Template Integrative Assessment Example Blank Form
Template Integrative Assessment Example Blank Form
Template Integrative Assessment Example Blank Form
Department of Education
National Capital Region
Schools Division of Pasig City
SUMMATIVE ASSESSMENT
Grade Level: ______ Quarter: ___ Date to be given/communicated to Time (Indicate the
the learner/parents/LSA: estimated time the
activity is to be
Date/ time to be submitted: accomplished):
e.g. 1 hour
Assessment Criteria
Learning Areas Most Essential Learning Competencies: Competency Codes:
Overview of the Assessment Activity (Provide a clear and concise description of your activity)
Assessment Activity
Expected Output:
Note:
Instruction and mode of submission will be communicated in the Weekly Home Learning Plan considering the
Learner’s Modality
Recording Methods (Put an x mark on the blank where appropriate)
____Checklist ____Marks
____Class Grids ____Anecdotal Record
____Grades ____Self assessment records
____Comments on Learner’s work
____Audio recording, photographs, video footages
Prepared by:
________________________ _______________________
Signature above printed name Signature above printed name
MAPEH-Teacher EsP-Teacher
________________________ _________________________
Signature above printed name Signature above printed name
English Teacher Math Teacher
________________________
Signature above printed name
Science Teacher
Date: ____________________