f:t' -_ irill

{ \i -+
L-.
Republic of tl..e Philippines
*utL.q. Department of Education
R.S&Ifl TlI IV=A CA.I'JIBA&SCE
'"ffiJ Gate 2 Karangalan Village
1900 Cainta, Rizal

DEPFD-4A-R M-a6-ta- 2b0

TO ftEGIOHAL
UPERINTENDENTS

fRofi,i sAN AW)Nro

SUSJECT ANNOUNCING THE 2018 CATAEARZON GAWAD PATNUGOT

DATE Moy 9, 2018

1. Anchored on the Civilservice Commission Progrom on Awcrds and lnceniives

for Service Excellence {PRAISE} cnd DepED Order No. 9, s.2AQ2 re: Esiablishing
PRAISF in the DepED, the Depcrimenl of tducotion Region IV-CALABARZON
onnounces the 2018 CALABARZON GAWAD PATNUGOT.

2. Thispr*grcm cims lo recognize cnd rewcrd tlre exemplcry contribution of tl-ie

Region's humcn resources-- instrr..rctionol leoders, teachers, cnd non-iecching
personnel who have broughi honor to iheir workplcce* the Schools Division
Offiees {5DOsJ resulting to work effieiency, orgonizctionol produclivity cnd
Bositive resulfs. This progrcm sholl olso give reeognition to schools ond SDOs
fhoi puf premium on delivering quclity basie educciion services through
effeetive cnd trcnspcrent implementation of School-Sssed and SDO's
Progrcms and Projects.

3. The oword cotegories ore:

Ho. lndividuol Coleqorv tevel

1
Outstonding Elementory Teacher K-Grode 6
Outstondins Hiqh School Teocher GrodeT-12
3 Oulstondino Elemeniory Principol Elementory School
Outstonding HighSchool Principol School
5 Outstondino Education Proqrom Su pervisor SDO
6 Outstondina Public Schools Disttici Supervisor sDo
7 Outstondinq Non-Teochinq Personnel Level I SG I-9
Outstondinq Non-Teachinq Personnel Level 2 SG l0-22 {excepl EPS & PSDS}
9 Ouisiondinq Reseorcher Elementory
r0 Outstondino Reseorcher Hiqh School

Trunk Line: (02) 682-5773 | 684-49t4 | 647-7487

Fax: (02) 682-2114
W€bsiter depedcalabarzon.ph
Facebook: DepFd R-4A Calabarzon
E-mail: resion4a(odeoed. gov,oh
AlAtT-0078
$-4A-RM-06-18- Page 2 of tl

No. SchoolColeqory* Level

Most Effective School Reoding Progrom lmplementer Elementorv School
2 Most Effective School Reoding Progrom lmplemenier Hioh School
Most Effective School ELIN lmplementer Elementory {K-3)School
4 Best School-Bcrsed Monooement lmplementer Elementorv School
5 Best School-Bosed Mcrnoqement lmplementer Hioh School
6 Outstondinq Compus Journolism Progrom lmplementer Elemeniory School
7 Outstonding Compus Journolism Progrom lmpiementer High School
I Outstandino Brioodo Eskwelo lmplementer Elementorv School
I Outstqndinq Briqodo Eskwelo lmplementer Hioh School
l0 Best Performino Public Elemenlsry School** Elementory School
l1 Best Performino Public Hioh School** Hiah School

No. Division Cotegory*

I Outstonding Division GAD Progrom lmplementer
2 Outsfondino Division Soorts Proqrom lmplementer
3 Outstsndino Division DRRM Proorom lmplementer
4 Best Performino Schools Division Office

*Nole.' For fhe schoo/ ond division cofegories. lhe recipient of the lrophy sholl be ihe
schooJldivision ond ihe cedrficate sho/l be the coordinolor.
**Ai the lime of lhe norninolion, schoolnominees ore o/ready SBM LeveJ2
lmplemenier.

SpeciqlCqtesory
Borongoy wifh Zero Out- of- SchoolYouth {OSY)
Nctctcnging Porcngol {for orgonizciion}

4. AllSchools Division Offices ore highly encouroged to porticipote in oll

cofegories ond send one officiolnominee in eoch oword cciegory. Likewise,
Heod Teochers who wish to join the Seorch con porticipcte in the
Outslonding Teocher cotegory depending on their level of ossignment.

5. Pleose be guided by the following schedule of octivities ond specified

dotes relotive to the soid Seorch.

Seorch lime Line

Aqttrtly Dole I Remcrks

- Lote documenis will not be
Deodline for submissi$ ;f the l:une zD, zorA L"t" ,
nominqtion folder to the Regionol I occepled
Office I
I

Screening ond Shortlisting Period I July 2-13,2018 Documents thot reoch Ihe70%
Stoge'l- cut off score will proceed to Stoge
. Evaluotion of the 2.
Nominstion Write-Up
including required Quolified nominees sholl be
dseuments notified through emoil.
. Shodlisting of nominees
bosed on the set criteria
forSicge i
-o-1A-Rr.A-06-rc- 2-tt3 Page 3 of ll
Aclivily Dole Remorks
Stoge 2 A Only nominees thot hove reached
. Onsite Volidotion of the 8O% cut off score bosed on
Quolified Nominees from the criierio will proceed io Stoge 3
Stoge I July 16,2018-
STAGE 28* Augusi 15,2018 stoge is only for the
This
r Nominees who reoch the Outstonding Teccher Cotegory
80% cut off score sholl
undergo the demo- Only nominees who reoch the 80Zo
teoching cut off score ore quolified for the
demo-teochina
Stoge 3 August 17-31, No more thon 3 finolists in every
r Finql Ponel lnterview of 20r8 cotegory. They hove met the cui
Quolified Nominees from off score qnd sholl be notified
Stoge 2 through o Memorondum for the
Finol Ponellnterview.

Preporotion, Finolizotion ond Sept.3

PRAISE Meetinos onwords
-I0,
Awording Ceremony October Venue: To Be Determined
2018
*for Outstonding Tecchers only

Nole: The Commitlee will slrlctly follow the scheduled dotes.

Expenses reloiive to theconduci of the ssid oclivity sholl be chorged ogoinst locol funds
while expenses during the owording ceremony such os trophies, ceriificotes, cosh prizes,
ond sioge decorotion sholl be chorged ogoinst Regionol Funds subject to the usuql
occounting ond ouditing rules ond regulotions.
Forfurtherinformsiion regording ihe Seorch, you msy contoct HRDD @ {02) 682-5773locol
126, 135 or emoil @ hrd.colobqzon@deped.qov.ph ottention PRAISf Secretoriot.

Attoched ore the Seorch Guidelines, Checklist of Required Documents and Nominolion
Forms.

lmmediote ond wide disseminotion of this Memorondum is eornestly desired.

r-1A-RtA-06-18- Page 4 of 11

Enclosure No. I lo DEPED-44-M-\8

Guidelines on lhe 2018 CATABARZON GAWAD PATNUGOT

l. Scope of lhe Progrom

The CALABARZON Gowod Potnugot is o regionol progrom on rewords ond

recognition anchored on the Civil Service Commission's Progrom on Awords ond
lncenlives for Service Excellence (PRAISE). The progrcm wos designed to encourcge
creoiivity, innovotiveness, integrity ond productivity in the public service by
recognizing DepEd CALABARZON officiols ond employees individuolly or in groups.

The progrom opplies to oll DepED CALABARZON employees thot include the teoching
ond non-teoching personnel holding permonent posiiions, os well os the schools and
schools divisions thoi brought recogniiion to the region.

Those whose nofure of employment fcrll either under job order or controct of services.
as defined in Seciions I ond 2, Rule Xl of the Revised Omnibus Rules on Appoinfmenls
and Other Personnel Acfions, ond those employed under exlension of service ore
excluded from the coveroge of the progrom.
This yeor's seorch opens oddiiionol special oword cotegory- Nctotcnging Porongol.
This is confened to on orgonizotion, whether tecching or non-teoching within DepEd
CALABARZON lhot mode significcnt contributions fo the community through its time,
octions ond dedicotions thot resulted to outstonding occomplishmenis. The
outstonding orgonizotion works for <r csuse ond hos impocted the lives of fhe leorners.
ihe orgonizction ond the community as well.

ll. Cotegories of Aword

A. The owords for the individuol cotegory cre the following:

l. Outstondlng Elementory School Teacher

2. Outstonding High SchoolTeocher
3. Outstonding Elementory School Principol
4. Outstonding High School Principol
5. Outstonding Educotion Progrom Supervisor
6. Outstonding Public Schools District Supervisor
"lI
7. Outstonding Non-Teoching Personnel (Level
8. Outstonding Non-Teoching Personnel (Level 2)
9. Outslqnding Reseorcher {Elementsry Schooll
L0. Outstonding Reseorcher (High School)

B. The awqrds for lhe school cotegory ore ihe following:

l. Most Effeciive School Reoding Progrom lmplementer- Flementory School

2. Most Effective SchoolReoding Progrom lmplementer- High School
3. Most Effective SchoolELLN lmplementer- Elementory {K-3) School
4. Best School-Bqsed Monogement lmplementer- Elementory School
5. Best School-Bosed Monogement lmplementer- High School
6. Oufstonding Compus Journolism Progrcm lmplemenier- Elemenfory School
7. Outstondlng Compus Journolism Progrom lmplemenler * High School
B. Ouistonding Brigodo Eskwelo lmplementer- Elementory School
?.
'10.
Outstonding Brigcdo Eskwelo lmplementer- High School
Best Perfonning Public Elementory Schcol
I L Besi Performing Public High School
*r-taA-m46-18- Page 5 rf 11

C. The owords for the division cotegory ore the following:

'1.
Outslonding Division GAD Progrsm lmplementer
2. Outstonding Division Sports Progrom lmplementer
3. Outsfonding Division DRRM Progrom lmplementer
4. Best Performing Schools Division Office

tpeqiql eslesery
l. Borongoy with Zero Out- of- SchoolYouth {OSY}
2. Nototonging Porcngol {for orgonizction}

lll, EllglbllHy Requlremenis ol Nomlneeg

Nominoted schools, schools division office. inslructionolleoders, teoching cnd non-

ieoching employees in the individuol, schoclqnd division ectegories nominees will
be evoluated bosed on their outstcnding occomplishments. They must meet the
following quolificotions:
lndlvlduol Colegory

l. Filipino Citizen, octive in the service ond hove rendered for noi less fhon lhree
{3} yeors of continuous government service cs of deodline of nominotion's
submission. Nominee's occomplishments which helshe is being recognized
should olso be mode wifhin the lost three yeors immedioiely prior io the
nominotion ond hove been continuously corried out by the nominee during
the soid period.
2. Must not be on lecrve oi the time of the Seorch.
3. Certificotion signed by the Administrotive Officer V/lV {Personnel} thoi the
nominee hos obtoined of leost Very Sotisfoctory {VS) performcnce rotings for
the losi three {3} yeors.
4. Copy of the roting forms {IPCR/OPCR) should be ottoched to the nominotion
folder
5. Has nof been subjecied to cny form of disciplincry cciions
6. No pending cdminisfrotive, criminoland civilcase filed
7. No Noiice of Disollowonce from COA
School ond Division Colegories

t. Ceriification signed by the Administrotive Oificer V/lV {Personnelof SDO} thot

the School/Division nominee hos obtained ot leost Very Satisfoctory {VS)
performonce rolings for the lost two {2J yeors (OPCRFI

2. Certificotion of No_Unliquidoted Cash Advonces ond Disollowonces for

previous accountobilities os of December 3l of the yeor prior to nominotion
to be secured by ihe HRMO from the Commission on Audit {COA} Resident
Auditor. Soid Certificotion should be signed by the <rgency's COA Resideni
Auditor NOT the ogency's Finonciol Officer/Accountoni.

3. ln cose of existing unliquidoted cosh cdvonce ond disallowonce, o

certificcrte of the staius of such fincnciol obligoiion sholl be issued by the COA
Resident Auditor.
 Page 5 of 11

lY. Dbquofficolkcn

l. Previous GAWAD Potnugot Awordee

2. Awordee of o NotionolSeorch
3. Lone contender in the specific cotegory

V. Criterio for Slcge I Evqluolion

A.lndividuol Colegory:

Outstonding Teocher {elementory, high school}, Outstanding Principol

{elementory, high school), Outstonding Educotion Progrom Supervisor.
Outstonding Public Schools District Supervisor, Outstonding Non-Teoching
Personnel {levels 1&2i, Outstonding Reseorcher Awords.

l. Performonce Roting (IPCRFIOPCRF)- 30 points

2. Significont Accomplishment/s- I 5 points

Project/Work Accomplished, number of strategies/octivities done thol
have significontly impocted the per{ormonce oi fhe school, numb€r of
cccomplished work/projects thct benefited the community. The rale of
TEA Governsnce must be highlighted.

3. lmpoct of Accomplishments- 25 points

ScopelReplicability of the progrsmlproject/ocfivify, number of
people/office benefited and tronsoctions focilitated, level of qttolnment
per identified Performonce lndicotor

4. lnnovotion- 20 points
Originol, creofive progroms, projects, activities mode in the lost three {3}
yeors in connection to the oword cotegory cnd the extent to which
itllhey islore being used ond ihe results; number of persons who
benefited; scopelreplicobility of the innovotion, level of ottainment per
identified Performonce lndicotor. The role of TEA Governonce musl be
highlighted.

