BORANG PEMANTAUAN HIGHLY IMMERSIVE PROGRAMME (HIP)

1 Name of State:

2 Name of PPD:

3 Name of School:

4 Name of School Head:

5 School Enrolment:

6 No. of English Teachers:

7 Total no. of Teachers:

Level of Immersiveness and

8
Total Immersiveness Score:

Fill in to complete

In-Class Out-of-Class Extra Class Outreach

9 Name of activity(s):

Fill in to complete

10 Objective of activity(s):
 Detailed description of
11
activity(s):

Activity(s) suited for (Fill in

12 which level the activity is
suited for)

No. and percentage of

students involved over total
13 no. of students
(refer online reporting
template for these scores)

14 Outcomes of activity(s):

15 Strategies to sustain
activity(s):
(how often is the activity(s)
conducted)
School Head Teachers Students Parents/Communit
y
16 Describe contribution of the
following fundamental in HIP
implementation in your
schools.
 SISC+ SIP+ FasiLinus

17 Describe the contribution of

the folowing officers in HIP
implementation in your
schools.

School Level District level State level

Outcomes of performance
18 dialogue (dialog prestasi) on
HIP.

Write a brief descriptions of

success stories on HIP
implementation.(Please
19
provide evidence in the form
of samples of report, photos in
JPEG and vidoes in MP4).

20 Name of Outreach Partner:

 Title and description of
21
outreach activity:

Outcomes of student
22 participation in the Outreach
activity.

Strategies to sustain Outreach

activity(s):
23
(How often is the activity(s)
conducted)
 How to count
Self Assessment Tool Scores and Percentage percentage.
Score received
Please fill in overall mean scores of the following divided by total
score.
School Head Teachers Parents Students Teachers
Score received is
50/80
Percentage = 50/80
50 (63%) x 100=
63%

OVERALL FEEDBACK BY OFFICER ON VISIT:

NAME OF OFFICER: DATE OF VISIT: