Adopt A School Form
Adopt A School Form
Adopt A School Form
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300
www.deped.isabela.com.ph (078)323-0281/323-2015 isabela.depedro2@gmail.com
Form 1
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY
School:_____________________________________ Address:________________________________________
School ID:__________________________________ Contact Nos.:________________________ Email Address:_____________________
LEARNING ENVIRONMENT
DONATIONS PARTICULARS QTY. AMOUNT DONOR DATE
PRIVATE LGU COMPLETED/
SECTOR TURN OVER
1. Classroom
-New Classroom
-Rehabilitation/Repair
2. Furniture
3. Toilet & Wash Facilities
4. Maintenance
5. Real Estate
6. Others (Pls Specify)
TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/Receipts (Xerox)
PREPARED BY:
_________________________
School Head/Principal
Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300
www.deped.isabela.com.ph (078)323-0281/323-2015 isabela.depedro2@gmail.com
Form 2
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY
School:_____________________________________ Address:________________________________________
School ID:__________________________________ Contact Nos.:________________________ Email Address:_____________________
LEARNING SUPPORT
DONATIONS PARTICULARS QTY. AMOUNT DONOR DATE
PRIVATE LGU COMPLETED/
SECTOR TURN OVER
1. Audio-Visual Educational Materials
2. School Supplies
3. Educational Film/Libraries
TOTAL
PREPARED BY:
_________________________
School Head/Principal
Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300
www.deped.isabela.com.ph (078)323-0281/323-2015 isabela.depedro2@gmail.com
Form 3
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY
School:_____________________________________ Address:________________________________________
School ID:__________________________________ Contact Nos.:________________________ Email Address:_____________________
TECHNOLOGY SUPPORT
DONATIONS PARTICULARS QTY. AMOUNT DONOR DATE
PRIVATE LGU COMPLETED/
SECTOR TURN OVER
1. Computer
3. Internet Connectivity
TOTAL
PREPARED BY:
_________________________
School Head/Principal
Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300
www.deped.isabela.com.ph (078)323-0281/323-2015 isabela.depedro2@gmail.com
Form 4
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY
School:_____________________________________ Address:________________________________________
School ID:__________________________________ Contact Nos.:________________________ Email Address:______________
3. Deworming Interventions
4. Health Supplies
TOTAL
Please attach the following documents:
10. Deed of Donation
11. Deed of Acceptance
12. Pictures/Receipts (Xerox)
PREPARED BY:
_________________________
School Head/Principal
Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300
www.deped.isabela.com.ph (078)323-0281/323-2015 isabela.depedro2@gmail.com
Form 5
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY
School:_____________________________________ Address:________________________________________
School ID:__________________________________ Contact Nos.:________________________ Email Address:_____________________
READING PROGRAM
DONATIONS PARTICULARS QTY. AMOUNT DONOR DATE
PRIVATE LGU COMPLETED/
SECTOR TURN OVER
1. Books
TOTAL
PREPARED BY:
_________________________
School Head/Principal
Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300
www.deped.isabela.com.ph (078)323-0281/323-2015 isabela.depedro2@gmail.com
Form 6
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY
School:_____________________________________ Address:________________________________________
School ID:__________________________________ Contact Nos.:________________________ Email Address:_____________________
2. Students/Pupils Training
Field Trip
TOTAL
PREPARED BY:
_________________________
School Head/Principal
Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300
www.deped.isabela.com.ph (078)323-0281/323-2015 isabela.depedro2@gmail.com
Form 7
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY
School:_____________________________________ Address:________________________________________
School ID:__________________________________ Contact Nos.:________________________ Email Address:_____________________
DIRECT ASSISTANCE
DONATIONS PARTICULARS QTY. AMOUNT DONOR DATE
PRIVATE LGU COMPLETED/
SECTOR TURN OVER
1. Stipend
TOTAL
PREPARED BY:
_________________________
School Head/Principal
Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Alibagu, City of Ilagan, Isabela 3300
www.deped.isabela.com.ph (078)323-0281/323-2015 isabela.depedro2@gmail.com
Form 8
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY
School:_____________________________________ Address:________________________________________
School ID:__________________________________ Contact Nos.:________________________ Email Address:_____________________
PREPARED BY:
_________________________
School Head/Principal
Republic of the Philippines
Department of Education
Region 02(Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
ECHAGUE EAST DISTRICT
SALAY ELEMENTARY SCHOOL
Salay, Echague, Isabela 103298
marion.tamani@gmail.com 09161077463
MARION B. TAMANI
Principal I