5. Awcrds <rnd Membership-10 points

Mojor owords/citoiions received relevont to the cotegory ond active
membership in o repuioble professionol orgonizotion

B. $chool <rnd Divicion Cnfegories:

Most Effective School Reoding Progrom lmplemenier {elementary schoal, high

school, Mosi Effecfive School ELLN lmplementer {K-3 elementary school}, Best
School-Bosed Monogement lmplementer {elementary school, high school}.Best
School-Based Monogement lmplementer (elementory school, hlgh
schooi),Outstonding Compus Journalism Program lmplementerie/emenlary schaol,
high sehoal),Outstanding Brigoda Eskwelo lmplementerfelemenlcry schoo/, high
schoolj.Best Performing Public Elementary cnd High Schoals, Cutstqnding Division
Sports Program lmplemenler, Oulslanding Division DRRM Program lmplementer
ond Best Performing SDO.
 Page 7 af 11

1. Performonce Roting {OPCR}- 30 points

2. Significont Accomplishment/s - 15 points

Project/Work Accomplished, number of strotegies/octivities done thot
hove significontly impocied the performonce of the school ond the
orgonizotion os well

3. lmpoct of Accomplishments- 25 points

Scope/replicobility of the progrom/project/octivity, number of
people/office benefited and ironsoclions focilitoted, level of altoinment
per identified Performonce lndicotor

4. lnnovotion- 20 points
Originol, creotive progroms, projecis, octivities mode in the lcsi two {2}
yeors in connection to the oword cotegory ond the extent to which
itlthey is/ore being used ond ihe results; number of persons who
benefited; scope/replicobility of the innovotion, level of cttoinment per
identified Performonce lndicotor

5. Awords ond Membership-l0 points

Mojor owordslcitotions received in connection to the oword

C. Division Colegory:Outsionding Division GAD Progrom lmplenrenter

l. Policies- 25 points
GAD-reloted policies {SpecialOrder, Memorondum Circulors ond Boord
Resolutions) formulcted, implemented ond institutionolized by ihe ogency,
2018 GAD Plon ond Budget,20ll GAD Accomplishment Report

2. People-25 poinis
GAD-reloted copocity developments (e.9. troinings, seminors,
orientotions, workshops. eic.) conducted by the office whether for
orgonizction or for clienfs; membership of men ond women in the
orgonizolions; and lhe top monogement supporl'for gender
moinstreoming

3. Enobling Mechanisms- 20 points

Structured GAD Foccl Point System; estoblished ond instilutionolized
portnerships wiifrvorious stakeholders to develop ond implemeni
progrsms, projects ond ociivities responding to genderissues;other
enobling mechonisms estoblished, institutionolized or choired by the office
to ensure ihot gender is msinstreamed {i.e. structures ond systems,
interogency/inter-LGU committees, TWGs, GAD dotabase snd budget
ollocotion).

4. GAD Related Progroms, Projects ond Activities-20 points

Number of lnformotion Educotion ond Communicotion {lEC} moteriols
produced; number of identified PAPs provided; number of progroms
 Page I of 12

ond/or projects moinstreomed with gender perspective or oddressing c

gender issuelGAD mondcrte thot were formuloted, implemented ond
institutionolized by the ogencyloffice
5. Awords Received- 10 points
Awords/ciloiions received in connection to the oword

D. SpeclolCotegory:

Barongoy wiih Zero Out-otSchool Youth

Nototanging Parongol

Criteric for Notatqning Porongol

1. lmpoct to Organizotlon- 50 points

Description of ihe Project/Work Accomplished, Acfivities Done thol hove
significontly impocted the performonce of the orgonizotion cs well. The
octivities / events or service should not be port of the nominee's job
description or duties ond the members connot receive cny monetory or
personol benefits from their involvement. The orgonizotion should hove olso
demonstroted how it embodies ond insiills the TEA Governonce principle.

2. lmpoct to Community - 50 polnts

Problems oddressed, peopleloffice irenefited. ond its impoct to the
community.

V. Requlred Nomlnolion Documenls

Eoch nominotion requires the submission of one {1} originol nominotion folder
contoining the fully-occomplished Gowod Potnugot nominotion form ond other
documentory requirements, ond two (2) odditionol copies of the origincl nominotion
folder.

A. Completely Filled-out Gowod Potnugot Nominotion Form {Moximum of l0

poges including Execuiive Summary ond Nominafion Write-Up)
o Gowod Potnugot {GP}Nominotion Form. l- Nominotion for the individuol
cotegories: Oulslonding leoche; Oulsfanding Principol, Outstonding
FSDS. Oulslonding FPS, Oulsfonding Non-Ieoching Personnei {levels I & 2)

Gowod Pctnugot {GP) Nonrinotion Form 2- Nominotion Form fot the school
cotegory: Mosf Fffective School Recding Pragram lmplementer, Mosl
Fffeclive School ELLN lmp/ementer, Besl School8osed Manogement
lmplemenfer, Oufstanding Campus Journolism Progrom lmplementer,
Oufsfonding kigoda Fskwelo lmplementer, Besf Performing Public
Elemenlary and High Schools

Gowod Potnugot (GP) Nominotion Form 3- Nominotion Form for the

division cotegory: Ouislonding Divtsion Sports Program lmplementer,
Oufslonding Drvfsion DRRM Program lmplemenfer, and Besf Performing
Schoo/s Divr'sion Office.
irret& Page 9 of 11

Gcnrod Potnugot (GP) Nominotion Form 3A- Nominotion Form for the
division cotegory: Oufsfonding Divisr'on GAD Program lmplementer

Gowod Potnugoi {GP} Nominotion Form 4- Nominotion Form for the

speciol cotegory: Nolofurngin g Parangal

B. Nominee's updoted Form2l2 or Personol Dofo Sheei with possport size photo
with nomelog ioken during the lost six months prior to the nomination fFor
lndividual Calegory only).

C. Certificotion from the Choirperson of the Division PRAISE Committee or its

equivolent, thct fhe nomination hos undergone deliberotion by lhe
Committee.
D. Letter from the heod of office endorsing ihe nominotion to the Regionol
PRAISE Committee

E. Self-cerliiicotion of No Pending Administroiive, Civilond CriminolCose {For

lndividual Calegory only)
F, Certificotion signed by the Administrotive Officer V/lV {Personnel} thot the
nominee hos obloined dt leost Very Sotisfcctory {VS} performonce rclings
{IPCRF} for the lasl three {3} yecrs for the individuol cotegory ond Very
Sotisfoctory {VS} performsnce rsting {OPCR} for the lsst two {2} yecrs for the
sehool cnd SDO cofegories. Copy of ihe rcling forms should be oltached to
tlre nominoiion folder (Nafatanging Parangalis not rncluded)
G. Copy of the recent CSC oppointment (For lndividuolCategory only)
H. Auihenticoied ond updoted PRC License {Farlndividval Cotegoryonly}

t. Copy of the SEC Registrotion /For Nofofoning Parangal only)

J. Certificalion of No Unliquidoled Cosh Advonces ond Disollowances for
previous occounfobilities os of December 3l of the yeor prior to nominotion to
be secured by the HRMO from the Commission on Audit {COA) Resident
Auditor. Soid Certificoiion should be signed by the cgency's COA Resident
Auditor NOT the ogency's Finonciol Officer/Accountont. (Far Principo/s, PSDS.
FPS, PSDS. SchooJ ond Diviston Coiegoriesj

K. ln cose of existing unliquidoted cosh odvonce ond disallowonce, o

certificote of the stotus of such finonciol obligation shcll be issued by lhe COA
Resident Auditor.

