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Republic of the Philippines

Department of Education
Region 02 (Cagayan Valley)

SCHOOLS DIVISION OFFICE OF ISABELA


Alibagu, City ofIlagan, Isabela 3300
www. deped.isabela.com.ph

Form 1
ADOPT- A- SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY

District: TUMAUINI SOUTH DISTRICT Address: CARPINTERO, TUMAUINI, ISABELA () 1st () 2nd ( √) 3rd () 4th Quarter
District Code:046 Contact Nos. 0905--- Email Address:

LEARNING ENVIRONMENT
DONOR
DONATIONS SCHOOL PARTICULARS QTY AMOUNT PRIVATE SECTOR LGUDATE COMPLETED/ TURN-OVER
1. Classroom AMES None None None None None None
-New Classroom AES 1ST
-Rehabilitation/ Repair AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES None None None None None None
LIS None None None None None None
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU None None None None None None
PILITAN None none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

2.Furniture AMES None None None None None None


AES 1ST
AES 2ND
BALUG ES
BANTUG ES Arm Chair 50 18,200.00 / / August 2019
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES
LIS
LES None None None None None None
MES
NES None None None None None None
SMES Arm Chair 50 18,200.00 / Aug 2019
PALLACOT
PARAGU Arm Chair 50 18,200.00 / Aug 2019
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

3.Toilet & Wash FacilitiesAMES CR with toilet 4 80,000 / / September 2019


AES 1ST
AES 2ND
BALUG ES
BANTUG ES CEMENT 10 2,300.00 NONE / September 2019
BEIS None None None NONE None None
CES None None None None None None
DAES None None None None None None
LSES
LIS
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU None None None None None None
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

4. Maintenance Construction
AMESmaterials None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES
LIS
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU None None None None None None
PILITAN none none none none none none

TSCS
TWCS NONE NONE NONE NONE NONE NONE

5. Real State Land AMES NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES
LIS
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU None None None None None None
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

6. Others (Pls. Specify) AMES None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES
LIS
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU None None None None None None
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

Please attach the following documents:


1. Deed of Donation
2. Deed of Acceptance
3. Pictures/ Receipts (Xerox)

Submitted by:

NITA G. PALOGAN, PhD


Schools District Supervisor
Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)

SCHOOLS DIVISION OFFICE OF ISABELA


Alibagu, City ofIlagan, Isabela 3300
www. deped.isabela.com.ph

Form 2

ADOPT- A- SCHOOL PROGRAM QUARTERLY REPORT


ELEMENTARY

District: TUMAUINI SOUTH DISTRICT Address: Carpintero,Tumauini, Isabela () 1st () 2nd ( √) 3rd () 4th Quarter
District Code:046 Contact Nos. 0905--- Email Address:

LEARNING SUPPORT
DONOR
DONATIONS SCHOOL PARTICULARS QTY AMOUNT PRIVATE SECTOR LGU
DATE COMPLETED/ TURN-OVER
1. Audio Visual Educational
AMES Materials
NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES none none none none none none
BEIS None None None None None None
CES None None None None None None
DAES
LSES None None None None None None
LIS None None None None None None
LES
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

2.School Supplies
AMES NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None
LSES
LIS Notebooks,pen,pencil410 65,000 Brgy.Council June 4, 2019
LES None None None None None
MES
NES None None None None None
SMES Backpack 64 19,200 NPC July 2019
PALLACOT
PARAGU
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

3.Educational Film/
AMESLibraries NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES
LIS
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

4. Others (Pls. Specify)


AMES NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES
LIS slippers 410 Caloocan Factory June 4, 2019
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/ Receipts (Xerox)

Submitted by:

NITA G. PALOGAN, PhD


Schools District Supervisor
Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)

