Filipino, of legal age, hereby allow my son/daughter,


_________________________________ to be tutored by ________________________, an Education
student of Camiguin Polytechnic State College known to me as literacy volunteer. The said tutorial which
lasts only for two hours weekly is an extension activity of Camiguin Polytechnic State College- Institute of
Teacher Education dubbed as Pakiglambigit sa Edukasyon sa kabataan Sa Panahon sa Pandemya and
Beyond Year 5.

I understand that I have no monetary obligation whatsoever to the literacy volunteer or to


Camiguin Polytechnic State College.

Sincerely,

_____________________________
Signature over printed name of parent

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA


PANDEMYA
and BEYOND YEAR 5

Profile of the Tutee

Insert latest
picture passport
size

Literacy Recipient: ______________________________


Age ____________ Sex ___________ Mobile Number:
_____________________
Address: __________________________________
School Attended: ______________________________ Grade: ___________________________________
Adviser: ______________________________ Mobile Number:
___________________________
Parent/Guardian: ______________________________ Mobile Number:
___________________________

Profile of the Tutor

Insert latest
picture passport
size

Literacy Volunteer: _____________________________________________________


Age ____________ Sex ___________ Mobile Number: __________
Address: _______________________________
Course and Year ________________________________

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA


and BEYOND YEAR 5

Summary

Date and Time of Subject & Topic Signature of Guardian


Session

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA


and BEYOND YEAR 5

Weekly Monitoring

Name of Literacy Volunteer: Date:


Week No: Time:
Topic/s tackled:
Attached Proof Here:

______________________________ ______________________________
Signature of Parent/Guardian Signature of Literacy
Recipient
of Literacy Recipient Over Printed Name Over Printed Name

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA


and BEYOND YEAR 5

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

Weekly Monitoring

Name of Literacy Volunteer: Date:


Week No: Time:
Topic/s tackled:
Attached Proof Here:

______________________________ ______________________________
Signature of Parent/Guardian Signature of Literacy
Recipient
of Literacy Recipient Over Printed Name Over Printed Name

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA


and BEYOND YEAR 5

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

Weekly Monitoring

Name of Literacy Volunteer: Date:


Week No: Time:
Topic/s tackled:
Attached Proof Here:

______________________________ ______________________________
Signature of Parent/Guardian Signature of Literacy
Recipient
of Literacy Recipient Over Printed Name Over Printed Name

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA


and BEYOND YEAR 5

Weekly Monitoring

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

Name of Literacy Volunteer: Date:


Week No: Time:
Topic/s tackled:
Attached Proof Here:

______________________________ ______________________________
Signature of Parent/Guardian Signature of Literacy
Recipient
of Literacy Recipient Over Printed Name Over Printed Name

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA


and BEYOND YEAR 5

Weekly Monitoring

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

Name of Literacy Volunteer: Date:


Week No: Time:
Topic/s tackled:
Attached Proof Here:

______________________________ ______________________________
Signature of Parent/Guardian Signature of Literacy
Recipient
of Literacy Recipient Over Printed Name Over Printed Name

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA


and BEYOND YEAR 5

Weekly Monitoring

Name of Literacy Volunteer: Date:


Week No: Time:

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

Topic/s tackled:
Attached Proof Here:

______________________________ ______________________________
Signature of Parent/Guardian Signature of Literacy
Recipient
of Literacy Recipient Over Printed Name Over Printed Name

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA


and BEYOND YEAR 5

Weekly Monitoring

Name of Literacy Volunteer: Date:


Week No: Time:
Topic/s tackled:
Attached Proof Here:

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

______________________________ ______________________________
Signature of Parent/Guardian Signature of Literacy
Recipient
of Literacy Recipient Over Printed Name Over Printed Name

PAKIGLAMBIGIT SA EDUKASYON SA KABATAAN SA PANAHON SA PANDEMYA


and BEYOND YEAR 5

Weekly Monitoring

Name of Literacy Volunteer: Date:


Week No: Time:
Topic/s tackled:
Attached Proof Here:

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

______________________________ ______________________________
Signature of Parent/Guardian Signature of Literacy
Recipient
of Literacy Recipient Over Printed Name Over Printed Name

Challenges Encountered

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

Reflection/ insights after doing the activity after 1 semester

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”
Republic of the Philippines
CAMIGUIN POLYTECHNIC STATE COLLEGE
Balbagon, Mambajao, Camiguin
Institute of Teacher Education

“The effectiveness of the College lies on its ability to produce quality men and women who will attain advancement
in life through arts, sciences, engineering and technology for the service of God, Country and Humanity ”

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