Ecch completely filled up nominotion form should be occomponied by o write-up

using the Nominotion Write-up form. ln no cose sholl the write-up exceed ihe
moximum ollowable ten (10) poges of A4 size bond poper, using Cenlury Gothic font
#11.

The nominoiion form snd documentory requirements should be ploced in legal size
folders iwhite color]. Hsrd-bound ond creotive covers ore discouroged. Copies of
onnuol reports, recommendotions from institutions/personolities, news clippings ond
certificctes of trcining, seminors ond recognition should not be included in the
nominotion folder. Only required documenfs must be submiited.
 rel* Page 10 of 11

}I. frle-up d Accompllshments

A. The write-up must highlight outstonding occomplishments or exemplory norms of
conduct monifested within the lost three yeors. Presentction of occomplishments or
norms monifested should be ln order of signiflconce. complete with descriptions,
justificotions snd slrould odhere to the lollowing pointers:

. Use specific terms. Define/clorify terms such os "ossisted", "contributed" or

"fociliioted";

. Stote outstonding accomplishments of exemplory norms disployed ond

impoct in brief, factual ond in bullet form;
r Present impoct of occomplishments by indicoting problems oddressed,
peopleioffice benefited ond/or tronsoctions focilitoted.
B. The following informotion must be odequotely provided:
r For outstonding work occomplishment, stote whether or nof the
cccomplishments presented ore pcrt of ihe regulor duties of lhe nominee or if
these ore his/her own initiotive. lf port of nominee's regulor duties or mondote,
cite justificotions on why the occomplishments cre considered exceptionol or
extroordinory.

Limiiotion on Nominotion
r The nominotion write-up should only be for o moximum of 10 pages {A4 size
bond paper, Century Gothic # 1 l font) to inciude the summary of
occomplishments, impoct ond other [nformotion.
o While there are 25 oword cotegories ond two {2} speciol owcrd cctegory
under the Seorch. an employee or olficiol should be nominoted to only one
cword cotegory.
. Gowod Patnugot cwcrdees or those who hove been previously conferred
with ony of the 25 owords can still be nominoted to the some or to o different
oword cotegory qfter three yeors from the conferment of his/her oword,
provided ihot the nominotion is bosed on o new sei of occomplishments
ondlor exemplary norms/behsvior manifesied.
Vll. Procedure for Nominotion

Nomination to the Seorch mcy be done by officicls; schools or schools division offices
within ihe DepED CALABARZON. The following ore ihe steps on how io nominote
outstonding instructionol leoders, teoching ond non-teoching ernployees, schools
ond SDOs:

A. For individuol cotegoflT nominotion:

. SchoolslSDOs sre expected to nominate their exemplors" Eoch SDO shsll
only have one ncminee in every oword category,

o The Division PRAISE sholl be responsible for preporing reviewing ond

preporing the nominalion folder of the officisl or employee being nominoted
for ihe opprovol of the heod of office.
.r.lll-#{0{i-:& Page 11 of 11

--: : -cE -e3.3 si'rii ooprcve the nominotion ond shoilissue on

3- Jrre.:-e'.'ieiier 1c lne Regionol PRAISE Committee,

3. cotegory nominotion:
For school/division
. SDOs ore expected to nominote their exemplors. Eoch SDO sholl only hove
one nominee in every oword cotegory.

The Division PRAISE sholl be responsible for reviewing ond preporing the
nomination folder of the schools/division being nominoted for the opprovol
of the heod of office.

The Office Heod shollopprove the nominotion ond shollissue on

endorsement letter to the Regionol PRAISE Committee

Vlll. Procedure for Screening ond Evoluotion

Regionol level Screening

DepED CALABARZON through the Regionol PRAISE Commiitee sholl creote o three to
five-memb,er Regionol Selection Committee on Awords for eoch oword cotegory
preferobly composed of ihe Assistont Regionol Director. Functionol Division Chiefs,
Section ond Unit Heods, Educotion Progronr Supervisors in-chcrge of speciol
progroms. Educotion Progrom Supervisors, Education Progrcm Speciolists li.
stokeholders ond PRAISE Committee members.

Likewise, the Selection Committee sholl olso screen oll nominotions with complele
documenfory requirements ond determine the conectness of the cotegory vis-o-vis
lhe occomplishment/s presented. lt sholl shortlist quolified nominees bosed on
Sections lll ond V of the Guidelines. Only those who poss the Sioge I evaluotion sholl
be subjecled to onsite volidotion. They shollreceive emoilon ihe further detoils of ihe
next stoge of the Seorch. Pleose refer to the Seorch Timeline.

lX. Grounds lor Dltquollflcotlon of Nomlnotlons

A. Non-complionce with the submission of complete documentory

requirenrents sholl render the nominee ineligible for ihe Seorch (deodline. size
ond number of folders, occurocy ond compleieness of informotion required in
the nominotion form, moximum number of pcges for the occomplishment
write-up, cleuronces ond other required documenisi, Nominofions with
lncomplete documents sholl no longer be processed.

B. Any misrepresentotion made in ony of the documents submitted sholl be o

ground for disquolificciion ond for <lisciplinory oction agCIinsf the certifying
nominee/outhority pursuont to cpplicctble CSC lows ond rules.

X. Submlssion of Nomlnollon

Nominotions to the onnUo|CALABARZON GAWAD PATNUGOI must be submitted to

the Regionol Office, otlention Hunrcn Resource Development Division not loler ihon
June 29,2018.
 ffi
...1;-1',,
Checklist of Requiredi
ffi3 Documenls for Nominqtioni
ISO 90Ol : 2015 Certified DEPED-4A-GFO6IOOI-IB i

DOCUMENT NO. yERSTON fVO. REY'S'ON NO. DATE:

0000002 l.t 0.1 1 1 August 2017 Poge 1 of 2

2018 CALABARZON GAWAD PATNUGOT

CHECKLIST OF REQUIRED NOMINATION DOCUMENTS

tl Nominotion Folder
r One {1} originol nominotion folderwith occomplished nominotion form ond other
documentory requirements, ond two (2) odditionol copies of the origincl
nomlnotion folder.

