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ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 01

As of March 31, 2015


Region: BATAAN
Division:
School: CAPITOL COMPOUND, BALANGA CITY, BATAAN
Address:
School ID:
Contact Nos.: 047-791-1295 E-mail Address: sgodunit.bataan @gmail.com

LEARNING ENVIRONMENT
DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER
aspsch_form 01

TOTAL - GPTA

* Please attach the following documents: Prepared by: Noted by:


1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:

Schools Division Superintendent


ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 02
As of March 31, 2015
Region: BATAAN
Division:
School: CAPITOL COMPOUND, BALANGA CITY, BATAAN
Address:
School ID:
Contact Nos.: 047-791-1295 E-mail Address: sgodunit.bataan @gmail.com

LEARNING SUPPORT
DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1.

2.

3.

4.

TOTAL -

* Please attach the following documents: Prepared by: Noted by:


1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:
Schools Division Superintendent aspsch_form 02
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 03
As of March 31, 2015
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

TECHNOLOGY SUPPORT
DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. COMPUTER

2. ELECTRONIC LEARNING
MATERIALS

3. INTERNET CONNECTIVITY

4. OTHERS PLS. SPECIFY

TOTAL

* Please attach the following documents: Prepared by: Noted by:


1. Deed of Donation aspsch_form 03
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:

Schools Division Superintendent


ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 04
As of March 31, 2015
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

HEALTH AND NUTRITION


DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. FEEDING PROGRAM

2. MEDICAL/DENTAL
MISSION/CHECK-UPS

3. DEWORMING
INTERVENTION

4. HEALTH SUPPLIES

5. OTHERS PLS. SPECIFY

TOTAL

* Please attach the following documents: Prepared by: Noted by:


1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator
Approved by: aspsch_form 04
Schools Division Superintendent
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 05
As of March 31, 2015
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

READING PROGRAM
DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. BOOKS

2. SUPPLEMENTARY
READING MATERIALS

3. OTHERS PLS. SPECIFY

TOTAL -

* Please attach the following documents: Prepared by: Noted by:


1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:
aspsch_form 05
Schools Division Superintendent
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 06
As of March 31, 2015
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

TRAINING AND DEVELOPMENT


DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. TEACHERS/PRINCIPAL TRAINING

2. STUDENT/PUPILS TRAINING
AND FIELD TRIP

3. OTHERS PLS. SPECIFY

TOTAL -

* Please attach the following documents: Prepared by: Noted by:


1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:
Schools Division Superintendent aspsch_form 06
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 07
As of March 31, 2015
Region: III
Division: BATAAN
School:
Address: CAPITOL COMPOUND, BALANGA CITY, BATAAN
School ID:
Contact Nos.: 047-791-1295 E-mail Address: sgodunit.bataan @gmail.com

DIRECT ASSISTANCE
DONOR'S NAME
DATE
DONATIONS PARTICULARS QTY. AMOUNT GOVERNMENT COMPLETED/
PRIVATE SECTOR LGU INTERNATIONAL
TURN-OVER
AGENCY

1. STIPEND

2. OTHERS PLS. SPECIFY

TOTAL

* Please attach the following documents: Noted by:


1. Deed of Donation
2. Deed of Acceptance Approved by:
ASP Division Coordinator
Schools Division Superintendent aspsch_form 07
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 08
As of March 31, 2015
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

ASSITIVE LEARNING DEVICES FOR STUDENT WITH SPECIAL NEEDS


DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. PENCIL GRIPS

2. SPECIAL CHAIRS

3. SPELLING CHECK DEVICES

4. HEARING AIDES

5. TALKING COMPUTERS

6. SPECIALIZED KEYBOARDS

8. BRAILLE (BOOKS)

9. COMPUTERIZED SYSTEMS

10. OTHERS PLS. SPECIFY

TOTAL -

* Please attach the following documents: Prepared by: Noted by:


1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:
Schools Division Superintendent aspsch_form 08
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
As of March 31, 2013

Assistive
Learning Learning Technology Health and Reading Training and Direct
SCHOOL ID SCHOOL Learning
Environment Support Suppport Nutrition Program Development Assistance
Devices

108085 San Juan ES 20,000.00 5,000.00

108149 Neogan ES 30,000.00 10,000.00 35,000.00

164013 Bagbag II ES 100,000.00

301202 Lumil NHS 40,000.00 60,000.00

301199 Lucsuhin NHS 100,000.00

TOTAL 160,000.00 30,000.00 5,000.00 100,000.00 10,000.00 60,000.00 35,000.00 -


TOTAL

25,000.00

75,000.00

100,000.00

100,000.00

100,000.00

400,000.00
ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
As of March 31, 2015
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

LEARNING SUPPORT
DONOR'S NAME
DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT PRIVATE GOVERNMENT
LGU INTERNATIONAL TURN-OVER
SECTOR AGENCY
1. AUDIO-VISUAL
EDUCATIONAL MATERIALS

2. SCHOOL SUPPLIES

3. EDUCATIONAL FILM/
LIBRARIES

4. OTHERS PLS. SPECIFY

TOTAL -

* Please attach the following documents: Prepared by: Noted by:


1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:

Schools Division Superintendent