Republic of the Philippines: Department of Education 14 AUG 2014 DepEd ORDER No. 36, s. 2014 REVISED DATA GATHERING FORMS FOR SCHOOL YEAR 2014-2015 OF THE ENHANCED BASIC EDUCATION INFORMATION SYSTEM (EBEIS) To: Undersecretaries Assistant Secretaries Bureau Directors Directors of Services, Centers and Heads of Units Regional Secretary, ARMM Regional Directors Schools Division Superintendents Heads, Public and Private Elementary and Secondary Schools All Others Concerned 1, The Department of Education (DepEd) continuously improves the Enhanced Basic Education Information System (EBEIS) in collecting data and information needed for planning and budgeting, allocation of resources and setting operational targets to provide all the learners access to complete quality basic education: 2. For School Year (SY) 2014-2015, the data collection and reporting of the annual school profile will be done once during the first quarter of every SY. Enclosed to this Order are the following revised forms to be accomplished: Enclosure No. Enclosure No. Enclosure No. Enclosure No. - Government Elementary School Profile (GESP} - Government Secondary School Profile (GSSP) - Private School Profile (PSP) - State Universities and Colleges (SUCs) Laboratory School Profile BONE 3. The data collection, processing and validation of school statistics shall begin with the dissemination of the revised data gathering forms for SY 2014-2015. 4. The timeline in the conduct of EBEIS activities shall be observed as follows: EBEIS Activity Timeline | Start of Encoding and Submission | August 15-31, 2014] Validation September 1-12, 2014 Glosing of System September 13, 2014 5. _ The cut-off date of data to be submitted is as of first Friday of the opening week of the SY. For public schools, this shall be as of June 6, 2014. 6. Enrolment figures entered in the Learner Information System will automatically be derived and tallied on Tables 1 and 2. esl Complex Merce Avenue, Pasi hy 1600 AY 60-700/699-7228/692-1961 4 626-1276/607-008 wen ese sovoh7. The following tables and boxes are either new, contain new data elements or revised: Government Elementary School Profile (GESP) ‘Table 1 Learners Data Box 1 Shifting Schedule Box 2 Multigrade Classes Table 5 Learners with Exceptionalities (non-graded) ble 6 Learners with Exceptionalities from Special Education (SPED) Classes last SY 2013-2014 Mainstreamed in Regular Classes Box 3 Learners with Exceptionalities who never attended any SPED Classes Table 9 Teaching Personnel Data (Nationality-funded) Table 10 Teacher Assignments (National-funded teachers working in the school) Box 5 Availability of Electrical Supply Table 13 Number of Functional Computers in the School by Funding Source Table 14 Average Monthly Expense (in Pesos) of Internet Connection by Funding Source Box 7 School Site Data Box 8 Feeding Program Government Secondary School Profile (GSSP) Table 1 Learners Data Box 1 Shifting Schedule Table 3 Learners Data by Program Table 4 Learners Data in Technology and Livelihood Education (TLE) Table 5, Learners with Exceptionalities Data Table 7 ‘Teaching Related and Non-teaching Personnel Data (Nationally-funded) Table 8 ‘Teaching Personnel Data (Nationally-funded) Table 9 ‘Teacher Assignments (Nationally-funded teachers working in the school) Table 10 Number of Teachers by Teaching Assignment Box 3 Availability of Electrical Supply Table 11 Number of Functional Computers in the School by Funding Source Table 12 Average Monthly Expense (in Pesos) of Internet Connection by Funding Source Box 5 School Site Data Box 6 Feeding Program Private School Profile (PSP) and SUCs Laboratory School Profile Table 1 Learners Data in Elementary Box 1 Multigrade Classes Table 3 Learners Data in Secondary Table 5 (PSSP only) Data on GASTPE Program Box 2 Senior High School Program 8. ‘The school heads/teachers-in-charge (SHs/TICs) of both public and private schools offering kindergarten, elementary and/or secondary education shall be responsible for ensuring prompt, complete and accurate accomplishment of the EBEIS data gathering forms. 9. The regional directors (RDs) and schools division superintendents (SDSs) through the Regional Planning Units (RPUs) and Division Planning Units (DPUs) shall jointly undertake online collection, processing and validation of the accomplished forms and collection of printed and signed forms to ensure the accuracy, consistency, and completeness of data submitted by the schools. 10. The regional and division education program supervisor in-charge of private schools and SUCs laboratory schools shall facilitate the online collection of forms and assist the Planning Unit in checking the accuracy, consistency, completeness and timely submission of all private schools.11. The personnel from the schools division offices (SDOs) shall oversee the encoding of data for schools with no access to Internet facilities. 12. Funds shall be downloaded directly to the SDOs to aid in activities that allow for the timely and accurate accomplishment of the EBEIS. The downloading of funds to all the SDOs shall be announced through a separate memorandum. 13. For changes and adjustments to derived data in Tables 1 and 2, school heads have to write their respective SDSs providing sufficient justification. The SDSs must review and support the request with a firm recommendation to the Office of the Secretary, Attention: Office of Planning Service-Research and Statistics Division (OPS- RSD). 14. All personnel involved in the EBEIS at the school, district, division, regional and central levels are allowed to render overtime services during weekdays, weekends and holidays as provided in DepEd Order No. 58, s. 2008 entitled Authorizing the Grant of Overtime Pay and Other Benefits to Personnel Involved in the Operations of the Basic Education Information System and DepEd Order No. 10, s. 2009 entitled Addendum to DepEd Order No. 58, s. 2008 (Authorizing the Grant of Overtime Pay and Other Benefits to Personnel Involved in the Operations of the Basic Education Information System (BEIS) whenever necessary in order to meet the EBEIS target schedules. 15. This Department would like to thank all personnel involved in the encoding, collection, processing and validation of data in the EBEIS. The support of all concerned has aided in DepEd’s efforts to institutionalize the use of accurate and timely data for planning, budgeting and implementation. 16. Provisions in this Order supersede the provisions in Item Nos. 2-7 of DepEd Order No. 30, s. 2013 entitled Revised Data Gathering Forms for the Beginning of School Year (BOSY) 2013-2014 of the Enhanced Basic Education Information System (EBEIS) and Item Nos. 2-5 of DepEd Order No. 23, s. 2014 entitled Data Gathering Forms of the Enhanced Basie Education Information System (EBEIS) for the End of School Year 2014-2015. 17. Immediate dissemination of and strict compliance with this Order is directed. BR. ARMIN A. LUISTRO FSC Secretary Encls.: As stated References: DepEd Order Nos.: 23, s. 2014; 30, s. 201. To be indicated in the Perpetual Index under the following subjects: (0 and 58, s. 2008 CHANGE FORMS SCHOOLS STATISTICS, Data SMA, DO Revised Data Oathering Form for SY 2014-2015 (EBEIS) 0568-August 5/12/14, 2014{Enclosure No. 1 to DepEd Order No. 36, s. 2014) mara SSiceriDl Republic ofthe Philippines DEPARTMENT OF EDUCATION OFFICE OF PLANNING SERVICE Research and Stati Division GOVERNMENT ELEMENTARY SCHOOL PROFILE INSTRUCTIONS ‘This form shall be accomplished by the head of all government elementary schools. In the case of schools with annexes, extensions, etc. a separate school profile shall be accomplished by every annex, extension, etc The head of the school shall sign the forms cetifying t0 the correctness of the data, and shall be responsible and accountable for any inaccuracy or false daa/information reported, He/She shall submit che accomplished forms 10 the respective Division Office on or before September L 2014. Important: Read the definitionsjinstructions found at the bottom of each table before filling up the form. No item should be left blank. Instead, “sero ( 0)" or “not applicable (nia) shall be writen. Shaded boxes shall not be filled. SCHOOL INFORMATION SY 2014-2015 Name of School Region Tal a Division School District Tena i Oi WET Legislative District Address Tel. No. Seeeisaiburae “Barangay Mobile No. Fax No. Saag Rng E-Mail Address Date of Establishment Integrated School AnnexiExtension School (Please check appropriate box ifthe schools offering both elementary and secondary levels) (Pe ch ponte oie sol isan exxeson si 2 Ys trese nice Sho ID a eden) a ] Yes Pease ince Scho! 1 ofthe Moe Sho Secondary School D: [TTT TT] Mather Soil DS PoE te) Dn Dn Certified True and Core by Checked by Dist Office Verified by the Diision Office Schl Heed Head of the Office Head ofthe Office Position Tile ave Position Tite Date Postion Tae DaeTablet LEARNERS DATA, SY 201-205 Aso June 6.20 Team a intergaven | Grade Grade? Grades Genet orate Excelente Mite Femate [ste Female | Mie[ femate | Wate femate [Mate [mate [Wale [ Fema Mate“ Female [Male] Female — a: Distnce Education (Dt 1 iranced-astetonl Menge by FARA Comunity ad Teachers eMPACT) 7 Modied te Shoal OF Se Aponte Repeater om Pte Stole (isa mter ot oropase Cares = aL [ T I I : ee J Now* = Dat IAL based on Learners Information atom Jor Being of te Sel Yet 20142015. naergane Erinent erste a seme! ent ee veya (Ose 31 a eeu Ge loca Grae 06) Erlend =n Wl es ouch sop () ea The ean ge hl at (9) ead ake 3 Learners wh Exeptgaliiey (we rad) Earlene sins eed ns who eh es sone plc (Crs Repet cents snr wen ms nuded he Conia Tater (CC) eae he Poni Farman pia Pram (Ps te Denne Soa! Welae ad Deep OSH D) ‘poem smi dt eer an cas Stimem he cles pe tol alowed Cae sl be fala Sue: Deb meme IDs 09 Moons nee eae Pao Pino Poa =P) atnce Edeoton (Di) for SPED - cee wo ah ADM wich asst aces poh of Karr with hice ass 6-19, Duc w he sage Perm he hon Seo QM Schl Apprash(HISOSA =e a8 ADM wich eres ne css ug omy pare 14, Traseree rom Oher Publ Scho ees oa ert! who was een het ols Be revs Se 15. ranger ram Pvt Shas ete ao scaled pe ee 1 Toate of Woagrade Clases = esa eb Sas gad le an Kase oie Reminder Totals in his abe wl tly ih the oes in Tables 2. eet rat an Coty Chet Dari oer sa ie Dio fe: Stet ft Oe Melee“Table 2, ELEMENTARY AGE PROFILE, SY 2014-2015 (As of June 6,201) Grade! Tearners wi TOTAL Rindergarten Grade? Grades Grades Grades Grades Exceptions | aiteqsnun Leann Age Wa ies [Wie OR nang) |) wih tersies Male [female [Male | Femsle Male | Female | Wale] Female | Wale | Femaic | Wale | Female | Wale | Female | Male | Female | Male | Female |\Male | Female 10 1 [ 2 3 16 7 8 19 Sabove TOTAL Note Age Profile data is EINAL, based on Learners Information Sytem for Beginning ofthe School Year 2014-2015. 1. Tee tcl enrolment ofthe shoo a of Jue 6, 2014 we rnd soe re levels, by sage geo age soup an by se 2. Computation ofthe eof earner vil be based 95 he eile a fast iy. Ths the leer ie 6 sears mokhe asf Ine 6th ag fh esters counted a 6 se, 5. ECD erly Childhood Development Experience ‘elas il ECD programs for young chit in exited Kndetumes a notin similar nin eden ition ‘Reminder: Tatts inthis able wil aly with he totls in Tables 1 & 5. Ceifed True and Cet by hacked Dia Ofc Vere tte Dn Ofer Sehoa! Hot eat ft ofr eal of he fee aox 1 SHIFTING SCHEDULE SY 20.4201 As of Je 6208) oes the sho implemen hing due tw rosarceconsrains? CL Ye. Ow 2 Ye, what in of iting sb at oa pee? Ch endon shine Sma sit 3, 33905 2.6m Spm sbi 3, D overtspping suit (eg S29 shi 1 9m by Roan (MF tin ,TFAS si 2) Dower ps specs Dest Sit Trl Shit uadreple sai sr oe ores a a TS Reminder: Fo Knderganen, Grade | and Grade 2 shiigs, consider ony hose lass wih mor than 0 (2) sons. DE CLASSES 9 sof une For Satire cts pes ine the rade les combined: (Check sappropeate. Kindepares Grade Gide? Grade. Gnd Giese MG Cos a o 9 Oo D2 DO 0 MG C2 a oo 9 9 3 93 90 MG caw 3 a (ee eee nena! Table 3 LEARNERS DATA BY PROGRAM SY 20142015 (Af Jane 62010 aoe ‘Kindergarten Grade Grade? Grade Grades ‘Grade § Grade 6 ‘Minden Wisle—[ Fewate_| ate [Fomate | ae Fowate | Maw Femaie | saw [Fema [ae | Fowae_[—Make Temata] ae | Fomle ‘oes Chetan (ALIVE) zs ey rd T T Soho! SSE) L i Ensen Papen eh mtr oes ng Poe oe hey "ype Spc er Table 4 GIFTED & TALENTED LEARNERS DATA. SY 20142015 sof ane 62614 [rem [yi Xie “a aa OE j { 7 Gta oS oN BHT oS 2 Kinder aia sos SPO Men pp ye lhe ans see tp ee ee 5. SPED cs feet vcs of sper tony ne two eceonnls in arepa chi Reminder Toles be accomplished ONLY by semen choo wh SPD elas an SPED centr: ad tr ant Coes het OeTable &, LEARNERS WITH EXCEPTIONALITIES (non graded) DATA. SY 20142015 (As of June 6 2014) Kindergarten Primary Level Translcion Area of Esceptonaises Wak Diagnose Sale Femaie | Wale___[__Female ‘Aula Specrur Dsder 7 moor Behavior) Disorder “Onhopedic Physical Handicap |" Speecttanguage Disorder 1 Cerebral Pay T t Special Hest rable /Chronie Mess T 7 ' LC Malipe Disables Zn Manes Difcuty Seeing Dieu Hering Difcuy Walking, Ching 30d |-———-—} Paying Ateation and Understanding 2 Primary Lev elton! Kdergaien whee tare with enero SU et eae ot msteamg i ep lass Letes wi exepuomies ae awed ay he poplar a mason of ‘ree () yeas ineach fhe te (ves Hower tne i etnies cat be mtn ected be ey bed on peromenc. 24 Transom = elersoleeogram orient win exceponaies who hve compete ie pny keel anor ove or te lm eve 1. Val tnpainent = an isonet th ven wi conection. aber af kl’ eventons performace, Tiina oth pri sigh nd nes, 2. Hearing mpeirmene an nginer, the pent o acting tat rely es cls dao peirmanes ch dean, 4. Leaming Deby» sore perception, len. iking tending, wring sea, dares ahoagh normal nemo ea an ills ae 4 Inutecte! Disa oy ed “eral etanton i Senet 8 siacenysubvege gene asi fncning wich anges dura he developmen eid and aoc wih impimen in dope 4. Ausiom Spectrum Disorder -chaaceid by vaving degre of impaimei commusication skis 2 6 Emoona Behavioral Dsrder 4 citon exkbing ot ox oof he flowing carctris mvt long eed of nev on mtd epee tha canoe espaned by sede, serory. or heath fon) a iis bud or aiminasfecy ines ion wih pe and ahr i) apropate pe havi feng’ nl? somal scons) geel pervasive ene of wenpine ot depen} a eben deep pes sponsor see with ers cho 1. Ontopatc Physica Handicap ~ ay coin a inet hx childs sym wn ore bo. 1 SpeciLanpuage Disorder "a ommuskationdssrer sch 4 nutes, pared ae, an 9. Corral Paes cased by Sumag 0 eveloping ae ibe foe rd birth onthe fit ew pets ie Tsim Geen wie nie Sin sama occ 11, Salil Dsabiies-a comin fd adel aft» chi action! perorman: (anit ln 4 mpm. oie pin th adhe afc c's aetna performs. orgie pine Reminders: 1, Tobe $ will accomplished ONLY by elementary sthoos with SPED classe and SPED center, 2. Tova his tae willy in colons for Learners wth Exceionalites (nom rade in Tables 1 & 2, Comes Trae and Corey hack by Dac fer Vr Dison Ofer. Scoot _ Head ofee = Menta offerTable 6. LEARNERS WITH EXCEPTIONALITIES FROM SPED CLASSES OR SPED CENTERS LAST SCHOOL YEAR 2013.2014 MAINSTREAMED IN REGULAR CLASSES, SY 2014.2015 (AS of June 6, 2018) ee Kindergarten Grade Grade? Grades Graded Grades TOTA Grade Nate Female [Wale | Female Trcnaie Male Wik Diagnonis from Spaces ‘Visual Impainen |__| — Female Enovional- Behavioral Disorder T [ T ot earning Diaby { { —T_ -— i ae —__ I ie Deanine t 1} ff 1 |_| _} Tnvllecwal Disaity { i I { EE eee eee eee eee [Auisn Spectrum Disorder I 1 [ 1 a a | - | ‘Ontopedie/Physieal Handicap { t eae i Speech/Language Disorder Mukipe Dissbitiies { Diffcuky Seeing eke as Cea Pay 1 | L ‘Special Heath Protiem/Chronic tess { [ [ [_ = a + — 4] { | I Diiculy Hearing 1 | | | Ditcuty Walking, Chmbing sad T { Grasping | | Difficuly Remembering, Conceniaing, | ] | __ Paying Atention and Understanding { Difficulty Commonicaing 1 TOTAL l “Tae ae trae with expats previously enol a SED clsseSPED cones bu curently alarmed negara Mainsireaming ~ ihe placement of a leaner with exceptional in regular educational programs and given special insration in pect learning ates, Box 3. LEARNERS WITH EXCEPTIONALITIES WHO NEVER ATTENDED ANY SPED CLASSES Do you have Learners with Esceptonalites who never attended any SPED clases? Oves No Conti ea and Core bs Cached by Dari Ofer erie by the ii School Heed: _ Head ef Offer: odo te Ole: on Office an re Fetaable 7. PERSONNEL DATA (Locally-funded and DepEd Subsidized Teachers Working inthe School), SY 2014-2015 (As of June 6, 2014) > Funding Source Class Spedal Educ Fund SEF) Toca Gov Unit ProvineiaCity | Muniipal (LGU) funded ! I Janis posions and whose compensation & chargeable apunst the lal bagel Depa Subsidized * PTA-funded ‘Others 7 Locally funded teachers working in the acho ~ ‘ashe These ate lasified according to the lowing 4. Special Education Fand (SEF) Teachers eacers whose saris are being pid bythe Lae Sehoo! Board Fund (ProvieciaCity or Municipal) where the schools oct 1 Local Government Unit (LGU) funded Teachers ~ teachers pai ot of the general fund nat the SEF) ofthe LGU ©, PTAcfunted Teachers ~ teachers wn ecewe their salanes tough the Prene-Teacers Associaton (PTA), A. Others ~ teachers wo ae being funded by neither oe ofthe above 2. Depld Subsidized Teachers ~ teachers ot having plana postions but pad by 3. ALIVE Teachers teachers signet tach ALIVE clases, re a ep through honorarium Reminder: * Those serving ovo ot more schools simultaneously shall be counted ony in the school with the mast teaching loads or numberof learners handled, in that order. ‘Table §. TEACHING RELATED AND NON-TEACHING PERSONNEL DATA (Nationally funded), SY 2014-2015 (As of June 6, 2014) NATIONALLY-FUNDED PERSONNEL, porriial T Persenal tied from ther ae positions Number actually working inthe Personnel detailed to aan [Natioally-fanded personnel working ession 2a ssn ‘os! | cnteae | Pasnsn Seconds | oeprainar Toray Inte shoot peritest — seroats) Jramtnasieme) roraL. | Sac sae] Fame] TOTAL HSioor | Mae [Fema | Tora “tte |stecopan Mate | Female} TOTAL | «80%, | tines [cuiees Prev T 4 Principal i Principal Principal | Head Teacher V Head Teacher IV “Teacher We Head Teacher I Head Teacher Guidance Coordinator Guidance Counselor TOTAL Note: For the definitions, please