E Completely Filled-Oui Gowsd Potnugot Nominotlon Form (Maximum of l0 poges

ineludinE Fxecufive Summary and Nomination Write-Up)
r Gowad Potnugot iGFlNominotion Form 1- Nominafion for the individusl
cctegories: Outstonding Teacher, Oulslondfng Principal, Oufslonding PSDS,
Ot;fsfonding FPS, Oulsfondrng Non-Ieoching Personnel {ievels I and 2)
r Gowod Potnugot {GP} Nomination Form 2- Nominotion Form for the school
cotegory: Mosl Fffecffve School Reodrng Pragram lmp/emenfer, Mosf Fffeclrve
School ELIN lmplemenfec Best SchoolBosed Monogemenl /mplemenfer,
Oulstonding Compus Journolism Progrom lmplementer, Oulslonding Brigada
Fskwelo lmplementer, Besi Perfarming Public Schoo/s
r Gowod Potnugot {GP) Nominotion Form 3- Nominotion Form for the division
cotegory: Oulsfondrng Drvrsion Sporls Program /mplemenfer, Outstanding Divislbn
DRRM Program lmplementer and Besl Performing Schools Drvrsion Office
. Gowod Potnugol {GP} Nominotion Form 3A- Nominotion Form for the division
coiegory: Ouistonding Division GAD Program lmplementer
r Natotonging Porongol {GP} Nomination Form 4 - Nominotion Form for the
orgonizofion ccfegory: Ncfofonging Parongal

Nominee's updoted Form 2'12 or Personol Doto Sheet with possport size photo wiih
nometog token during the lost six months prior to the nominotion (For lndividual
Category)
Cerfificotion from the Choirperson of the Division PRAISE Committee or iis equivolent,
thot the nominotion hos undergone deliberction by the Committee

t] Letter from the heod of office endorsing the nominotion to the Regionol PRAISE
Commiitee
tl Self-certificction of No Pending Adminiskotive, Civil ond CriminclCose {For lndfviduol
Calegary]

il Certificolion signed by"the Administroiive Officer V/lV {Personnel) thot ihe nominee
hcs obtoined at leost Very Satisfoctory {VS} performonce rotings for the lost ihree {3}
yeors {individuol, IPCRJ ond ot leqst Very Sotisfoctory (VS} performoRce rotings for
ihe lsst two {2} yeors for the school and dlvision cotegories {OPCR). Copy of the
rating forms should be atlached io the nomination folder. {Natafanging Porangal is
not included)

il Copy of the recent CSC oppointmeni iFor trtdividuoieotegoryJ

 Checklisl of Required
Documents lor Nominoiionl
SO cOCl : 20l5 Cedrfied DEPED-4A.GFO6IOO] -I8
DOCUMENT NO. YERS'ON NO.
0000002 Ll Poge 2 of 2

T*l Authenllcotsd ond updoled PRC Llc€nse {For lndividuolCotegory}

tl Copy of the 5EC Registrotion {For Notolanging Porongalon/y/

Ll Certificofion of No Unliquidoied Cosh Advonces ond Disollowonces for previous

occountobililies os of December3l of the year prior to nominotion to be secured by
ihe HRMO fronr the eommlssion on Audlt (COA) Resident Auditor. Soid eertificstion
should be signed by the cgency's COA Resident Auditor NOT the ogency's Finonciol
Officer/Accounianl. {For PrincipoJs, PSDS, FPS, PSDS, School and Division ColegoriesJ
ln cose of existing unliquidoted cosh odvonce ond disollowonce. o certificote of the
stotus of such financiol obligotion sholl be issued by ihe COA Resideni Auditor.

E Detoiled informotion on dismissedldecided cosels of the nominee. if ony.

Nole: Complefi'on ol ,he above requiremenls will make lhe nominee eliglble to p<;ldicipdte in fhe Setrrch.
 ,ffiffi Nominotion Form I
lndividual Calegory
ISO 90Ol : 2Ol 5 CERTIFIED
DEPED-4A-GFO62OI2_I B
DOCUMTNI NO. YERSIOIII I'tO. Rrylsroil I'Jo. DATE:
0000002 1.1 0.i l1 August 2017 Page I of3

lndividuol Coteoory:
THE NOMINEE

Nome: Signolure:
Scx: Plcce of Bidh:
Home Address:
Mobile Number: Civil$lstus:
School /Office Address:
SDO:
Phone Number: DepED EmoilAddress
OTFICE/DIVISION HEAD
Ncme:
Pos$ion:
TelephonelMobile No:
Deped EmoilAddress:
NOMINATOR
Nqme: Position:
Office: Telephone/Mobile No.:
Oflice Address: EmoilAddress:
ADDITIONAT INFORMATIOH ABOUT THE NOMINEE

Were you CI previous Gowod Potnugoi Nominee? fl yes [1 tto lf yes, whot year?

Whot owcrd cctegory?

Were you c: previous Gowod Patnugai Semi-finolist? fl Yes I No lf yes, whoi yeor?

Whot oword coiegory?

Were you c previous G owqd Pctnugot Winner? X Yes tl No lf yes, whot yeor?

Whcrt cword cotegory

 Nominqlion Form I
t-ffi ffi' lndividuql Cotegory
iSO 9@1 : 2015 CERTIFIED
DEPED-4A-GFO62OI 2.I B

DOCUMENT NO. VERSION NO. REvrsroN No. DAIF:

0000002 l.t 0.1 1 I August 2017 Poge 2 of 3

NOMINATION WRITE.UP
(Maximum of I0poges, A4size bondpoper: eenturyGolhic #llfont, inc/udingexeculivesurnrnoryf

Nqme ol Nominee: SDO:

SchooUOffice:

Posilion/Desig nolion :

Length of Service in the Posilion: ln Governmenf:

l. Executive Summory (Description of why the nominee is deserving of the oword in noi more thon
.l50
words which includes personol ond professionol trqits ond competencies.)

ll. Significonl Accomplishmenl/s within the lost Three Yeors (June 2015- June 2018) {Description of
the Project/Work Accomplished, Strotegies/Activities Done thqt hove significontly impocted the
performonce of ihe school / school community)

lll. lmpoci of the Accomplishmenls (lndicote problems oddressed. people/office benefited ond
tronsoctions focilitoted. lndicote whether or noi ihe occomplishments ore port of ihe nominee's
regulor funciions/mondoted or the product of his/her initiotive. lf ports of the nominee's regulor
dulies or mondqied, justify why the occomplishments ore considered exemplory or extraordinory.

lV. lnnovolions {lf ony. Originsl, creotive programs, projects, octivities mode in the lost three {3)
yeors in connection to the oword e otegory)'lpoge obstroct.

