Region XII

Division of Sultan Kudarat

Health and Nutrition Section
Tacurong City

FAMILY MAPPING S.Y. 2015-2016

MUNICIPALITY & BARANGAY : LEBAK, PANSUD

Age Educational Educational Occupation
Head of the Family Attainment Occupation Wife Age Attainment

Other Persons within the

household
1
2
3
4
5
* Indicate if not going to school anymore since what year.
 Mortality in Cause of
Age of Children Sex (Bdate) Grade/Year the Family Death
1
2
3
4
5
6
7
8
9
10
11
12
13

Prepared by:
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region XII
Division of Sultan Kudarat

BRIGADA ESKWELA 2015

NUMBER OF VOLUNTEERS
Private Sector Community Government A
Religious
Private
School ID School Name NGO(PTA,SGC,G Corporation Parents Alumni individual/Comm Organization lCongerssiona
and Provincial City/Municip Barangay
wad Kalinga, Etc. s (Youth & Officials Officials al Officials Officials
unity Member staf
Adult

131114 Pansud ES

Prepared by: Approved:

GEORGINIA C. ESPARTERO
School BE Coordinator
vernment Agencies/National and Local

AFP(PA,Mari Barangay Otehers Total

SK Provincial/Ci Firemen/P ne,Airforce,e (Students/P Number of
Officials ty/Municipal NP Workers
tc. upils Volunteers
Employees

ved:

REYNALDO A. CADIZ
School Head
 Repuplic of the Philippines
Department of Education
Region XII
Division of Sultan Kudarat
District of East Lebak
PANSUD ELEMENTARY SCHOOL
School Year 2015-2016
BRIGADA ESKWELA
DAILY ATTENDANCE OF VOLUNTEERS
Date: May_____2015

Instruction: Volunteers themselves should personally fill in the details required by this form under the supervision of any of the co
For the last column , indicate if masonry,carpentry,plumbing,painting,electrical,gardening/landscapin

ADDRESS
POSITION /
NAME ORGANIZATION/AFFILI CONTACT NUMBER TIME
DESIGNATION ATION

IN
OL

TEERS

rvision of any of the committee members.

l,gardening/landscaping,ordinary labor or others.

NATURE OF
TOTAL NUMBER OF VOLUNTEER
TIME SIGNATURE HOURS SERVED SERVICES
RENDERED
OUT
Appendex F
BE Form 07
Department of Education

BRIGADA ESKWELA
SCHOOL ACCOMPLISHMENT REPORT
(to be accomplished by the School Head)

DIVISION: SULTAN KUDRAT REGION: XII

SCHOOL: PANSUD ELEMENTARY SCHOOL SCHOOL ID: 131114
SCHOOL ADDRESS: PANSUD, LEBAK S.K.

(Please check appropriate box)

Level Type of School:
Elementary Central School
High School Non-Central School (Complete)
Multigrade
Primary School /Incomplete

Integrated School
SCHOOL HEAD: REYNALDO A. CADIZ CONTACT NUMBER: 09295448489
PTA PRESIDENT: WOODY F. FRIERES CONTACT NUMBER:

A. SCOPE OF REPAIR AND MAINTENANCE WORK COMPLETED (Please check appropriate colum)
What was done?
Repaired Repainted Replaced Others
(Brief Description)
1 Roofs
2 Ceiling
3 Walls
4 Windows and Doors
5 Chairs/Desk/Tables and Blackboards
6 Comport Rooms
7 Leaking Pipes
8 School Grounds/Landscaping
9 School Signs
10 Other (specify)

B. DONATIONS / MATERIALS RESOURCES GENERATED ( Use separate sheets, if needed)

Type of Donations Source Estemated Cost
Appendex F
BE Form 07
Republic of the Philippines
Department of Education
Region XII
Division of Sultan Kudarat
School Year 2015-2016

BRIGADA ESKWELA
RECORD OF DONATIONS RECEIVED
(Tobe accomplishedby the Documentation Committee)

ASSUMED COST OF ITEMS

ITEM OR MATERIALS QUANTITY DATE RECEIVED NAME OF DONOR
PER UNIT TOTAL

TOTAL

Prepared by:

Committee on Documentation Chair/Member

Noted:
REYNALDO A. CADIZ
School Head
BE Form 7
Department of Education

F. SUGGESTION TO STRENGTHEN BRIGADA ESKWELA PROJECT (include support needed from

Centra, Region, and Division Office that can increase the impact of Brigada Eskwela Project
in your school)

G. EVEIDENCE / ATTACHMENTS
A. Photos (before, during and after)

Form 1 Form 4
Form 2 Form 5
Form 3
Form 4

Prepared by: Date:

REYNALDO A. CADIZ
School Head

Submit copy on this completed form to ADOPT-A -SCHOOL PROGRAM DISTRICT COORDINATOR or
District Supervisor on or before June 15.
BE Form 07
Department of Education

C. VOLUNTER SERVICES
Name of Individual/ Number of Volunteers
Type of Volunteer Organization Day 1 Day 2 Day 3 Day 4 Day 5

1. PTA Members
2. Barangay Officials
Municipal Gov. Officials
BE Form 07
Department of Education

D. Estemated cost of volunter services rendered. Rtefer to guide for Computing Labor Cost.

Total Number of Total Number of

Type of Service Total Estimated Cost
Volunters Hours Rendered
Masonry
Carpentry
Plumbing
Electrical /Electronics
Landscaping/Gardening
Painting
Ordinary Labor
Others
Total

D. Significant Events/ Expereince

Who were What is/are its important
involved? contribution to the operation of
What happened? When?
the school or to the existing
needs of the school?

E. ISSUES AND CONCERNS (Describe briefly problems enountered and bow resolved)

E. Lesson Learned/ Best Practices