refer to Teaching Personnel Data (Table 9), ‘Reminder: Totals in column 12 mus tally with entries in column 2 Cie Tre ond Correct Checked by Disries Office eid bythe Dison Office School Head Head of he office Head ofthe Ofer Peston Ta Date Postion Tile Date Position Tite aseether hte ht mt member ih,‘Table 10, TEACHER ASSIGNMENTS (Natlonally funded teachers working inthe schol, SY 2014.2015 (As of Jane 6.2014) ‘Carre fulltine lts acne ad “Asigned part sine to lat acing, eo TOTAL Master Teacher 1 Master Teacher I Teacher Teacher SPED Teacher V PED Teacher 1V [ SPED Teacher i SPED Teacher lt SPED Teacher TOTAL “Anca serves thse ened a udece couse, var propery esol, oc ok, caeen manip, corto (ALS, BOG Seu, He) Weichert, Cat aralap nace Reminder: Tea in column 7of thistle must be equal tothe al in Tables 9, & 9, (eolumm 18 - Tota Nationally Junded personnel working in the schoo Table 11. NUMBER OF TEACHERS BY GRADE LEVE Table 12. NUMBER OF TEACHERS BY TEACHING ASSIGNMENT IN GRADE 5 AND 6 ‘Nationaly-funded teacher actually working inthe schoo! Nationally funded teachers actually working inthe whoo), SY 2014-2015 (Asaf June 6 2015), SY 2014-2015 (As of June 6, 2014) ‘Grades ‘Grade ‘Number af Teachers Teaching Asizament [inte | Female | Toul | Male | Female [ Total Grade Lovet Female Teal Fagin Kinder Mahenatis Grade 1 ipo Grade? Science t 1 Makabsyen SIBIKATHERAST Grade $ _ __| __-HEIERP, a aoe Grade 6 | EKAWP, - 7 es | MSEP ja TOTAL T t TRemindarss 1 Teacher sos teaching mv han Oe TeaPng a3 rads To ae aminders: 1 Ta esrb teaching mar tan ne ro Ts FO canbe counted mar than ce fan be counted mare thn once 2, Grade Sand af hse ean be eet then oF eal to Grae Sand 6 in able 11 2 Grade Sond 6 of ths abe mast eee ham a gu 2 Cerf Truc and Crt by ected Dut Ofc eed yh Dison Of Scho et Headfte Ofice = Meak ofthe OferBox 4. AVAILABILITY OF WATER SUPPLY, SY 2014-2015 (As of June 6, 2014) Tox 5. AVAILABILITY OF ELECTRICAL SUPPLY, SY 201 ‘Water Supply Sources: Q) Local Piped Water (Check as appropriate) Water WellDeep Well G1 Rainwster Cactmens Natural Source Without avaiable Water Suppty -ocal Piped Water check the appropriate water supply provider: CD Maynitas Local water dsect Manila Water — CQ Local water cooperative OF other, pease specify Average Cost of Monthy BllvMaiatenan ‘What i the funding source? (Check s appropriate): school MOOR Sehoot Canteen Fund ‘Please indicate the amount) O tou Private tndviduatSeetor Q cu Private tndviduaiSecor O pra G1 omers, please specity Q era 1 omers, please specify 1. Locel piped water «ais sutce coming fam lal water service provides 2015 (As of June 6, 2014) Electrical Supply Sourees: Gr py (Checkas appropriate) OD ott cre Sure Q Sotar Power OD Gene: O ooters, please specify 1 No souee of elect “Average Cost of Monthly BllvMaintenance: (Please indicate the around) What isthe funding source? (Cheek a appropriate): SenootMooe School Canteen Fund 2, Water well an exesvtion sacar nthe ground by diaging, driving oting or illingo acess water ia uncerround agli 3. Rainwater catchment - wate soutced fom tinwate and sleted hough 2 unwater elect. Netnrl source water souced from x ping or seam. 'S. Without eviable wate supply -withos exising wate sappy ta Ceres Truc and Correct by Checked by Die Office 1 Grid Supply - esr coming fem major or loa power dso (eg lsc conperatives, Meco, 2, Off Grid Supply lc coming tom aternative source of power eg. slar power, generator, ete) 1. No source of eletrily - witout exiting eleevical supply aa Verified by the Divison Office Schoo Head ea ofthe Office Head ofthe Office Poston Tee eee eT Peston Yigg, IEEE ee Postion Ties Dae‘Tabie 13. NUMBER OF FUNCTIONAL COMPUTERS IN THE SCHOOL BY FUNDING SOURCE, SY 2014-2015 (As of June 6, 2014) NUMBER OF COMPUTERS BY FUNDING SOURCE T Types of Computer vepea | vere! | ouster | ora | st, [orrmen| ones | tuat per non-DCP | Donations | Academic Use Ea ~ Notebook/Netbook [toe Deskiop Vietual Terminal Administrative Use Desktop Notebook/Netbook ‘Desktop Virtual Terminal - 1 _t. | _ [ _ TOTAL 7 Indicate the number oF functional computers according wo the following funding sources 42, DepEd DCP - computers procured through the DepEd Computerization Program . DepEd non-DCP procured through other DepEd downloades funds ¢. LGUISEF ~ computers procuted from the Special Education Fund (SEF) and the budgets of Local Govern 4. PTA. computers funded from the Parens-Teachers Association (PTA). ¢ Private Donations ~ computers donatediprocured by private individuals, comporatons, alumni associ comput 1 Units (LGU): provincial, municipal or barangay unit. ions, non-government organizations, philanthropic organizations or though foreign-assisted funds, ‘Jf Other Government Agencies - computers funded from other government agencies such as DTI, DOST, CICT, ete ‘Others - computers procured from other sources not listed above 2. Computer - refers oelecizonic devices fr storing and processing data such as ‘a. Desktop ~ refers toa computer tha is designed tobe used on a table. NotebookiNetbook - refers 1 laptop computer that can easily be transported. 6. Tablet refers toa portable primary means of input 4. Desktop Virtual Terminal - refers to 2 computer terminal consisting of monitor, key 3. Computer for Academic Use sputer that has a touchscreen feature a yard and mouse connected to a terminal device that connects to a computer host. (Reminder: do not count the computer host). +4. Computer for Administrative Use =r CCerified True and Correct by Schoo! Head (Signaur over Printed Name) Position Tite Date ‘0 computer units used for encoding administrative data ofthe schoo! ( (Checked by istit Office Head of the Office (Signature over Printed Name) Position Tie Date fers to computer units utilized inthe classroom/aboratory as an ald to instruction, rolment, attendance, disbursements financial statements, and other reports), Verified by the Division Ofc Hea ofthe Office ignoture over Printed Name) Position Title DateBox 6. DATA ON INTERNET CONNECTIVITY, SY 2014-2015 (As of June 6, 2014) Are there internet service providers in the area? Oyes ONo If Yes, check the appropriate internet service provider/s servicing the area: Q BAYANTEL, QGLoBE Ci sMarT Q WIT Global (Satellite) Q DIGITEL QpLpr Osun O Others, please specify Does the school subscribe to any of the internet service provider/s listed above? Oyes QNo Internet Service Provider (ISP) - refers to the organization that provides services for accessing, using, 0 Table 14. AVERAGE MONTHLY EXPEN E (IN PESOS) OF INTERNET CONNECTION BY FUNDING SOURCE Types of Internet Connection Funding Source Internet Service Provider Average Monthly Expense| (DepEd DICP, MOE, School Funds, (Wired, Fixed wireless, (Select from available |LGUISEF, PTA, Private Donations, Other satellite, USB Modem ) ISPs above) Government Agencies, etc.) Indicate the average monthly expense of Internet connection by funding source 1. Types of Internet Connection: ‘a. Wired - internet connection using the phone lines from the service provider to @ client. b. Fixed wireless - internet connection through radio frequency bands with directional radio antenna on each end of the signal. ¢. Satellite - internet connection using satellite dish supplied by an internet provider. 4, USB Modem - internet connection using USB dongle (e.g. SMART Bro, Globe Tattoo). 2. Average Monthly Expense - average cost spent for the internet connection Certified True and Correct by: Checked by District Office Verified by the Division Office: School Head : _ Head of the Offic Head of the Office (Signature over Printed Name) (Signature over Printed Name) (Signature over Printed Name) Position Title Date Position Title Date Position Title Date sticipating in the internet.Box 7. SCHOOL SITE DATA a, Mode of Acquisition of Sehoot Site: ». Proof of Ownership sind Occupancy: ¢. Legal Ownership Issues: Mode Year (Check as appropriate) (Check as appropriate) O Original Transfer Cerificate of Title Asverse Ciaim Donation D1 Tax Declaration Encroachment Deed of Absoiute Sate O Others, plsspecity Usuiruct Agreement C1 Deed of Donation Expropriation © Presidential Prociemation’Special Patent Exchange (Land Swapping) © Contract of Usutruct 4. Total Land Area: __(in square meters) Presidential Proclamation/Special Parent Memorandum of AgreementLease Agreement ‘Others, ps-specity - Others, pisspecity _ 1. Mode of Acquistion of School Site ~ refers tothe means of a0 1, Donation - includes the four (4) ypes of donation {a Simple Donation - is one whereby a person, through an act of liberality disposes apiece of land in favor ofthe government 142. Conditional Donation - is one which imposes 3 condition (e, "tha the lad shall be used only for education”) In such case, the property is reverted to the owner whed th in the donation isnot me. 123, Inter Vivos Donation «is one tat iin effect dating the iene ofthe donot 14. Mortis Causa - i one that akss effect only after the dono’ death, Donations by mots causa should conform to the formalitics required ofthe las wil 2, Purchase - a schoo site was acquired by direct purchase from the legal owner who voluntarily sald i as evidenced by 3 Deed of Sale duly executed, notarized and eg Deeds «. Expropriation «school ste was acquired by the government through the exercise ts power of eminent domain (i. by aking private propery for public use upon payment of just compensation). 