V. Awords ond Membership {List or mention mojor owords/citotions received relevont io the
cotegory ond octive membership in o reputoble professionol orgonizotion. No need io ottoch
photocopies of certificoies.)
 .{

Nominolion Form l
/
'.ffi3ffiffi
ISO 9001 :2015 CERTIFiED
lndividuql Cotegory
DEPED-4A-GFO62OI2-I B
DocundfhrrNc. yfnstoil Na REvrsrof{ ruo. DATE:
0000002 t.l 0_1 1 1 Augusi 2017 Page 3 of 3

CERTIFICATION

We sttest to oll fqcts coniained herein and quthorize the use of these informqtion for
publiccticn. We undersiand thst the Regiancl PRAISF Ccn:rniffee rvillvclidcte the cccurccy of
the information contained in this fcrm and grcni our consent to the conduct of a background
investigotion. Any misrepresentotion msde by the signotories sholi be o ground for disciplinory
sction pursuont lo opplicoble CSC lows ond rules.

PRINTED NAME AND SIGNATURF

NOMINEE DIVISION PRAISE COMMINEE CHAIR

DIVISION HRMO DIVISION OFFICE HTAD

 **.1'% Nominolion Form 2
itil.F $chool Cc*egory
ISO 90O1 : 2015 cedified
DEPED-4A-GFO62009-I B

DOCUi4ENI l,l0 YERSION fi'O. RFvrsroN No. DATE:

0000002 1.1 0.1 l1 Augusi 2017 Pcge 1 of3

Schaol ColeEory:
THE NOMINEE

School:
Sc hool/Of{ice Address:
Dislricl: SDO:
Telephone Number: DepEd EmqilAddress:
SCHOOL HEAD
Nome: Sex:
Designolion:
Telephone/Mobile No:
Deped EmoilAddress:
NOMINATOR
Ntrrne: Posiiion:
Olfice: Telephone/Mobile No.:
Office Address: EmoilAddress:
ADDITIONAT INFORMATION ABOUT THE NOMINEE

Was your school o previous Gowod Poinugot Nominee? f] Yesil No lf yes, whot yeor?_
Whoi oword cotegory?

Wos your school o previ ous Gowod Polnugot Semi-finolist? tl Yes I No lf yes, whot yeor?

What oword cotegory?

Wos your school 0 prev ious Gowod Potnugot Winner? fl Yes[J No lf yes, whot yeor?

Whot cword cotegory

 Nominqtion Form 2
iSj
"{::.%
ISO
ffi,
9001 : 2015 Ceriified
School Cotegory
DEPED_4A-GFO62009-I 8
DOCU/vlENr ruO. YERSION NO. REYI$|oH HO" DATE:
0000002 t.1 0.1 l"l August 2017 Poge 2 of 3

NOMINATION WRITE.UP
{Maximum of I0 poges, A4 size bond poper, Cenlury Golhic #l I font, including execufive summary)

Nqme of School:

SDO:

Colegory:

L Execulive Summory{Description ofwhy the school is deserving of the oword in not more thon
.l50
words which includes TEA Governonce implemeniotion, Finonciol mCInogement, DepED
Progroms ond Projecis lmplemeniotion.]

ll. Significonl Accomplishmenl/s within lhe lssl Two Yeors {June 2016- June 2018}{Description of
the Project/Work Accomplished, Siroiegies/Activiiies Done thot have significonlly impocted the
performonce of ihe leorners ond the school os well.)

lll. lmpocl of the Accomplishmenls{lndicate problems addressed, people/office benefifed snd

tronsoctions fociliiated. Justify why ihe crccomplishments sre considered exemplory or
exiroordinory.

lV. lnnovqtions (lf ony. Originql, creotive progroms, projects, octivities mode in the lost two (2)
yeors in connection to the oword cotegory)l poge obstroct.

V. Other lnformolion (List or mention Mojor Awords/Ciiotions Received by the school in

connection to the oword. No need lo ottoch pholocopies of cerfificaies.i
 (

Nominqlion Form 2
/ 'ffiISO
ffi,
9001 : 2015 Cedified
School Colegory
DEPED-4A-GFO62009-I 8
DOCU,T,IFNT NO. YERSION tto. REYIS|oN ilO. DAIE:
0000002 1.1 0.1 I 1 Augusi 2017 Poge 3 of 3

CEFTIFICATIOH

We oitest to oll focts contoined herein qnd outhorize the use of these informqtion for
publicaiion. We understand ihui the Regionol PRAISE Commiilee willvolidole the occurccy of
the informcrtion conlained in ihis form ond gront our conseni to ihe conducl of a bockground
investigotion. Any misrepreseniotion mode by the signotories sholl be o ground for disciplinory
ociion pursuont to opplicoble CSC lows ond rules.

PRINTED NAMF AND SIGNATURE

SCHOOL PRINCIPAL DIVISION PRAISE COMMINEE CHAIR

DIVISION HRMO DIVISION OFFICE HEAD

 Nominstion Forrn 3
Division Cctegory
DEPFD_4A-GFO62OI O-IB
DOCUi,IENI n O. YERSION NO. RgyrstoN No. DATE:
0000002 l.t 0.1 I 1 August 2017 Poge 1 of 3

Division Cqfegory:
THE NOMINEE

Schools Division Office:

Division/Office Address:
Telephone Number: DepEd EmqilAddress:
oFFrcE/DrvtstoN HEAD
Nome: Sex:
Designolion:
Telephone/Mobile No:
Deped EmoilAddress:
NOMINATOR
Nqme: Position:
Office: Telephone/Mobile No.:
Office Address: EmqilAddress:
ADDITIONAL INFORMATION ABOUT THE NOMINEE

Wos your SDO o previous Gowod Pcrtnugot Nominee? Yes [I No f] lf yes, whot yeor?_
Whot oword coiegory?

Wos your SDO o previous Gawod Potnugoi Semi-finolist? Yes [ ruo[J lf yes, whcrt yeor?

Whot oward cofegory?

Wos your SDO o previou s Gowod Potnugot Winner? Yes[ No[ lf yes, whot year?

