Clientele/Beneficiary/ies Date Over-all Assessment (Pls. check) Name/Title of Name of Student Involved (Name of community, Number of indicate Activity organization, etc.) beneficiaries inclusive period) Very Good Outstanding STUDENT EXTENSIONPROGRAMS/PROJECTS– TARGET FOR THE SUCCEEDING FISCAL YEAR Clientele/Beneficiary/ies Date Over-all Assessment (Pls. check) of Name of Student/sInvolved (Name of group, Number of (Pease indicate Activity community, organization, beneficiaries inclusive period) Q1 Q2 Q3 Q4 etc.) Good Good Good Good Very Very Very Very Outstanding Outstanding Outstanding Outstanding Submitted by: ________________________________________________ Name, Designation and Signature of the Head of the Office Date:____________________
Name/Title of Activity Name of Student Involved Clientele/Beneficiary/ies (Name of community, organization, etc.) Number of beneficiaries Date indicate inclusive period) Over-all Assessment (Pls. check) Very Good Outstanding STUDENT EXTENSIONPROGRAMS/PROJECTS– TARGET FOR THE SUCCEEDING FISCAL YEAR of Activity Name of Student/sInvolved Clientele/Beneficiary/ies (Name of group, community, organization, etc.) Number of beneficiaries Date (Pease indicate inclusive period) Over-all Assessment (Pls. check) Q1 Q2 Q3 Q4 Very Good Outstanding Very Good Outstanding Very Good Outstanding Very Good Outstanding Submitted by: ________________________________________________ Name, Designation and Signature of the Head of the Office Date:____________________
ARFACAD2013.docx