4. Exchange (Land Swapping) - schoo site was acqited by exchanging an existing school ste for a new site for justifiable reasons as identted by fw €, Presidential Proclamation ~ a school ste was acquired by virtue ofa declaration by the President under the procedures established by aw. 2. Proof of Ownership and Occupancy -this refer a sny legal and official document tha act a a competent proof of one's ownership andor occupancy of the subject property. 4, Original Transfer Certificate of Tite ~ a document evidencing tbe ownership of teal property a issued by the Register of Deeds. >, Tax Declaration - a document ssued by the Assessor's Office of the jurisdiction (eg. city or municipality) evidencing te payment of txes onthe use ofthe ral propery ©, Deed of Absolute Sale - s document executed by the vendor evidencing the absolute (without conditions) sue ofthe real property i favor ofthe vende, 4. Deed of Donation - a documznt executed by the donot, under the formalities required by aw, evidencing the donation af the property €. Presidential Proclamation! Special Patent - a proclamation issued by he President reserving an united land for public se F Contract of Usufruet - a document which stipulates that DepEdschool is alowed of Fal use ot perpewal right of use af property without consideration as long as the propery i used solely for xivational or designated purposes, {&. Memorandum of AgreementiLease Agreement - 3 document executed bythe legal ownerloccupant ofthe land sting unnecessary the conditions on the use ofthe propery 1, Others oiher documents hat ae competent root ef osrnership and occupancy 2, Legal Onnership Issues: 1. Adverse Claim - claim 1 the property agains! that of one who bas ether le and 1. Encroachment «presence of egal oecupantiinformal seers 4. Total Land Area - iste size in square meter fal tes designated 4 land use 2 the schoo st. dion as stipalared possession a he propery some particular purpose suchas school building No in case, he school head does not have adequate information on the items listed above, the assistance of the Industrial Arts teacher\Division Physical Facilities Coordinator(Division Project Engineer can be asked. Certified Trucand Correct by (Checked by DisritOffce Verified by the Dinson Office Schoo! Head Head ofthe Office oad of he Office Date Position Tite Date Position Tite DateBox 8 FEEDE ROGRAM. SY 2013-2015 ‘4 Dac the schoo havea feeding program?) Yeu 1D setoot MooE GD sehoot Canteen Fund O Lourie O Pra rune 1D Gutayanss pasratin Agricole! Crops Dish Pon OD Livesoek ‘Does aricultora and fishery in the schoo useé fr feeding program? Ee, what the nding source? (Checks appropriate) GD sehoot Mooe GD tou Fans school Canteen Fuss PTA Fund Darang Fund 1D Privat odviculSetor Fund Owe IC Ye, what isthe funding source of schol feeding program? (Check as appropriate aingny Fund Private travicen Secor Fund Doers, pease specify », Availabilty of agriculture and fishery resources inthe school: (Check as appropiate. 1D thers, pease specify D Nose D ves Tne others, pias specify Table 16. DISASTERSICALAMITIES Forthe months of Api and May (ar aplicable, check under the months tha these occurred) Disaster/Calamiies DicasteriCalamites Naural Hacards| rovgh Eamngaake (unludesfores fire, fires as consequence of maura dase each ss nphoons and ecthuates) ood ‘May ‘rime against ecool Reale ‘Crime agaist schon prope (he rubbery, arom ‘Cine gains stadenis (marderibomicde phic! injurs ape sexual haresonen et) (roderihomicide, piel injurs raps, seal harassment) Landslide Storm Sarge Teun “Gime gains aches Fire Electrical wiring failure, Tesh Trent cu si Voletsie Eruption Result of Disaster Incdences ‘Schoo! Used as an Evacuation Center Q CO] ones. Pease specify "Security teeat 6a result of civilian violence (Bomb reas idmpping teas. hasta ge waking ney ape, seul bras) he Dengue, Maano, Measles fod psoning, disease aebreak Oooo oO olo|;o| oc \ojo Noser Far te defnions, peas se Depa Order No, Ph 3201, cori Frat neve by Chected by Dirt Offer Schad Head ofthe Of ee Din Of: Headef ne OfferfEnclosure No. 2 to DepEd Order No. 36, s. 2014) Republic of the Philippines DEPARTMENT OF EDUCATION OFFICE OF PLANNING SERVICE ‘Reseorch and Statics Division 1 CELTITT Municipal 1D School GOVERNMENT SECONDARY SCHOOL PROFILE INSTRUCTIONS ‘This form shall be accomplished by the head of all government secondary schools, Inthe case of schools with annexes, extensions, etc, a separate school profile form shall be accomplished by every annex, exiension, ete The bead of the school shall sign the forms cenifying 10 the coreciness of the data, and shall be responsible and accountable for any inaccuracy or false data/information reported. He/She shalt submit the accomplished forms tothe respective Division Office on or before September J, 2014 Important: Read the definitionslinstructions found at the bottom of each table before filing up the form. No item should be left blank. Instead, "zero (0)" or "not applicable (nla) " shall be writen, Shaded boxes shall not be filled. ‘SCHOOL INFORMATION Name of School ical ama) rnamel, pase dae old ram) Address 7 SreainaPo Ban Integrated School (Please check appropriate ox ifthe soos offering bth elementary and secondary vel) 2a) Yes (ease inne Schoo 1D of Elementary tev Elementary School: _|11_T Tn Implementing Unit Pease check appropriate box ifthe school has book of accounts of hs fsa autonomy’) Lives Cine (Corte True and Correct by School Head Pes Til Date SY 2014-2015 Region Division Legislative District Tel. No. Mobile No. Fax No. E-Mail Address Date of Establishment Annex|Extension School (Please check appropriate box if the school isan annexientension schoo.) Yes (Please indicate Schoo! ID ofthe Mather Schoo!) Mother School ID: Ono Night Classes (Please check approgriate box if the schools offering night classes.) Des Ono Verified by the Division Office Head of the Office Sige Ore Ped aT Position Tite pteTable 1, LEARNERS DATA, SY 2014.2015 (AS of June 6, 2014) 7 rach irade jrade Grade 12 a Pena rte crates Se Cote cre) eRe |i [Fa Sere “ie [rama e—Feme a a. Open High School Program (OHSP) | 1 Oe Sor ned enenon | | = Muslim Learner t [ es * = Dat is EAL Bd on Larsen Seo Being oe Sho Vo TEST Reminder: Tos his be it a wh eas in Tae Carte Taney + elt on‘Table 2. SECONDARY AGE PROFILE, SY 2014-2015 (As of June 6, 2014) Grade7 Age Grades Grade9 Grade 10 Grade 1 Grade 12 TOTAT (Grades 7.12) Male [Female Nate | Femate Male Female Female Male Female Male] Femate Male Female 10 & Below I it 12 | | | 3 18 19 20& Above TOTAL Note: Age Profile data is FIN: 1, The oa enrolment ofthe school a of Jane 6, 2014 willbe distributed across grade levels, by single age or age group and by sx. ased om the child age a of ls birthday. Thus, ihe learners 12 years 11 months as of Jue 6 he age of he learners counted as 12 years 2 Computetion ofthe ape of learners il ‘Reminder: Totals in this table wil tally withthe totals in Table 1 Cofed True and Correct by Schoo! Heed Postion Tie Date IL based on Learners Information System for Beginning ofthe School Year 2014-2015. Verified by the Division Office Head ofthe Division Poston Tile2014-2015 (As of June 6.2014) _Doos the school implement sifting due fo resource constraints? Yes Avo 2 1FYes, what kind of siting shee does the shoo! Implement? CD End-om Shit (e.g, 6am-1 1am shift, Mpm-spm shift 2, 6pm-9pm shift 3) overlapping Shift (¢,6am-12pm shit 1, Yam-Spm sit 2,!2pm-Spm shift 3 3m-9pm shit 4) Daily Rotation (eg. MWF ti 1,77HS sbi 2) Dorhers, pls. specity ’, How many learners are there in: Double Shit, ‘Teple Shit Quadruple shit ‘Shifting refers wo adoption of ine schedules for ferent wt of anes de to resource constrain Reminder: Night classes are not considered a shifing schedule ‘Table 3. LEARNERS DATA BY PROGRAM, SY 2014-2015 (As of June 6, 2014) Ter Grade rade 8 rade 9 rade ade Grade Grade? Grad Grad Grade 10| Grade 1 Gade | again) Enrolment by Program Mate [Female [Mate | Femate [Male [ Female [Male | Femate | Male | Female [Male | Female | Male [Female “Rabie Language and lame ‘Values Education (ALIVE). Regional Science High Sehoo! ‘Special Program in he Aas Sr 1 Program in Foreign Language Special Program in ouratiso ‘Spesal Program in Science, Teekay and Eagineeing Special Prost in Spars Spesal Praga in Techical Vossionad Edenton ‘Enrolment by Program ~ ofr the numberof lecnes according to programs offered in secondary shoals “Types Special Programs: 1. Arabic Language and Islamic Values Education (ALIVE) ~ a program which ams to preserve Arabic lnguige and Muslim culture trough its inclusion the regular basic edvatoneurrclum, 2. Regional Science High School» rogram which offers 2 seieacecvenedcuncuum that caes 1 leses With apse inthe scence. Is ame 1 develo te scence cure among the students to prepare them for