Whoi qword cotegory

 t:l# ffi
l5O 9001 ; 2015 Certified
Nominolion Form 3
Division Cotegory
DEPED.4A-GFO620I O-I B
DOCUMFf{I NO. YERS'ON NO. REvrsroil ilo, DAIE:
0000002 l.l 0"1 l1 August 2017 Poge 2 of 3

NOMINATION WRITE.UP
(Maximum of I0 poges, A4 size bond poper, Century Gathic # I I fonl including execufive summaryJ

SDO:

Office Address

l. Execulive Summf,ryiDescription of why the division is deserving of ihe oword in not more ih<rn
I50 words which includes physicol oitributes, performcnce qnd communiiy linkoges, TEA
Governcnce implemeniqiion, FinonciolMonogement, DepEd Progrom lmplementotion.)

ll. Significont Accomplishmenl/s wilhin fhe losl Two Yeors (June 2016- June 2018){Descripiion of
the Project/Work Accomplished, Strcrtegies/Activiiies Done thoi hove significontly impocted the
performonce of the learrrers ond ihe orgonizo.fion os well.)

lll. lmpocl of lhe Accomplishmenls {lndicaie problems addresseci, people/office benefiteci ond
ircnsoctions focilitoted. lndicqie wheiher or nof lhe accom;:lishmenis ore pcrt of the nominee's
regulcr functionslmondated or the product of the SDO's initioiive. lf ports of the nominee's
regulcr duiies or mondcted, justify why the occomplishments ore considered exemplcrry or
extroordinory.

lV. lnnovqlions {lf ony. Originol, creotive progroms, projecis, octivilies mode in the losi fwo (2}
yeors in connection to ihe oword cotegory)i poge obstroct.

V. Olher lnlormolion {List or menlion Mojor Awords/Citotions Received by ihe SDO. No need to
ottqch phoiocopies of certificotes.)
 Nominqtion Form 3
Division Cotegory
DEPED-4A-GFO620I O-I8
DOCUA,IFNT HO. YERSION l,JO. REvtstoN rro. DAIE:
0000002 l.l 0.1 I 1 August 2017 Poge 3 of 3

CERTIFICATION

We <rtiest to ollfocts contoined herein ond oulhorize the use of these informotion for publicotion.
We understond thot the Regionol PRAISE Committee will volidote the occurocy of lhe
informotion contoined in this form ond gront our consent to the conduci of o bockground
investigotion. Any misrepresentotion mode by the signotories sholl be o ground for disciplincrry
oction pursuont to opplicoble CSC lows ond rules.

PRINTED NAME AND SIGNATURF

PERSON IN.CHARGE OF THE PROGRAM DIVISION PRAISE COMMITTEE CHAIR

DIVISION HRMO DIVISION OFFICE HEAD

 Nominotion Form 3
';Ht lSO 9OOl : 20J 5 Certified
Division Coteg
DEPED-4A-GFO62O1 1-18

DOCUMENI NO. I VERSTON NO.

0m0002 II I I August 2017 | Pooe I of 7

A. GENERAT INTORMATION

Schools Division:

Address:

Office Heod: Designolion:

Telephone: Mobile:

Fox: E-moil:

{Nole: Docurnentqtian repods, stlendonce sheefs. owords ond certificqfes, phofos wrife-ups, FIC rnsfenols
sh<ruld be rnode ovailqble duing fhe onsife validation)

B. POLICIE$

Pleose enumercte GAD-relcted policies {SpeciolOrder. Memorcndum Circulars ond Bocrd

Resolutions] formuiaied, impiemenied and insliiutionclized by the cgency. {Pleose use
additional sheeis when necessoryJ

B.l 2017 GAD Plan and Budget

l ]Avoiloble Inpproved/Endorsed

Itntegroted in the plonning documents IMoinstreomed

8.2 2A i6 GAD Accompirshmenl Reporf

Izs to 49% implemented lso to T4Zoimplemented

IzS to ?9% implemented I imZ implemented

&3 Afher Palfcl*s

TANGET
DATE POPULATION BRIET DESCR!PTION
TITLE OF POTICY
ISSUED (slctl or (How lhe pollcy ls qddressing on imporlont
cllenls) qender issuel
 r,f;H: Nominofisn Form 3
Division Cotego
ISO 9001 : 2Ol 5 Cedified
DEPFD-4A-GFO62O1 I -I B

YERS'ON NO.
1.1 I 1 August 201 7 | Pooe 2 of 7

C. PEOPLE

C" I GAD+e/oied CspsbilitV Building Activitles ConducfedlAftended

Please enumerote GAD-reloted eopocily devetopments (e.9. trainings, semlncrs, orientations.

workshops, etc.) conducted by fhe offiee whether inlernql or for clients, /Pleose use addilional
chaa*c
J' IUU'J r^rha^
f VI IVI I Inaaaccnnzl
'UUUJJVI //

NO. & PROFILE Of

TITLE OF ACTIVITY DATT OUTPUT
PARTICIPANTS
TYPE CONDUCTED
A.ORGANIZATION

B. FOR CTIENTS

C.2 Membership of men ond wornen in arganizations

It orgonizotion IZto3orgonizotions
il+ to 5 orgcnizolions I e or more orgonizctions
 Nominqtion Form 3
Division Cotego
NO 90Ol : 2015 Cortified
DEPED.4A-GFO52OI ]_IB
DOCUA,IENINO. YERS'ON NO.
t.t I I Augusi 2017 Pose 3 of 7
0000002 |

C.3 Iop monogernenf supporl for gender moinslreominEt

l) zsn of top monogement lsoz of top monogement

llzsn of top monogement ItooZ of top monogement

D. ENABIING l,lECHANlSlf,$

D.l GAD FocalPoinf Sysfem

r Dote estoblished:

r Title of the policy issuonce on the creotion ond/or strengthening of the GFPS

GFPS Composilion lPleose use oddifiono/sheets when necessoryJ

Executive Committee Heod:

Position:

Designoted Alternste Heod:

Position:

ExeCom Members:

NAME POStTION
DEPARTMENT / NO. OF YEARS AS
DIVISION / UNIT MEMBER
 Nominotion Form 3
Division Coteg
9001 :?015 Ceriified
ISO
DEPED-4A-GFO62OI 1-I8
i DOe UJl,tf tr No. YER$'ON RgvrstoH I{o. frATE:
i ooooooz 1.1''TO. ll Augu* 2A17 Page 4 of 7

TWG Choirperson:
Position:

IWG Members:

NAME POSTTTON
DEPARTMENT / NO. OF YEARS AS
DIVISION / UNIT MEMBER

D.2 Networking Sfforts (Attach IOR ond or MOA/MOU cnd the works and finsncial plan of lhe
podnership cgreemenfJ

Pleose enumerote pcrtnerships estoblished ond institutionolized with vorious stokeholders to

develop and implement progroms, projecls ond octivities responding to gender issues.
{P/esse use additionolsheels when necessory}

TITTE OF
DATE
PARTNER$HIP
ESTABLISHED &
(Pfeose o;ftEch ACCOMPTI$HMENTS
STATUS OF
TOR when
PANTHERSHIP
 Nominotion Form 3
Division Coteg
DEPED.4A-GFO62OI I -18

IIAugust2017 Pooe5of7
i

D.3 Other enabling mechanisms eslob/ished

Flcose enumcrole other enabling mechsnisrns estsblished, institutionalized or choired by the

offiee to ensure that gender ls mainsiresmed {i.e. sfructures cnd systems, intercgeney/inter-lgu
eommitiees, TWGs, GAD dotobose snd budget ollocotion).

