ANNEX 1.

Research Proposal Application Form and Endorsement of

Immediate Supervisor

A. RESEARCH INFORMATION

RESEARCH TITLE

SHORT DESCRIPTION OF THE RESEARCH

RESEARCH CATEGORY (check only RESEARCH AGENDA CATEGORY

one) (check only one main research theme)
o National o Teaching and Learning
o Region o Child Protection
o Schools Division o Human Resource Development
o District o Governance
o School (check up to one cross-cutting theme,
if applicable)
(check only one) o DRRM
o Action Research o Gender and Development
o Basic Research o Inclusive Education
o Others (please specify): __________

FUND SOURCE (e.g. SERF, AMOUNT

SEF, others)*

TOTAL AMOUNT
*indicate also if proponent will use personal funds

B. PROPONENT INFORMATION

LEAD PROPONENT I INDIVIDUAL PROPONENT

LAST NAME: FIRST NAME: MIDDLE NAME:

BIRTHDATE SEX: POSITION I DESIGNATION:

(MM/DO/YYYY)
REGION I DIVISION I SCHOOL (whichever is applicable)

CONTACT NUMBER 1: CONTACT NUMBER 2: EMAIL ADDRESS:

EDUCATIONAL TITLE OF THESIS I RELATED RESEARCH
ATTAINMENT PROJECT
(DEGREE TITLE)
enumerate from bachelor's
degree up to doctorate degree

SIGNATURE OF PROPONENT:

PROPONENT 2

LAST NAME: FIRST NAME: MIDDLE NAME:

BIRTHDATE SEX: POSITION / DESIGNATION:

(MM/DD/YYYY)

SCHOOL I OFFICE ADDRESS:

CONTACT NUMBER 1: CONTACT NUMBER 2: EMAIL ADDRESS:

EDUCATIONAL TITLE OF THESIS I RELATED RESEARCH PROJECT

ATTAINMENT
(DEGREE TITLE)
enumerate from bachelor's
degree up to doctorate degree

SIGNATURE OF PROPONENT:

PROPONENT 3

LAST NAME: FIRST NAME: MIDDLE NAME:

BIRTHDATE SEX: POSITION / DESIGNATION:

(MM/DD/YYYY)

SCHOOL I OFFICE ADDRESS: DIVISION I REGION:

CONTACT NUMBER 1: CONTACT NUMBER 2: EMAIL ADDRESS:

EDUCATIONAL TITLE OF THESIS I RELATED RESEARCH PROJECT

ATTAINMENT
(DEGREE TITLE)
enumerate from bachelor's
degree up to doctorate
degree

SIGNATURE OF PROPONENT:

IMMEDIATE SUPERVISOR'S CONFORME

I hereby endorse the attached research proposal. I certify that the proponent/s has/have the
capacity to implement a research study without compromising his/her office functions.

_____________________________________
Name and Signature of Immediate Supervisor

Position I Designation: ____________

Date: ________________

_____________________________________
Name and Signature of Immediate Supervisor

Position I Designation: ____________

Date:________________