ares inte 4. Special Program inthe Arie 3 program designe to cater tothe pedo eres who ace alee in he a 4. Special Program in Forign Language «program which sims lo develop learners understand and appreciate foreign lnusges, 5. Special Program in Journalism 3 program ssignd to enrich he experiences, hoe the ouralitie kils and competencies of lester writs and 0 swengtea fee and asporsible journals & Special Program in Science, Technology and Engineering - popram which sis w develop the Waterski in scence, echooogy and ensineetiog 7. Special Program in Sports prorat wil eat earners wih pottil ele i spor an hone her kl for higher eves of alec endeavor Special Program in Technical Vocational Education + program whch sis to develop he lates sil techn vocational education Comiid True and Core by Verified by the Divison Office Scheel Head Head of he Dison =‘Table 4. LEARNERS DATA IN TECHNOLOGY AND LIVELIHOOD EDUCATION (TLE), S¥ 2013-2014 (As of June 6,2014) Grade 9 ade 10 Totat supyect Female ‘Male Female Beauty Care Caregiving Cooker Deessmaking Front Office Services Handierat Household Se ‘Travel Services Wellness Massage Agri-Fishery Arts aa Agri-Crop Production Animal Production ‘Aquacu Fish Processing Horticulture Industrial Arts ‘Automotive Servicing Carpentry Cons er Bleeionies Servicing Electrical Installation and Maintenance Masonry Plumb Reftigeration 1d Airconditioning Shiled Mel Ave Welding | Taformation and Communication Technolo ach, (Computer Hardware Servicing Contact Center Services iitustation “Technical Dratin Certified True and Correct by Verified bythe Division Office Schoo! Heat _ Hood ofthe Ogee Postion Tie Dose Poston Tie DateTable &, LEARNERS WITH EXCEPTIONALITIES DATA, SY 2013-2014 (AS of June 6, 2014) Ace of Eaceptnais Grede? Grades Grade 10 rede 12 ‘cru 3 ‘Maie—[-Famate | —Niale_[-Femate Niale | “Female Male [Female [Wale [Female Wah Diagnosis from Specie Visual lxpaiement Hearing impairment TET Tearing Disability “aes Dsbiiy ‘Autism Specrum DiSoder “Emotona-Beaviorl Disorder (OrhopediciPhysical Handicap ‘SpeechrLangusge Disorder Cerebral Palsy ‘Special Health Problerw/Chronic Hines Maltiple Disabiines| ~ Biased on Manifestation: Ditfcly Seeing Disc Heating Bical Waking, Cag and Grasping Difficulty Remembering, Concern, Paying Atetion and Understan Difficulty Communicating TOTAL “The dain tis abe sal inca ol ered ares with exoeponlies Mainstreaming - the placemen! a a erneswih exepconality replay educational programs and given special astuction in specie leasing aes. Areas of Exceptional 1 Visual Impairment ~ an pail even wi co 2, Hearing Impirment ~ 2 npairment,whtherpermanet 0 fssting tha adversely asa ch’ edsationa performace such sdafess 3. Learning Daily ~ x disorder in ptcepion. ening nk eating wig, pling a rat alough normal it ear, ential ed neil abies. 4 tnetctual Disabil = Sorel deed er aration” fied os ipicntysbaveage paca tele factining which originates rng developena peti nasil wth impaient it sdoptivebebavor Hhe matuzaion earning and soca adjustment jos adver affect chil ueston performance. This ielues bo anal ight and badness 5, Autism Spcrum Disorder» hastened by vying dee of ipizmen in orruncton kil a sol neractons nin esis, rpg pater of beanie. 1, Emotonatchaiorel Disorder costion exnbing ae ot re of te flowing haaterice oer og peo of tine and oa mares degree ot aerly fects les Ghctonl performance: () 9 isbiy to et that enna be explained by Inet, sensory, of eat factors, (i) a tality to ud or stan saistacoyierpesonrelinshige wih peers and teaches (i) Rappoprate eyes of Gehevir or Ccings ander noma exeunsaoes, (i) 2 geet pervasive Moed of Unkappnessor epresion, (9 a tendency develo physical smptoms fear asoies wih Fersonal or school factor, 7. Ontopdie Physical Handicap ~ sy conto st ieee wth ch abt to se iS eos. 1, SpeccilLenguage Disorder ~ a comotancson drt, sch sting. psd reson anguae iain, oF li i's edueatona perfomance 9. Cerebral Pay «is suisesby damage to deveopingtrain che before Sug bih, one fir ew yeas fife. The impairment depends on whet te ain he damage cus. 0. Special Health Problom’Chrons lines chronic ot acute eal problems each as, aeton dei order o atenam defi hyperacy daorder, bees, epilepsy, «heat condition, Remopois, lead posonng ake ephrits reamatic fever sche cell ania, and Tree some tht adversely afer a chil Suction performace 1. Mule Disblies~s comb nation of spies ht aun severe educations neds th aut mip fil ection programs sch as mena rearaion adness or ela Reminder: Alllearner with excetionalties in secondary level are mainstreamed inthe regular clases. Cone Pra at Comey Vente Dison Of Soho od Headof the Dissionthe Schon, SY 20143015 (sof Jame 6.2018) “Tuble 6 PERSONNEL DAT Local funded and DepE¢ Sebiied Teachers Working Fesding Sure css Speci Eve Foot SER) TeetGort Ua | res ee a oa FmRTGAy Tenpg —]_EOU Locally faded Tommy conan | ‘elf as rig ch hn an a aN ARNE ea Spc tno and (SEF) Tene =r we ns 2 eng iy he Ll Schl Hod Fan evn Mon whe Shi ees 1 eat Gorrmen Un (U3 fnded Feces ~ Tobe ped fe nd (he SED) obeLL { Potjaned Tsar ash so neve ste oes Pasa a PTA) 4 Oat naa seb aed nee oe abe one 2 Dep Susi Techs ets a pies bp by Dep rg norm Reminder: *- Those serving to or more schol smalancanly shal Be counted ony i he schoo ih he mo! acing las or number of erers handled in tat order, “Tale TEACHING RELATED AND NON TEACHING PERSONNEL DATA (Maton fnded SY 20142015 As of Jue 6201) roauon Te Sa ee ania en a ae tne ome ig Vesna too! Amine Piatt Head Teacher ¥ Guidance Connor Senor Boktener Tors Nowe: For the diins please refer oTeaching Persone! Data Te Reminder: Foe in cola 2 mast ly with entre cla 2. oad ad Combs eet ye io.“Tabte & TEACHING PERSONNEL DATA (Nanay fundf), SY 20142015 sof Jane 62018) Sesto tay cong ani pen Sa oe | Teaching Potions SPED Teeter IV 'SPED Tencte 'SPED Teac fe Asigment Number of twacher action i th choo SPED cere TOTAL 1 aon foe pre ing ih ng i es ig ee wit ps pier, 2 Namba fen schon er len PSEPOP “nue ofa bossa hee 5 Samberafuacor cay wi me rho! i ex ed ao ache perp oes woth ermine te penne esc {Paper aa Dep eerie rte) whe on pene! aed on io al esc el win te on {Pal pre ded Depeche io ar oer oun aero! ln node! Defies ho) oui he dion th eee sees 9 Pane prov Broce dea fom ahha Digan) «ean whe ly wn hh seh tvs hens gam enna cho om Oe Dep i) He Be Nove: Ines Ther tem Cra fr SY 0149015 wt file or af Reminders 1 nT, mtn clin 12 may heii com In Tabled, ifaternrihnding wo ot mort oni oh shold coi in hich signet reese ha met ambos ie te on Of Matern ofer ron penn ron ion pean wething|‘Table 9. TEACHER ASSIGNMENTS (Nato funded teachers working i the schoo), SY 2014-2015 (As of June 62015) ‘Carries u-time clase teaching ad “Assigned part-time clase teaching, ' TOTAL a Annignedftttineto J, TOTAL ation Tie Navanigned ancy Asigedie anor HAIG] Cas ahng Tain pr | Ce acgTerManTIO] ancillary services CoA24Cal Cotte ‘ene anal ad Gyeenee | min pray ou oo a cat | aes cue ou Tosa | Instructor It | tesco Master Teasher1V Master Tessher Master Teacher Master Tessher “Teacher it ‘Teacher it Teacher SPED Teacher V ‘SPED Teacher 1V ‘SPED Teacher It ‘SPED Teacher It SPED Teacher TOTAL, Ancillary seices Reminder: Totals in column 7 of this table must be equal tothe oals in Table 8 , (column 18 » Total Naionally-funded personnel working in the school. Cerfed True and Corey Postion Tate Date Verifed bythe Dison Office He of he Of Poston Tae aie "hove rendered aa guidance counselor, Haran, property easodan oie clerk, eanleen manage, coordnaie (ALS, Boy/Girl Scot sy eahernuee, Clas advsohip is oot nadeTable 10. NUMBER OF TEACHERS BY TEACHING ASSIGNMENT, BY GRADE LEVEL AND BY SEX (Nationally-fanded teachers only), SY 2014-2015 (As of June 6,2014) Grade 7 Grade 8 Teaching Assignment Grade 9 Grade 10 Male Female Male [Female Male | Female | Male | Female | Mathematies | Filipino | science General Science Biology _ Shemisry |___Physics_ Araling Panlipunan Edukasyon sa Pagpapakatao ‘Technology and Livelihood Education Physical Education : —__| — Health Reminder: A teacher who is teaching more than one learning area or grade level can be counted more than once, Verified by the Division Office Certified True and Correct by Head of he Office School Head ‘Signanre Ov Position Tite Date Position Title Date‘Table 11, NUMBER OF FUNCTIONAL COMPUTERS IN THE SCHOOL BY FUNDING SOURCE, S¥ 2014-2015 (As of June 6, 2014) NUMBER OF COMPUTERS BY FUNDING SOURCE ] Other | Types of Computer DepEd DepEd - Private : aon nerdce | LSUSEF | FTA | pesatons | Geterament| Othe | Tol ‘Academic Use Deskiop I [ Tablet - - a - | Desktop Virwal Terminal i a i i Desktop - | Natebook/Netbook Tablet Desktop Virtual Terminal TOTAL I 7. Indicate the number of functional computers according to the following funding sourees: 4 Deped DCP - computers procured through the DepEd Computerization Program, i. DepEd non-DCP - computers procured though other DepEd downloaded funes, ¢. LGUISEF ~ computers procure from the Special Education Fund (SEF) and the budgets of Local Government Units (LGU): provincial, municipal or barangey vnits. 