Editable Ict Survey 2024
Editable Ict Survey 2024
I. SCHOOL PROFILE
Instruction: Put a check ()on the grade level of your school. If it is an integrated school, create separate reports for elementary, junior high
school, and senior high school. Write legibly.
Elementary Junior High School Senior High School
Is your school a recipient of DICT internet connection? Yes No
School Contact
Number/s:
(Write “None” if the school has no contact number) This number should be owned by the school; this number should be different from the contact number of the school head or
any personal number of an employee. It will be posted on the SDO website.
SCHOOL ELECTRICITY
Does your school have a source of electricity? Yes No
If your school has electricity, check all the sources.
Electric Grid (OMECO, LUBELCO, NAPOCOR, etc.) Hydro Power
Generator Wind Energy
Solar Power Geothermal
Others source of electricity (Specify):
Certified true
Prepared by ___________________________________________ ______________________________________
Signature over Printed Name
and correct Signature over Printed Name of School Head
Internet service provider Internet plan (if known) Cost /month Download Upload
Picture of the inside of the Computer room Picture of windows and doors of the Computer room
Certified true
Prepared by ___________________________________________ ______________________________________
Signature over Printed Name
and correct Signature over Printed Name of School Head
B. To be converted into a Computer Room (this is only optional – include this portion if there is a room needs to be transformed in ICT
Room)
Check () all that apply to the existing ICT/Computer Room.
It has electricity and enough power-outlets duly certified by the Municipal/City Electrician
Safe during flooding
Roofs are strong enough to withstand typhoon and no leaks
Windows are safe on splashing during heavy rain and strong wind.
Windows and doors are secured with grills to protect from any theft incident
What is the planned internet connection to be installed in the new computer room?
____________________________________________________
Picture of the inside of the proposed computer room Picture of windows and doors of the proposed computer room
Certified true
Prepared by ___________________________________________ ______________________________________
Signature over Printed Name
and correct Signature over Printed Name of School Head
SOURCE: (How did the ICT equipment become school's possession? Ex. Donated by Ayala Foundation, Purchased by School, etc.)
What items, how many, and when were received based on the Document available
Where are the units/equipment currently placed / stored or current user, how many are functional, and how many are defective?
Certified true
Prepared by ___________________________________________ ______________________________________
Signature over Printed Name
and correct Signature over Printed Name of School Head
Grade 7 Teachers
Full Name Position Desktop / Laptop provided by school or Personal
Certified true
Prepared by ___________________________________________ ______________________________________
Signature over Printed Name
and correct Signature over Printed Name of School Head
LED TV:
Example Offices
Principal’s Office Faculty Room Library
Internet Connection: ( )Yes ( )No Internet Connection: ( )Yes ( )No Internet Connection: ( )Yes ( )No
If YES, Download: ________ Upload: If YES, Download: ________ Upload: If YES, Download: ________ Upload:
______ ______ ______
Certified true
Prepared by ___________________________________________ ______________________________________
Signature over Printed Name
and correct Signature over Printed Name of School Head
Certified true
Prepared by ___________________________________________ ______________________________________
Signature over Printed Name
and correct Signature over Printed Name of School Head
Certified true
Prepared by ___________________________________________ ______________________________________
Signature over Printed Name
and correct Signature over Printed Name of School Head