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ALS RPL Form 1
Page 1 of 4 10/2020
DOCUMENTATION OF LIFE EXPERIENCE
Name of Learner: ______________________ Community Learning Center: _______________
Level: BL LE AE JHS Name of ALS Teacher: ____________________
(1) About Me
Directions: Kindly write your hobbies, strengths, interests, weaknesses, ambition/s, and a simple
sentence about your family on the spaces provided.
Hobby/ies (Libangan):
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
Interest/s (Hilig):
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
Ambition/s (Mithiin):
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
Strength/s (Kalakasan):
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
Weakness/es (Kahinaan):
________________________________
________________________________
________________________________
________________________________
________________________________
________________________________
Write a simple sentence about
your family.
(Sumulat ng pangungusap tungkol sa
iyong pamilya.)
________________________________
________________________________
________________________________
________________________________
ALS RPL Form 1
Page 2 of 4 10/2020
(2) Experiences
Directions: Read each of the common daily life experiences listed in the first column. Place a
check ( ) in the second column if you have ever had such similar life experiences. If you have
had a significant life experience not on the list, kindly check “Others” and specify on the space
provided. Use a separate sheet of paper if necessary. Briefly explain the experience in the third
column; indicate when it happened in the fourth column; and specified where it happened in the
fifth column.
Experience
(Karanasan)
P
u
t
i
f
y
e
s
What specific
experience/s?
(Anong karanasan ito?)
When did you
experience it?
(Kailan ito
naranasan?)
Where did
you
experience
it?
(Saan ito
naranasan?)
A. Communication (Komunikasyon)
Reading/Viewing (e.g.,
newspaper, internet)
Listening/Speaking (e.g.,
dialogue)
Writing (e.g., note-taking)
Others, please specify:
______________________
______________________
______________________
B. Social Activity (Panlipunang Aktibidad)
Outdoor Activities (e.g.,
engaging in sports, tree
planting, clean-up drive)
Charitable Works (e.g.,
caring for the sick; giving
donation)
Others, please specify:
_______________________
_______________________
_______________________
C. Science (Agham)
Using/Operating Simple
Machines (e.g., inclined
plane; wheel and axle)
Using Electronic Devices
(e.g., electric bike )
ALS RPL Form 1
Page 3 of 4 10/2020
Natural Calamities (e.g.,
typhoon, earthquake)
Human-induced Calamities
(e.g., fire; war)
Others, please specify:
______________________
______________________
______________________
D. Numeracy (Matematika)
Money (e.g., counting and
recording the amount of
money earned and spent)
Geometric Shapes/Figures
(e.g., lines, perimeter, angle,
polygon)
Measuring Devices (e.g.,
linear; kilo, kilometers)
Tables, Graphs, and
Statistics (e.g., collecting and
recording data;
reading/interpreting data in a
graph)
Others, please specify:
______________________
______________________
______________________
E. Livelihood (Kabuhayan)
Agri-fisheries (e.g., food
processing; farming)
Industrial Arts (e.g., welding,
plumbing)
Home Economics
(e.g., housekeeping;
bartending )
Handicraft (e,g., basket
weaving, knitting)
Others, please specify:
_______________________
_______________________
_______________________
ALS RPL Form 1
Page 4 of 4 10/2020
F. Intrapersonal and Interpersonal Relationships (Pang-unawa sa Sarili at
Pakikipagkapwa)
Positive Sense of Self (e.g.,
learning to know oneself;
self-worth; self-direction)
Family and Community
Solidarity (e.g.,
demonstrating smooth
interpersonal relationships
between and among family
and community members)
Others, please specify:
______________________
______________________
______________________
G. Information and Communications Technology (ICT) (Teknolohiya ng Impormasyon at
Komunikasyon)
Basic Hardware/Software
Operations and File
Management (e.g., operating
a computer and other
computer peripherals;
managing files in a computer)
Common Office Application
Software Packages (e.g.,
word processing;
presentation software)
Mobile Devices
(e.g., operating mobile
phones, smart
devices/wearables, digital
video cameras, etc.)
Others, please specify:
______________________
______________________
______________________
_________________________________ ___________________________________
(Learner’s Signature over Printed Name) (ALS Teacher’s Signature over Printed Name)
Date: ____________________________ Date: _______________________________

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RPL-Form-1 (1).pdf

  • 1. ALS RPL Form 1 Page 1 of 4 10/2020 DOCUMENTATION OF LIFE EXPERIENCE Name of Learner: ______________________ Community Learning Center: _______________ Level: BL LE AE JHS Name of ALS Teacher: ____________________ (1) About Me Directions: Kindly write your hobbies, strengths, interests, weaknesses, ambition/s, and a simple sentence about your family on the spaces provided. Hobby/ies (Libangan): ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ Interest/s (Hilig): ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ Ambition/s (Mithiin): ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ Strength/s (Kalakasan): ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ Weakness/es (Kahinaan): ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ Write a simple sentence about your family. (Sumulat ng pangungusap tungkol sa iyong pamilya.) ________________________________ ________________________________ ________________________________ ________________________________
  • 2. ALS RPL Form 1 Page 2 of 4 10/2020 (2) Experiences Directions: Read each of the common daily life experiences listed in the first column. Place a check ( ) in the second column if you have ever had such similar life experiences. If you have had a significant life experience not on the list, kindly check “Others” and specify on the space provided. Use a separate sheet of paper if necessary. Briefly explain the experience in the third column; indicate when it happened in the fourth column; and specified where it happened in the fifth column. Experience (Karanasan) P u t i f y e s What specific experience/s? (Anong karanasan ito?) When did you experience it? (Kailan ito naranasan?) Where did you experience it? (Saan ito naranasan?) A. Communication (Komunikasyon) Reading/Viewing (e.g., newspaper, internet) Listening/Speaking (e.g., dialogue) Writing (e.g., note-taking) Others, please specify: ______________________ ______________________ ______________________ B. Social Activity (Panlipunang Aktibidad) Outdoor Activities (e.g., engaging in sports, tree planting, clean-up drive) Charitable Works (e.g., caring for the sick; giving donation) Others, please specify: _______________________ _______________________ _______________________ C. Science (Agham) Using/Operating Simple Machines (e.g., inclined plane; wheel and axle) Using Electronic Devices (e.g., electric bike )
  • 3. ALS RPL Form 1 Page 3 of 4 10/2020 Natural Calamities (e.g., typhoon, earthquake) Human-induced Calamities (e.g., fire; war) Others, please specify: ______________________ ______________________ ______________________ D. Numeracy (Matematika) Money (e.g., counting and recording the amount of money earned and spent) Geometric Shapes/Figures (e.g., lines, perimeter, angle, polygon) Measuring Devices (e.g., linear; kilo, kilometers) Tables, Graphs, and Statistics (e.g., collecting and recording data; reading/interpreting data in a graph) Others, please specify: ______________________ ______________________ ______________________ E. Livelihood (Kabuhayan) Agri-fisheries (e.g., food processing; farming) Industrial Arts (e.g., welding, plumbing) Home Economics (e.g., housekeeping; bartending ) Handicraft (e,g., basket weaving, knitting) Others, please specify: _______________________ _______________________ _______________________
  • 4. ALS RPL Form 1 Page 4 of 4 10/2020 F. Intrapersonal and Interpersonal Relationships (Pang-unawa sa Sarili at Pakikipagkapwa) Positive Sense of Self (e.g., learning to know oneself; self-worth; self-direction) Family and Community Solidarity (e.g., demonstrating smooth interpersonal relationships between and among family and community members) Others, please specify: ______________________ ______________________ ______________________ G. Information and Communications Technology (ICT) (Teknolohiya ng Impormasyon at Komunikasyon) Basic Hardware/Software Operations and File Management (e.g., operating a computer and other computer peripherals; managing files in a computer) Common Office Application Software Packages (e.g., word processing; presentation software) Mobile Devices (e.g., operating mobile phones, smart devices/wearables, digital video cameras, etc.) Others, please specify: ______________________ ______________________ ______________________ _________________________________ ___________________________________ (Learner’s Signature over Printed Name) (ALS Teacher’s Signature over Printed Name) Date: ____________________________ Date: _______________________________