4. PTA - computers funded from the Parents-Teachers Association (PTA), €@, Private Donations - computers donated/procured by private individuals, corpo Jf Other Government Agencies - computers funded {rom other government agenci 'g Others ~ computers procured fram ather sources not listed above. 2. Computer - refers to electronic devices for storing and processing data suchas 4, Desktop ~ refers to a computer that is designed to be used on a table. '. NotebookiNetbook - refers toa laptop computer that can easily be transported. . Tablet - refers (o a portable computer that has a fouchsereen feature asthe primary means of input 4. Desktop Virtual Terminal - refers o & computer terminal consisting of moniter, keyboard and mouse connected a terminal device th 3. Computer for Academie Use - sefers to comptes units utilized in the classroonvaboratory a8 a0 aid to instruction 4. Computer for Administrative Use - refers to comps ions alumi associations, non-government organizations, philanthropic organizations o th such as DTI, DOST, CICT, ete ugh foreign-assisted funds, er units used for encoding administrative data of the school (e.g. enrolment, attendance, disbursements, financial state ents, and other repors) Cortified True and Correct by Verified by the Division Office Sehool Head Hea of he Office (Signature over Printed Name) (Signature over Printed Name) Position Title Dae Postion Tite Date connects toa computer hos. (Reminder: do not count the compute hos)Box 2. AVAILABILITY OF WATER SUPPLY, SY 2014-2015 (As of June 6, 2014) Box 3. AVAILABILITY OF ELECTRICAL SUPPLY, SY 2014-2015 (As of June 6, 2014) Water Supply Sources: QQ Local Piped Water G1 Natwrat Source (Check as appropriate) C) warer Well/Deep Well) Without Available Water Supply D Rainwater Catchments Ii Local Piped Waier, check the appropriate water supply provider: CD Maysitad —— Local water isnt OD Otters please spciy CF Marita Water) Local water cooperative Average Cost of Monthly Bill/Maintenance: (Please indicat the amount) What i the funding source? (Check as appropriate) O School MOOE Schoo! Cancen Fund Q tov OF Private incivduau Sector Q Fra OI otters, please specify Electrical Supply Sources: QQ Grid Supply (Checkas appropriate) C) rr Gri Supply Solar Power O Generator OD ores, OD Nosource ofeleewicity specify ‘Average Cost of Monthly Bills/Maintenance: (Plcase indicate the amount) What is the funding source? (Check as appropriate): 1 Schooi Mooe OF Schoot Canteen Fund Q icv OF Private IndviduatSecwor O pra C1 otters, pease specity 1. Local piped water - water souce coming fom eal water service providers 2. Warer well -an excavation structure in he ground by digging, driving, boring oiling to acess wate in underground aquifers 3. Rainwater catchment - water sourced from tsinwater and collected though a rainwater eolcte “4 Natural source «water sourced fom a sping or seam 5. Without available water supply - without exiting water soppy at al Cerifed Tra ana Core by 7. Gri Supply - lec coming trom major or lea power distributors electric cooperatives, Meralco, ee) 2. Off Grid Supply electric coming fom akernatve source of power (solar power, generate, et) 4. Nosoure of electricity - without existing electrical supply sl Verified byte Dision Ofc. Head of te OfficeBox 4. DATA ON INTERNET CONNECTIVITY, SY 2014-2015 (As of June 6, 2014) Are there internet service providers in the area? Oyes QNo If Yes, check the appropriate internet service provider/s servicing the area: Q BAYANTEL OGLope CO sMART O wit Giobal (Satellite) Q picrTEL Opipr Osun Others, please speci Does the school subscribe to any of the internet service provider/s listed above? O yes QNo Internet Service Provider (ISP) - refers to the organization that provides services for accessing, using, or participating in the internet. Table 12. AVERAGE MONTHLY EXPENSE (IN PESOS) OF INTERNET CONNECTION BY FUNDING SOURCE Types of Internet ' ji i ypes of Internet | Internet Service Provider: Funding Source Connection Average Monthly Expensel (DepEd DICP, MOOE, Schoo! Funds, (Wired, Fixed wireless, (Select from available LGUISEF, PTA, Private Donations, Other satellite, USB Modem) ISPs above) Government Agencies, etc.) Indicate the average monthly expense of internet connection by funding source. 1. Types of Internet Connection: 4, Wired - internet connection using the phone lines from the service provider to a client b. Fixed wireless - internet connection through radio frequency bands with directional radio antenna on each end of the signal ¢. Satellite -intemet connection using satellite dish supplied by an internet provider. d. USB Modem - internet connection using USB dongle (e.g. SMART Bro, Globe Tattoo) 2. Average Monthly Expense - average cost spent for the internet connection. Certified True and Correct by: Verified by the Division Office: School Head Head of the Office : (Signature over Printed Name) (Signature over Printed Name) Position Title Date Position Tite : Date :Box 5. SCHOOL SITE DATA. a. Mode of Acquistion of School Site: ». Proof of Ownership and Occupancy: «Legal Ownership Isues: a Yor {Check as appropriate) (Check as appropriate) Acquired Original Transfer Cenitiate of Tile Adverse Chim Donation Tax Dectaration 1D Encroachment archase 1D deed of Absolute Sale 1D Others, pls specify ‘Usufruct Agreement 1 Deed of Dosaton Expropriation 1D Presidemiat Proclamation’Specal Patent Exchange (Land Swapping) 1D Contact of Usufruct 4. Total Land Areas in square meters) Presidential Proclamation Special Patent Memorandum of AgreemenvLease Agreement Ores, pls specify OF others, plsspecity 1, Mode of Acquistion of School Site «refers the means of weir he schoo sit 10. Donation - includes th out 8) ype of donation 11. Simple Donation -is one whereby «peson, though ae at of iberaliy disposes a pec f land in favo ofthe government 422, Conditional Donation -is one which impones s condition ("tha the lat ssl be use ony for education) In ack at, the property i revered tothe owner when the condition a ipalted 103, Inter Vivos Donation ~ woe tat isn sfect ding he ietine ofthe doer (04. Mortis Causa - is one tha takes effet ony ater the door death, Donations by mrt aus should conform tothe formsiies require ofthe ls wl. , Purchase ~» school site was cquted by cliet purchase fom ihe tpl owner who voluntary sold it ak evidenced by 2 Deed of Sale daly executed, noaize and registred with the Reps of Deas. «, Expropriation -aschot site was acquired by the government through the exercise its power af eines domai (by taking private propery fr publi se upon payment of jst compensation), 4. Exchange (Land Swapping) ~ x school site was acquited by exchanging an existing schoo ste fora new ste fr jasifale reasons 8 identi by Law {Presidential Proclamation - a schoo site was acquired by vue ofa eclaraton by the Presidet ance the procedures established by aw. 2. Proof of Ownership and Occupancy - this refers to ay legal 208 offical document tht acs 3a competent proc of ene ownemship andlor acupancy of he sbjet propery. ‘Orginal Transfer Cericte of Tite» a document evidencing the orership of al ponent 8 asbed by the Register of Deeds 1, Tax Declaration ~ a document issued by the Assessors Ofice af the jurisdiction (clot municipality) evidencing the payment of tenes o heat ofthe real pore ©, Deed of Absolute Sale - 3 document execite bythe vendo evidencing the seo (witht conto) sale ofthe ra prope in favor of the vendes 1 Deed of Donation 3 Socumen execs by the donor, ence the formalities egies by In, evidencing the donation of the propery , Presidential Proclamation! Special Patent ~ poctaraion sued bythe President reserving a uted land for publi we, F Contract of Usuruet ~ a document which stipules that DepEAschool i alowed of full use or perpetual igh of use of propeny without consideration as long asthe propery & used slely for educational or designated purposes 1. Memorandum of AgrementLeave Agreement «3 document excited by the egl owerlocapan ofthe fd setting unnecessiy the conditions onthe eof he proper. Others» eter documents that we competent poo af wership abd occupancy 3. Legal Ownership Issues: {Adverse Claim -a lim ote propeny agaist tht of one who has either tile andor possession of he propery, 2. Encroachment - presence of egal occopantnformal sete, ‘4 Total Lond Area ~is he size in square meters of al aeas designate sland sed for some paicular purpose suc as schoo ulin. Note: In case the school head does not have adequate information on the items listed above, the assistance of the Industrial Arts teacher\Divison Physical Facilites oordinator(Division Project Engineer can be asked. nf Trae and Correct by Verfed bythe Division Ofice + Sehoal Mead: Mead of he Office ‘Bara: Oo Pet ome ‘Bears Or Pid Nama) Postion Tite Dawe Postion Tie Dateox 6. FEEDING PROGRAM, SY 20142015 ‘Does the shot havea feeding program? Yer O x0 IF Yes, whats the fanding source of choo! feeding program? (Check as appropriate) OF schooi MOOE G1 tGuFind —Q Barangay Fund others, pease specify choot Canteen Fund Q.PTAFune QQ PuvatelndiviusSector Fund by, Availabilty of agriculture and fishery resources inthe school: (Check 28 pproprias. TH Guisyans Paran CQ Agrotast Crops otters, peat spesty Fish Pond OD Livestock OD None Docs agricultural and fishery inthe school used for feng program? Yes Ovo IVs, what isthe funding source? (Check as appropriate. 