SCHOOLS DIVISION OFFICE OF ISABELA


Alibagu, City ofIlagan, Isabela 3300
www. deped.isabela.com.ph

Form 3

ADOPT- A- SCHOOL PROGRAM QUARTERLY REPORT


ELEMENTARY

District: TUMAUINI SOUTH DISTRICT Address: Carpintero,Tumauini, Isabela () 1st () 2nd (√) 3rd () 4th Quarter
District Code:046 Contact Nos. 0905--- Email Address:

TECHNOLOGY SUPPORT
DONOR
DONATIONS SCHOOL PARTICULARS QTY AMOUNT PRIVATE SECTOR DATE COMPLETED/ TURN-OVER
LGU
1.Computer AMES NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES None None None None None None
LIS None None None None None None
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU
PILITAN none none. none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

AMES
2. Electronic Learning Materials NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES
LIS None None None None None None
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

AMES
3.Internet Connectivity None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES
LIS
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

4. Others ( PleaseAMES
specify) NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None None None None None None
LSES
LIS
LES None None None None None None
MES
NES None None None None None None
SMES None None None None None None
PALLACOT
PARAGU
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/ Receipts (Xerox)

Submitted by:

NITA G. PALOGAN, PhD


Schools District Supervisor
Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)

SCHOOLS DIVISION OFFICE OF ISABELA


Alibagu, City ofIlagan, Isabela 3300
www. deped.isabela.com.ph

Form 4

ADOPT- A- SCHOOL PROGRAM QUARTERLY REPORT


ELEMENTARY

District: TUAMUINI SOUTH DISTRICT Address: Carpintero,Tumauini, Isabela () 1st () 2nd (√) 3rd () 4th Quarter
District Code:046 Contact Nos. 0905--- Email Address:

HEALTH AND NUTRITION


DONOR
DONATIONS SCHOOL PARTICULARS QTY AMOUNT PRIVATE SECTOR DATE COMPLETED/ TURN-OVER
LGU
AMES
1. Feeding Program NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES
LSES None None None None None None
LIS Sangguniang Bayan 300 SB. MARK DE ALBAN
October 8, 2019
LES None None None None None None
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

AMES
2. Medical/ Dental None
Mission/ Check-ups None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES
LSES
LIS Vitamins 2 box LD1 Nurses June 4, 2019
LES None None None None None None
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN none none none none none none
TSCS
TWCS NONE NONE NONE NONE NONE NONE

AMES
3. Deworming Intervention None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES
DAES
LSES
LIS None None None None None None
LES
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

AMES
4. Health Supplies NONE NONE NONE NONE NONE NONE
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES NOne None None None None None
DAES
LSES
LIS None None None None None None
LES
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

AMES
5. Others ( Please specify) None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES
BEIS None None None None None None
CES None None None None None None
DAES
LSES
LIS None None None None None None
LES
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE
TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/ Receipts (Xerox)

Submitted by:

NITA G. PALOGAN, PhD


Schools District Supervisor
Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)

SCHOOLS DIVISION OFFICE OF ISABELA


Alibagu, City ofIlagan, Isabela 3300
www. deped.isabela.com.ph

Form 5

ADOPT- A- SCHOOL PROGRAM QUARTERLY REPORT


ELEMENTARY

District: TUMAUINI SOUTH DISTRICT Address: Carpintero,Tumauini, Isabela () 1st () 2nd ( √) 3rd () 4th Quarter
District Code:046 Contact Nos. 0905--- Email Address:

READING PROGRAM
DONOR
DONATIONS SCHOOL PARTICULARS QTY AMOUNT PRIVATE SECTOR DATE COMPLETED/ TURN-OVER
LGU
1. Books AMES None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES
LSES
LIS Encyclopedia 5 30,000.00International grp Aug.2, 2019
LES None None None None None None
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

2.Supplementary Reading Materials AMES None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES
LSES
LIS story books 30 interantional grp. Aug.2, 2019
LES None None None None None None
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

3. Others (Pls. Specify) AMES None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES
LSES
LIS None None None None None None
LES None None None None None None
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/ Receipts (Xerox)

