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School Name:

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Prepared by:
Question

School District
Legislative District
Telephone Number
Website of the school
Email Address
Year of Establishment
Is this a Regular School? (Yes or No)
Is this a Central School? (Yes or No)
Is this a SNED (formerly SPED) Center? (Yes or No)
Does this school have SNED classes/programs? (Yes or No)
Is this a Science HS? (Yes or No)
Is/Does it have a farm school? (Yes or No)
Is night class offered? (Yes or No)
Is this school an Implementing Unit? (Yes or No)
Does the school have an annex or extension school? (Yes or No)
If has an annex or extension, please indicate mother school ID.
What is your school's Curricular Offering Classification (COC)
Options: Purely ES (K to 6), Purely JHS (G7 to G10) ,Purely SHS (G11 to G12), JHS with SHS (G7 to G12), ES and
Offering (K to 12)
Maximum Number of Shifts
Options: 1 (Single Shift), 2 (Double Shift), 3 (Triple Shift), 4 and above
SE
Sub-Section: Number of Nationally Fun
Total Number of Teacher I-III
Total Number of Master Teacher I-IV
Total Number of Special Science Teacher I-V
Total Number of SNED Teacher I-V
Total Number of School Principal I-IV
Total Number of Assistant School Principal I-III
Total Number of Head Teacher I-VI
Total Number of Administrative Officers
Total Number of Librarians
Total Number of Guidance Service Specialists
Total Number of Guidance Counselors (Licenced Guidance Counselors)
Total Number of School Counselor Associates
Total Number of Project Development Officer I
Sub-Section: Number of Unfilled Positions (
Total Number of Teacher I-III
Total Number of Master Teacher I-IV
Total Number of Special Science Teacher I-V
Total Number of SNED Teacher I-V
Total Number of School Principal I-IV
Total Number of Assistant School Principal I-III
Total Number of Head Teacher I-VI
Total Number of Administrative Officers
Total Number of Librarians
Total Number of Guidance Service Specialists
Total Number of Guidance Counselors (Licenced Guidance Counselors)
Total Number of School Counselor Associates
Total Number of Project Development Officer I
Sub-Se
Locally Funded Teachers actually working in schools
Locally Funded Teaching-related personnel actually working in schools
Locally Funded - Administrative Officer
Locally Funded - Librarian
Locally Funded - Guidance Advocates
Locally Funded - Guidance Counselor (Licensed Guidance Counselor)
Locally Funded - Guidance Assistant/Aide
Locally Funded - Project Development Officer
SECTI
Number of Instructional Rooms
Number of Instructional Rooms on-going construction by DPWH?
Number of Non-instructional Rooms
Number of Non-instructional Rooms on-going construction
Number of faculty rooms
Number of faculty rooms on-going construction
Number of Libraries / Learning Resource Centers
Number of Libraries / Learning Resource Centers on-going construction
Number of ICT rooms / Computer Laboratories
Number of ICT rooms / Computer Laboratories on-going construction
Number of Science Laboratories
Number of Science Laboratories on-going construction
Number of TVL Laboratories
Number of TVL Laboratories on-going construction
Number of Guidance Offices
Number of Guidance Offices on-going construction
Number of Clinics
Number of Clinics on-going construction
Number of Functional toilet bowls
Number of Electric Fans
Number of school buildings compliant with the Accessibility Law for Persons with Disabilit
School Buildings with: Presence of ramps for wheelchair users, Presence of designated comfort rooms for PWDs, Presence of S
Stairs with handrails and non-slip nosing
Entrance and exit gates have ramps for wheelchair users
School Site Ownership in the name of?
Options: DepEd, LGU, Private Entity/Individual/s, Other Government Agency
Proof of Ownership
Options: Original Certificate of Title (OCT), Transfer Certificate of Title (TCT), Certificate of Land Ownership Award (CLOA), S
Proclamation, Tax Declaration, Deed of Absolute Sale, Deed of Donation, Certificate of Stewardship, Special Land Use Permit (S
Memorandum of Agreement or Understanding, Lease Agreement, Special Forest Landuse Agreement (FLAg), Gratuitous Specia
Others (specify)

Proof of Ownership if others on item 76

With available buildable space? (Yes or No)
Estimated Buildable Space (size in square meters)