1D schoot MOoE Q Lcu Fund —O Barangry Fund oer, pease speciy OD schoot Cartes Fund. PTAFund —_O) Private IndvidaliSecor Fund ‘Table 13, ISASTERS(CALAMITIES For the months of April and May 2014, which incidents acute in your school and immediate surroundings? Afepplicble, check under the monte tha there occurred) Disasters/Calamities [April] May Disasters/Calamities | Aprit| May Drought ajo Armed conflict asa result of organized crime (terrorism. siege. etc)! (| Q includes forest fire, fires as consequence of natural disassers suck | | CQ Crime against school property (theft, robbery, arson) o|a Crime against stdens - DO] trundothomide psa! nary rape seat hares ae) || O ‘Storm Surge o/;o Fire (Electrical wiring failure, ere.) aja = GLO] onsen ala = —— eee {g/0 ‘School Used as an Evacuation Cone Others. Please specify ajo Naver For the dfn, please ica Dep Oni? Nos 207 ore ran Core by ried the Dison Ofte: Scho Heat Habel he Ofc(Enclosure No. 3 to DepEd Order No. 36, s. 2014) CL) CrTiTiyT) Municipal 1D ‘Sool 1D Republic ofthe Philippines DEPARTMENT OF EDUCATION OFFICE OF PLANNING SERVICE Research and Statsties Division PRIVATE SCHOOL PROFILE ‘This form shall be accomplished by the head of the private school offering kindergarten, elementary andjor secondary levels. In the case of schools/intiutions offering more ‘than one level, only one school profile shall be accomplished Only private schools whose establishment has been approved by the DepEd Regional Office shal be issued a Private School Profile, Private Schools whose documents have been submitted to the Regional/Division Office but are still undergoing evaluation atthe time ofthe distribution ofthe Private School Pafile can also e issued this form. The head of the schoo! shall sign the forms cerifying to the correctness of the dats, and shall be responsible and accountable for any insccuracy or false data/information reported, He/She shall submit che accomplished forms tothe respective Division Office on or before September 1.2014. Important: Read the definitionsinstructions found at the bottom of each table before filling up the form. No item should be left blank. Instead, "sero ( 0)" or "not ‘applicable (nia)" shall be writen. Shaded boxes shall not be filed. SCHOOL INFORMATION SY 2014-2015 Name of Institution Region (Offcat ame) Division Legislative District (afrenamed plese indicat od name) Tel. No, Address re Mobile No. © SwetiiParok Pavnsay Fax No. E-Mail Address Municip Province ‘Write appropriate information Level of Education Offered | Kindergarten Elementary Secondary With Permit (Permit No) With Recognition (Recognition No, Permiton Process (Date of submission of documents 10 Regional Division Office) Certified True and Correet by : Hood of fasion Designation Daevariates Rinderpaten ‘rate Grades Gndes Grates Grter | extn frre Mae Fee | inte | Femate [Wie] Femae [ Wate [ Fewate [Mia Fema Mae Fema | ae] Femate [We] Female | Moke_[ Female TOTAL ENROLMENT T 5 mao fata nes em are el eo re ca sna pg Gi 4: Emily tna? Eee a et ef ra cet wn pen a eae ws (se ef Oh 3 (6 Monogrede Enrfment »rfers to leerer being taught in clases consisting of a single sade oni ‘ {tdci saat pa ny oe 1 hans orto hah tea ra so es EAT, ep pA 9 Ge pa pl Rome se ie yan py 1h TWh aronora Car's benny oe cape ne Reminder: 1, Toa in this blll with he tla Table 2 2 "Palip Grade? coma in hs tbl f Grade 71s at fhe schoo’ lomentay eduction Cait Trucand Comet‘Table 2 ELEMENTARY AGE PROFILE, SY 2014-2015 As of I" Friday ofthe SV) Gade Taman] TOT . indesain Gonde2 rate Grates rates Grae Gate7 | Excponatts | amon wen Male] Female “Male | Femate | Male | Female | Male [Female | Male | Female | Male] Female | Male | Female | Female | Male | Female | Male | Female, a 1 ’ 7 oi [ 1 o _ | ! { | = | {yd i { 1 : 1 = 8 [ I { iz T aoe I | | TOTAL [eas i 1 es 2, Campation ft at of arte 2 RCD arly Choad DevopmenBspernceinclae al ECD pgs oe ynny cen np negen ad he insignis aye een, Reminder Toa in hia wl ely with esa able ox . MULTIGRADE CLASSES, SY 2014-2018 (As of * Friday ofthe SY) For Maligrade class, lea indicate he grade lve co (Checkas appropriate, ‘indergarea Grade Grate? Grade) Grade Grates Gene MG Clas 1 Q Q Q a a Q Q MG Clas? a a a a Q a o MG Class3 o a a a a a a Certed True and Covet by Heaton Dengan _ uw‘Table 3. LEARNERS DATA IN SECONDARY, S¥ 2014-2015 (As of 1" Friday ofthe SY) a Yer! Yara vers Ware vars vere TOTAL Male Female Male Female Male’ Female Mate | Femai ‘Mate [Female Male Female Male | Female TOTAL ENROLMENT ] | I ‘Balik-Aral aa | Tadigenous Peoples Laurer [earner eared i ALIVE classes, 1 i Muslim Learner Repeater [Foul Number of Cases “Learner ees tan invidal who may may not be ena in ob mule prams Tote Enrolment ~eersto te total number of learners nfl inte soho ess of program Secondary (Grade? to 12} Enrolment - resto he he thir stage of compulsory basic education, The eta age tis evs tele (12), Dalit-Arat- refer toa learner who finished a grade evel, stopped Schooling ad then ere in he next grade level afer a year or me. 5. Indigenous Peoplet Learner refers to leaner born feo both parents who Pas defined ia RA 8371 Indigenous Peoples Republic Ast of 197 (soups of people or hmogenous ores iented by seltacripion and scriton by ars who have conngoysy ive a ap oanaed community or communally bounded an define etry String common bonds language, estas, tains and ciber sisinctive curl Was), 7 2 2 {. Learnr in Arabi Language and Islam Values Eduction (ALIVE) elses ~ refers taka enrol in ALIVE (3 progam wth the i of reserving Aabc language and Muslin cae ough ts incision nthe regular se eaton erica) 2. Mua Learner «fee 0 lester who is born ofthe ot bth pret practicing the am reliion ih @ ‘Repeter fers are who ied left psticular rae lve in ry previous eh00 9. Taal Number of Classe reer the ube of classes ya evel om Yet 0 Yes andi nole in he se grad evel where hase ef oat Reminder: Totals in this tale will lly with the totals in Table 4 Cerifid True and Correct by : Head ef isTable 4. SECONDARY AGE PROFILE, SY 2014-2015 (As of 1 Friday of the SY) year Year2 Age Yeart Year 3 Year4 Year § Year 6 TOTAL Mate | Female_| Male] Female Mate [Female Mate [Female Mate | Femate Mate [Female Male |_Femate 10.& Below [ i 2 7 18 19 E Above. TOTAL 1 The worl entclment of the shoo! as of 1 Friday of the SY willbe dsibuted actos yar evel, by single ae age group and by sex. 2, Comput Reminder: Totals inthis table wil ally with the totals in Table 3 Certified True and Correct by Head of siaion Date ion ofthe age of earners wil be based onthe cls age a of las bay. Thus, ifthe lenner i 12 years 1 mons a of 1" Frid of the SY. the age ofthe lene is counted 2s 12 yeas‘Table 5. DATA ON GASTPE PROGRAM, SY 2014-2015 (As of 1" Friday of the SY) Year Year? Year3 Year Years Year6 poled Particule en Male [Femaie|-—Waie[Femaie_| Wale —[Fomate [Mate [Female [Minte [Female | Wale [Femate | Wiole [Female Examen! I | Number of Slows 7. The Government Assistance to Students and Teachers in Private Education (GASTPE) Program to deserving lememary Scho! gradutes who wish o pute their secondary education privat choos 2. Number of Slots - umber ofalocted slots gives othe paicipatng private school in GASTPE. ‘Table 6 PERSONNEL DATA, SY 2014-2015 (As of 1 Friday of the SY) sme ta desongest public secondary schoee trough the enension of iansal stance om Secondary Particulars Kindergarten lementary al Secondary “Teacher Salary Subsidy (GASTPE) Mate [| Femaie [Twat [Mate [Female [Totat [Mate | Female [Tout | Mate [ Female [Toul INo. of Teachers I I Io. of Aan snd Soppon Pe t I ‘aner ofeach cover teaches wi line aching ed nd pa ne weachng ad Thee nes Professor ands handing asc eet Reminder: A teacher handling 2 or more levels shal be counted once and counted where he most number of teaching loads ox 2. SENIOR HIGH SCHOOL PROGRAM Are you interested in opening Senior High School in school year 2016-20172 2 Yes ne Yess there any usable vacant classroom in your school? Yes, how many? Ono Certified True and Correct by nto tsnion Desenan DaeTable 7. DISASTERS/CALAMITIES For the month of April and May 2014, which incidents cccurred in your school and immedint surroundings? (Afeppicable, check under the months that these occurred.) DisserdCalamies anal soy Disaser/Calames ol va Natural Hazards ‘Human-Induced Hazards Drovght ‘Armed conflict as a result of organized crime (terrorism, siege, etc.) Q Crime against schoo! headis Earthquake (murderihomicide, physical injury, rape, sexual harassment, etc.) a Fire ~ — r crime (includes fores fire, fies as consequence of natural disasters such ast school property (thef, robbery, arson) 4 phoons and earthquakes) oo ‘Crime against stadenus a (murderihomicide, physical injury, rape, sexual harassment, ec) Landside ‘Crime against teacheris (murder homicide, physical injury, rape, sexual harassment, etc.) Storm Surge