Submitted by:

NITA G. PALOGAN, PhD


Schools District Supervisor
Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)

SCHOOLS DIVISION OFFICE OF ISABELA


Alibagu, City ofIlagan, Isabela 3300
www. deped.isabela.com.ph

Form 6

ADOPT- A- SCHOOL PROGRAM QUARTERLY REPORT


ELEMENTARY

District: TUMAUINI SOUTH DISTRICT Address: Carpintero,Tumauini, Isabela () 1st () 2nd (√ ) 3rd () 4th Quarter
District Code:046 Contact Nos. 0905--- Email Address:

TRAINING AND DEVELOPMENT


DONOR
DONATIONS SCHOOL PARTICULARS QTY AMOUNT PRIVATE SECTOR
LGU DATE COMPLETED/ TURN-OVER
1. Teachers/ Principal's Training AMES None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES
LSES None None None None None None
LIS None None None None None None
LES None None None None None None
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

2.Students/ Pupils Training Field Trip AMES None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES
LSES
LIS None None None None None None
LES None None None None None None
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

3. Others (Pls. Specify) AMES None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES
LSES
LIS NOne None None None None None
LES NOne None None None None None
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

TOTAL 0 ₱0.00 0 0
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/ Receipts (Xerox)

Submitted by:

NITA G. PALOGAN, PhD


Schools District Supervisor
Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)

SCHOOLS DIVISION OFFICE OF ISABELA


Alibagu, City ofIlagan, Isabela 3300
www. deped.isabela.com.ph

Form 7

ADOPT- A- SCHOOL PROGRAM QUARTERLY REPORT


ELEMENTARY

District: TUMAUINI SOUTH DISTRICT Address: Carpintero, Tumauini, Isabela () 1st () 2nd ( √) 3rd () 4th Quarter
District Code:046 Contact Nos. 0905--- Email Address:

DIRECT ASSISSTANCE
DONOR
DONATIONS SCHOOL PARTICULARS QTY AMOUNT PRIVATE SECTOR
LGU DATE COMPLETED/ TURN-OVER
1. Stipend AMES None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES None
LSES None None None None None None
LIS None None None None None None
LES None None None None None None
MES
NES None
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

2. Others (Pls. Specify)


AMES None None None None None None
AES 1ST
AES 2ND
BALUG ES
BANTUG ES None None None None None None
BEIS None None None None None None
CES None None None None None None
DAES
LSES
LIS None None None None None None
LES None None None None None None
MES
NES
SMES None None None None None None
PALLACOT
PARAGU
PILITAN
TSCS
TWCS NONE NONE NONE NONE NONE NONE

TOTAL 0 ₱0.00 0 0
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/ Receipts (Xerox)

Submitted by:

NITA G. PALOGAN, PhD


Schools District Supervisor
Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)

SCHOOLS DIVISION OFFICE OF ISABELA


Alibagu, City ofIlagan, Isabela 3300
www. deped.isabela.com.ph

Form 7
ADOPT- A- SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY

District: TUMAUINI SOUTH DISTRICT Address: Carpintero Tumauini Isabela () 1st ( ) 2nd (√) 3rd () 4th Quarter
District Code:046 Contact Nos. 0917--- Email Address:

ASSISTIVE LEARNING DEVICES FOR PUPILS/ STUDENT WITH SPECIAL NEEDS


DONOR
DONATIONS SCHOOL PARTICULARS QTY AMOUNT PRIVATE SECTOR DATE COMPLETED/ TURN-OVER
LGU
TSCS
1. Pencil Grips

2. Special Chairs

3. Spelling Check Devices

4. Hearing Aides

5. Talking Computers

6. Specialized Keyboards

7. Braille (Books)

8. Computerized Systems

9. Others (Pls. Specify)

TOTAL 0 ₱0.00 0 0
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/ Receipts (Xerox)
Submitted by:

NITA G. PALOGAN, PhD


Schools District Supervisor

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