Number of Kinder Modular Tables

Number of Kinder Chairs
Number of Armchairs
Number of School Desks
Number of other classroom tables
Number of other classroom chairs
Number of DepEd New Design Table
Number of DepEd New Design Chair
Number of Teacher Table
Number of Teacher Chair
SECTION: INV
Number of Grade 1 - Reading and Literacy
Number of Grade 1 - Makabansa
Number of Grade 1 - Good Moral and Right Conduct
Number of Grade 1 - Language
Number of Grade 4 - Araling Panlipunan
Number of Grade 4 - Good Moral and Right Conduct
Number of Grade 4 - Filipino
Number of Grade 4 - Science
Number of Grade 4 - Music and Arts
Number of Grade 4 - English
Number of Grade 4 - Mathematics
Number of Grade 4 - Physical Education and Health
Number of Grade 4 - Edukasyong Pantahanan at Pangkabuhayan (EPP)
Number of Grade 7 - Araling Panlipunan
Number of Grade 7 - English
Number of Grade 7 - Mathematics
Number of Grade 7 - Filipino
Number of Grade 7 - Music and Arts
Number of Grade 7 - Physical Education and Health
Number of Grade 7 - Technology and Livelihood Education (TLE)
Number of Grade 7 - Good Moral and Right Conduct
Number of Grade 7 - Science
Number of SHS - Health Optimizing Physical Education 1&2
Number of SHS - Health Optimizing Physical Education 3&4
Number of SHS - Personal Development
Number of SHS - Physical Science
Number of SHS - Statistics and Probability
Number of SHS - Understanding Culture, Society and Politics
Number of SHS - Media and Information Literacy
Number of SHS - General Mathematics
Number of SHS - Contemporary Arts
Is Learning Tools and Equipment - Science and Mathematics Equipment (SME) Available? (Y
Year of the most recent LTE-SME package acquired/received?
Is Learning Tools and Equipment - Technical Vocational Livelihood (TVL) Available? (Yes or No
Year of the most recent LTE-TVL package acquired/received?
SECTION: INVE
Number of SMART TV
Number of non-SMART TV
Number of E-Learning Carts
Number of E-Learning Cart laptops
Number of Laptop for Teachers
Number of Laptop for non-teaching personnel
Number of Desktop for Administrative or learning use
Number of Tablet for learners
Number of Laptop for learners (LGU provided, ALS learners, SNED learners, and others)
Number of Tablet PCs for learners (tablet with keyboard)
With Internet Connectivity?
Options: School Wide Access, Academic/Instructional Purposes, Administrative Use Only, No Internet

With access to water supply (Y/N)?

With access to electricity (Y/N)?

Top 1, 2,

Name
Rationale
Objective 1
Objective 2
Objective 3
Does this project contribute to the achievement of High Performing Teachers?
Does this project contribute to the achievement of Learners' Physical and mental well-bein
Does this project contribute to the achievement of Efficient and supportive governance str
Activity 1 Name
Activity 1 Schedule
Activity 1 Physical Target
Activity 1 Date
Activity 1 Budget
Activity 2 Name
Activity 2 Schedule
Activity 2 Physical Target
Activity 2 Date
Activity 2 Budget
Activity 3 Name
Activity 3 Schedule
Activity 3 Physical Target
Activity 3 Date
Activity 3 Budget
Activity 4 Name
Activity 4 Schedule
Activity 4 Physical Target
Activity 4 Date
Activity 4 Budget

Name
Rationale
Objective 1
Objective 2
Objective 3
Does this project contribute to the achievement of High Performing Teachers?
Does this project contribute to the achievement of Learners' Physical and mental well-bein
Does this project contribute to the achievement of Efficient and supportive governance str
Activity 1 Name
Activity 1 Schedule
Activity 1 Physical Target
Activity 1 Date
Activity 1 Budget
Activity 2 Name
Activity 2 Schedule
Activity 2 Physical Target
Activity 2 Date
Activity 2 Budget
Activity 3 Name
Activity 3 Schedule
Activity 3 Physical Target
Activity 3 Date
Activity 3 Budget
Activity 4 Name
Activity 4 Schedule
Activity 4 Physical Target
Activity 4 Date
Activity 4 Budget

Name
Rationale
Objective 1
Objective 2
Objective 3
Does this project contribute to the achievement of High Performing Teachers?
Does this project contribute to the achievement of Learners' Physical and mental well-bein
Does this project contribute to the achievement of Efficient and supportive governance str
Activity 1 Name
Activity 1 Schedule
Activity 1 Physical Target
Activity 1 Date
Activity 1 Budget
Activity 2 Name
Activity 2 Schedule
Activity 2 Physical Target
Activity 2 Date
Activity 2 Budget
Activity 3 Name
Activity 3 Schedule
Activity 3 Physical Target
Activity 3 Date
Activity 3 Budget
Activity 4 Name
Activity 4 Schedule
Activity 4 Physical Target
Activity 4 Date
Activity 4 Budget
 Region:
SDO:

Value Stored

NTORY OF SCHOOL PERSONNEL (FILLED AND UNFILLED POSITIONS)

a Actually Working in Schools (Including plantilla borrowed/detailed from other School(s)/DepEd Offi

ement Unit schools, get data from the Division HRMO while for Implementing Unit schools provide
 er of teachers actually working in schools as Locally Funded Personnel.

ORY OF FUNCTIONAL SCHOOL INFRASTRUCTURE (in any funding source)

DepED
 Presidential Proclamation

SECTION: INVENTORY OF FUNCTIONAL FURNITURE

LEARNING RESOURCES (TEXTBOOKS AND LEARNING TOOLS AND EQUIPMENTS)

UNCTIONAL INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) EQUIPMENT

SECTION: AVAILABILITY OF ACCESS TO UTILITIES

ROPOSED PROGRAM/PROJECT/ACTIVITY FOR FUNDING REQUEST

am, Project, or Activity needing funding from the Department of Education
Program, Project, or Activity Number 1
Program, Project, or Activity Number 2

Program, Project, or Activity Number 3

Validated by:
 Validated Data

D POSITIONS)
wed/detailed from other School(s)/DepEd Offices.

while for Implementing Unit schools provide the data)

unded Personnel.

funding source)
OOLS AND EQUIPMENTS)
NOLOGY (ICT) EQUIPMENT

REQUEST
rtment of Education
Remarks (explain the difference of value stored and validated data)

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