GENDER-RESPONSIVE
GENDER ISSUE/GAD
ENABI.ING MECHANISMS
DATE ESTABIISHED MANDATE
(Pleose offtlclt IOR ACCOMPLISHMENTS
ADDRTSSED
when gpollcoble)

E.l lnformaiion, Educotion ond Communicofion

Lisl down the IEC moierials produced

BRIEF
GENDER
DESCRIPTION DATE
ISSUE/GAD STATUS & OUICOME
TITTE OF THE BUDGET IMPtE,
MANDATE OF IMPTEMENTAIION
PROGRAM/ MENTED
ADDRESSED
PROJECT

E.2 Client-direcled

Dt ot the identified PAP provided ilZ ot the identified PAPs provided

ile ot the identified PAPI provided I+ or more af fhe idenlified PAPs provided
 Nominotion Form 3
'ffiffiffi
EO 9@1 : 2015 Certified
Division Coteg
DEPED-4A-GFO620I I -I B

DOCUi{fNrNO. YE'RS'ON ilO. .l Pcoe 6 or 7

0000002 1.1 1 August 2017 |

F. 3 Other Clrenf-direcied PAPs

Pleose enumerote progroms ond/or projecfs moinsfreomed with gender penpeclive or

oddressing o gender issue/GAD mondoie thct were formuloted, implemented ond
insiituiionolized by the ogency/office. {Pleose use oddifiono/ sheefs when necessoqr'f

SRltt
STATUS &
DESCRIPTION OF
OUTCOfiAF OF
THE PRCIGRAMI
IMPLEMENTATION
PROJECT

F. OTHER RETEVANT INFORMATION ( Awords/citotions received in connection to ihe oword.

Pleose use oddifionolsheets when necessoryl

G, WHY DO YOU THINK THE SDO DESERVES THE AVYARD? {Please use addifionolsheels when
necessory)
 Nominotion Form 3
SO 9001 : 2015 Certified
DEPED.4A.GFO62OI I -I B
DOCUMFNT NO. vEns,oN No. REV'$TON ilO.
'I
0000002 1 August 201 7 | Pooe 7 of 7

H. INFORMATION ABOUT THF NOMINATING PANTY

Nsme of naminoting porty:

{Nome of lhe nominafing party}

CERTIFICATION

We qftest to all focts contoined herein qnd outhorize the use of ihese informoiion for
publicotion. We understond thot the Regionol PRAISE Commitiee will volidote the
cccurocy of the informotion contqined in this form ond gront our conseni to the conduct
of o bcckground invesiigotion. Any misrepresentotion mode by the signotories sholl be
c ground for disciplinsry oction pursuoni to opplicoble CSC lows ond rules.

PRINTED NAME AND SIGNATURE

PERSON IN-CHARGE OF THE PROGRAM DIVISION PRAISE COMMITIEE CHAIR

DIVISION HRMO DIVISION OFFICE HEAD

Fom Adopled fr$ffi RGADLI NFDA 4A

 -.d T"o+ Nominqlion Form 4
'#j ISO 9001 : 2015 Certified
Orgonizolion Cotegory
DEPED.4A_GFO62A22-18
DOCUMENT NO. YERS'ON NO. REY'sION NO. DATF:
000000r l.l 0.1 B Moy 2018 Poge 1 of 3

Cqleqory: Nololonqinq Pqronqql

THE NOMINEE

Nome of Group: Nome ol Teom Leoder:

Posilion:
Telephone/Mobile Number: EmoilAddress:
Orgo nizolionlDivision Address:
Telephone/Mobile No.:
TeOm MgmbgfS (Nome - Position Title bcsed on Service Record)

I 6.

2. 7.
3. 8.
4. 9.
t 10.
OFFICE/DIVISION HEAD
Nome: Sex:
Designolion:
Telephone/Mobile No: Deped EmqilAddress:
NOMINATOR
Nome: Position:
Office: Telephone/Mobile No.:
Office Address: EmoilAddress:
ADDITIONAL INFORMATION ABOUT THE NOMINEE

Wcs your Orgcnizotion o previous Gcwod Potnugot Nominee? y*, f] rvo I lf yes, whct yeor?-
Whct oward cotegory?

Was your Crgonization o previous Gawod Fctnugof Semi-finalist? Yes I Nof] lf yes, whct yeor?
\A/hnl nrrrnrr{ rntannnrZ
rr -

Was your SDO a previous Gawcd Patnugot Winner? Yes [f No f] lf yes, whqt yecr?
Whot oword cotegory

-
 Nominstion Form {
'ffi ffi
ISO 9001 : 2015 Certified
Orgonizotion Cotegory
DEPED-4A-Gr?62A22_18
DOCUrVtgf{r NO. YERS'ON NO. REyrSroN NO. DATE:
0000001 1.1 0.1 B May 2018 Pcge 2 of 3

NOMINATION WRITE.UP
{Maximum of lA pages, A4 size bond paper, Century Golhic #I I fr>nt, inclurling execufive summary)

Nome of the Group: Teqm Leoder:

Lenglh ol Exielence {ns orgsniz€fir:n) Qffice Address

I' Exeeullve Summory{Description of ihe or$cnizction;the why and when it wns s€crsdiled by a
reliable cnd reputcble instilution;why the orgonizatlon is deserving of the awcrd in nat mCIre
than 150 words,

ll. lmpact to Orgonizoiion {June 2A16- June 20I8}{Description of the Projeci/Work

Accomplished, Activiiies Done lhoi hove significontly impocied ihe performonce of the
orgonizoiion CIs well" The octivities / events or service should not be porl of the nominee's job
descripiion or duiies ond the members connot receive ony moneiory or personol benefils from
their involvement. The orgcnizqtion should hove slso demonsirqled how it embodies cnd instills
the TEA Governonce principle.

lll. lmpocl lo Communily {lndicote problems oddressed, people/office benefited, ond its impoct
1o the community.]
 ffi #
ISO ?001 : 2015 Certilied
Nominqtion Form 4
Orgonizslion Cotegory
DEPED-4A.Grc62A22-18
DOCUT,{ENI HO. vER$tor{ ftro. RFytStof,J I{o. DATE:
0000001 1.1 0.i B May 2018 Poge 3 of 3

CERTIFICATION

We ottest to ollfocts contoined herein ond outhorize ihe use of these informotion for publicotion.
We undersisnd thot the Regionol PRAISE Committee will volidoie lhe occurocy of the
informclion contoined in this form <rnd gronl our consenf tc the conduct of o bockground
investigolion. Any misrepresentotion mode by ihe signotories sholl be o ground for disciplinory
oction pursuonl to opplicoble CSC lows <rnd rules.

PRINTTD NAME AND SIGNATURE

PERSON IN-CHARGE OF THE FROGRAM DIVISION PRAISE COMMITTET CHAIR

DIVISION HRMO DIVISION OFFICF HEAD