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Department of Education: Ely S. Ubaldo, Ceso Vi

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Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN

August 9, 2021

ELY S. UBALDO, CESO VI


Assistant Schools Division Superintendent
Officer In-Charge, Office of the Schools Division Superintendent
SDO 1Pangasinan, Lingayen

Madam:

Greetings of hope and peace!

I have the honor to request permission from your good office to allow me to prepare a
Strategic Intervention Material entitled “<<TITLE>>”. This will serve as <<purpose>>

The objectives of this instructional material include the following:


1.
2.
3.

I am hoping for your kind approval.

Very truly yours,

<<PROPONENT>>
<<Designation>>

Noted:

<<SCHOOL HEAD>>
<<Designation>>

August 09, 2021

PERMIT TO PREPARE A STRATEGIC INTERVENTION MATERIAL

Address:Alvear St. Lingayen, Pangasinan


Telephone No.:(075)-522-2202
Email:pangasinan1@deped.gov.ph
Republic of the Philippines
Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN

This proposed instructional material entitled “<<TITLE>>” is to be prepared and to


be developed by <<PROPONENT>>, <<Designation>> at <<SCHOOL>>, <<District>>.

It has been forwarded to the office of the Schools Division Superintendent for
approval.

Reviewed and Evaluated:

JERRY R. JUNIO
Education Program Supervisor, Science

Recommending Approval:

CARMINA C. GUTIERREZ, Ed. D.


Chief Education Supervisor, CID

Approved for the Schools Division Superintendent:

MA. CRISELDA G. OCANG, CESE


OIC, Assistant Schools Division Superintendent

PARTS OF PROPOSAL

A STRATEGIC INTERVENTION MATERIAL

I. Title:

Address:Alvear St. Lingayen, Pangasinan


Telephone No.:(075)-522-2202
Email:pangasinan1@deped.gov.ph
Republic of the Philippines
Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN

II. Introduction

A. General Overview

B. Sub-tasking

C. Objectives

III. SIM Parts

A. GUIDE CARD

B. ACTIVITY CARD

C. ASSESSMENT CARD

D. ENRICHMENT CARD

E. ANSWER KEY CARD

F. REFERENCE CARD

Prepared by:

<<PROPONENT>>
<<Designation>>

Address:Alvear St. Lingayen, Pangasinan


Telephone No.:(075)-522-2202
Email:pangasinan1@deped.gov.ph

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