Fire (Electrical wiring failure, etc.) Health Threat ese eee ae ee eer eee (ie, Dengue, Malaria, Measles, food poisoning, disease outbreak) ‘Tsunami folojolo Security threat as ars (Gomd threats, kidnapping threats, hostage taking, shooting, etc.) It of civilian violence olol/ojo[olo| ololo olo|olololo| a jojo Voteanic Eruption Result of Disaster Incidences Structural collapse (as a result of engineering failures) qoojojocalol|o oo ooa Center Others. Please specify o Oo Noter Forthe defations, please se Dep Order No. 23, 52014. Box 3. VULNERABILITIES, lay increase your vl br opinion, what are the top 3 conditions, circumstances or festres of your schools and the sutounding environment that lt or put life and property a teat risk to aatural and heman-induced disasters? Reminder: This table should not be left blank. Conified True and Correct by + Head of tnstution Designtion ee eee ran OT Tam(Enclosure No. 4 to DepEd Order No. 36, s. 2014) Republic of the Philippines DEPARTMENT OF EDUCATION OFFICE OF PLANNING SERVICE ‘Research and Statistics Division SUCs LABORATORY SCHOOL PROFILE INSTRUCTIONS This form shall be accomplished by the head of the laboratory school of State Universities and Colleges (SUCs) offering kindergarten, elementary and/or secondary levels. In the cease of schools/institutions offering more than one level, only one school profile shall be accomplished. The head of the school shall sign the forms certifying to the correctness of the data, and shall be responsible and accountable for any inaccuracy or false data/information reported. He/She shall submit the accomplished forms to the Research and Statistics Division, Office of Planning Service on or before September 1, 2014. Important: Read the definitionslinstructions found at the bottom of each table before filling up the form. No item should be left blank. Instead, "zero ( 0)" or "not applicable (nja)" shall be written. Shaded boxes shall not be filled. Name of Institution SCHOOL INFORMATION ‘SY 2013-2014 (ffcial nome) Address (Afrenamed, please indicate od mame) Street Stio'Parok Barangey Municpaticy Province\City Region Division Legislative District Tel. No. Mobile No. Fax No. E-Mail Address Type of School: (Tick as appropriate) (J) Kindergarten Level of Education Offered Elementary Secondary Certified True and Correct by : Head of Instcation Designation irate Over Printed Names Date‘Table 1. LEARNERS DATA IN ELEMENTARY, S¥ 20142015 (As of 1" Friday ofthe SY) Taman | ToT ‘Male | Female [Mate | Female [Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female | Male | Female TOTAL ENROLMENT [ [ [ T T [ [ Noman 1 1 1 1 ra { eal t Balik-Aral | T ~ Tegenous Peoples Lent [ | Tener in ALIVE det | 1 1 Repeater LC a [ | 2. Total Enrolment ero he al aumber feet eval in the cos! esd of prog. 13, Kindergorten Enrolment eso he al ube of ares ctsoed io oe (1) ya reper educan fx chien ates fie (5) yens ol (eof October 31a preeuisie for Gre “F. Elementary (Grader 1196) Enrolment «fers tothe outer of ener ale athe sso ste of comply Ds ection which compose of sik (0) years The enan ae ts evel se(6) ea ol of October 31 ‘5. Leamers nih Exceptonalies(nom-reded) Enrolment retro sinily popes ares who ae nyt ey fr caso in he eu as {5 Monograde Enrolment vt eames eng aug nesses consiving os nl rade cl. 7. Multa Enrolment - (50ers beng taht in elses coming woo more grades ede by ne echt 1. Baldr -refertos arer who fished 3 ge lee), topped schol then eral ia he et ade level fer ea oF more 9, Inigenoes Peoples Learner eso ere bots cero oh pans who iP dene in RASS nsgenoos Peoples Republic Act of 187 (ie atop of poplar omosenes Scie ead by season ad ttitog by thers who hae ntinvocly ved sn orpized corso communal bounded te efined trey sharing common boos of hnguage cisions dons ad ate isiactve ural ais). 10. Maan Learner refers aera Deno ero bth pues practice sam eligon a 11. Repeater “cess ane abo aed ls patter eel nay prev cho year and aoe phe ae ae le] where hey et ole 12, Toa Number of Monograde Clases «reeset urbe of chases by pad eve fom Kieran Gr 6 Reminder: Toa this table wil lly withthe tals In Table 2. Certified True and Correct by Mentos ntaion Deseaon aseTable. ELEMENTARY AGE PROFILE, SY 2014-2015 (As of 1" Friday of the SY) ‘Graet Age Exceptionalltes [ToT ao 5 Maie_[ Female © We move L TOTAL L I 2. Compustion ofthe of of eraer lb aes on techs 2 36 fn Reminder Totals inthis table wil aly with he total én Table Box . MULTIGRADE CLASSES, SY 2014-20 (As of" Friday ofthe SY) Tr The tool eavlment othe schol eof |™ Fry ote SY wil be rb aces grade eves by og gy or ape OP 00) Hx by. Tous, The aoe 6 yeas 17 mobs 8 of TFs fhe SY th ag of he ee counted a 6 yes 5. ECD tBarly Childhood Development) Experience acaces sl ECD pops for young chien in epteredKindergane nd foe in ima oraz esuctnal ins and a eee For Moltigrae clases, plese indicate the grade levels combined (Checks appropriate Kindergarten Grade Grade MG Class Q a a MG Class2 a Qa a MG Gas3 a a a Certified True and Corect by Mead tesintionTable 3. LEARNERS DATA IN SECONDARY, SY 2014-2015 (As of I" Friday of the SY) vanieters ie? Grit Gai Grae 10 Gree cris pe = TOTALENROMNENT | | * Balik aval 1 T T Indigenous Peoples Learner [ Misi Lae I Rea | | l [ Toot None of Chass 1 Tat aman toe olen ere eel ne shat eprom, 5 Seon radar Enon cn oe en capstan Tc eat ng to ie ave (2. {bates a lererat ashe eel ged hes ee en se ety ee 5 tion rts ar ae oss oh puns IP Sn a ng Pps Rp At 1987 sou of pap or hoon ss iene ytd gan by bo bn ety Ica 8 pn ony oo ely Date teed ry ng oon Vso gags cc, 6, Lert a amped ele Eston ALIVE) ses fo eel ALIVE Gx in wih snl peeing bic gg né Min le ui can ero sont) 1 Matin Lets st eo oh pes pig bo gir {prion mere eres pope el ny ees she end ela ie peel wy et 9 Fo Nntr of Cases te a Scns tel fGen 2 Cominder: Totals n hil wl al with te ts Table. Cert tv and Corby‘Table 4. SECONDARY AGE PROFILE, SY 2014-2015 (As of 1" Friday of the SY) Grade? Grades Grade Grade 10 Grade Grade 12 OTAL Age (Geode 72 Male | Femate_| Male [ Female | Male | Female | Male | Female | Male [ Female | Male | Female | Male | Female 10.& Below Hl 2 5 1 5 16 7 18 9 20 Above TOTAL 1, The 1 enrcment ofthe schol as of 1 Feiday ofthe SY will be distibuted across year evel, by single age or age group and by Sex. 2. Computation ofthe age of earners wil be based onthe childs age 35 of ast bday. Thus, if the eae is 12 years 11 months as of 1 Friday of he SY the age ofthe earner is counted 3612 years. Reminder: Totals inthis table will ally with the totals in Table 3. Certified True and Correct by : ead of nsication Designation Date Bia Oe rT NITable 5. PERSONNEL DATA, SY 2014-2015 (As of 1" Friday of the SY) Number of Teachers Kindergarten I Elementary Secondary Number of Administrative and Support Personnel Male Female L Male Female Male Female Total Male Female Total Number of teachers covers teachers with full-time teaching load and part time teaching load, These includes Professor and Instructor handling basic education. Reminder: Box 2, SENIOR HIGH SCHOOL PROGRAM. Are you interested in opening Senior High S chool in school year 2016-2017? Q Yes If Yes, is there any usable vacant classroom in your school? O Yes, how many? QNo Certified True and Correct by : Head of Institution ignaure Over Printed Name) Designation A teacher handling 2 or more levels shall be counted once and counted where the most number of teaching loads. Date :‘Table 6, DISASTERS/CALAMITIES For the months of April and May 2014, which ncidens occured in your school and immediate surroundings? Afapplicabe, check under the months that hese occurred.) Disasters/Calamities April| May Disasters/Calamities April] May Natural Hazards Human-Induced Hazards ‘Armed confit asa result of organized crime (terrorism, siege, et) CCrime against school headis (rurderhnomicide, physical injury, rape, sexual harassment, ec) Fire (includes forest fr, fres as consequence of naswral disasters such ‘as nphoons and earthquakes) Crime against school property (theft, robbery, arson) Crime against stadens (murderihomicide, physical injury, rape, sexnal harassment, ec) Flood (Cre against teachers Landslide (rnurderihomieide, physica nurs, rape, sexual harassment olol/o|olojo ‘Storm Surge Fire Electrical wiring failure, etc.) Health Threat ‘Tropical Cyclones (Storm, Typhoon, Tropical Depression, etc) fie Deigue Malaria, Measles, fod poisoning, disease oxsbreck) ojoo ojo;/o|}o|o\o oloja ‘Tsunami it spilt Security threat asa result of civilian violence (bomb threats, Kidnapping threats, hostage raking, shootin, etc.) School Used as an Evacuation Center ala Others. Please specify Note: For the definions, please see DepEd Order No, 33, 52014. Volcanic Eruption ojol/ciojejojaja/afajo oojo cools ojo ojala Box 3, VULNERABILITIES In your opinion, what are the lop 3 conditions, circumstances ot featres of your school and the surrounding environment that increase yout vulnerability of pu fe and property a reat Sk 0 maura and human-induced disses? Reminder: This table should not be left blank Conified True and Correct by + Head of Iniution Designation Date