Republic of the Philippines

Department of Education
Region IX, Zamboanga Peninsula
Division of Pagadian City
West District
BALANGASAN CENTRAL ELEMENTARY SCHOOL
Telephone No. (062) 925-0029

BRIGADA ESKWELA
National Schools Maintenance Week

STATEMENT OF INTEREST FORM

May 30 June 4, 2016
I am interested to be a part of the National Schools Maintenance Week.
Name:
Name Of Company/
Organization:
Address Of Company/
Organization:
Telephone No.
Contact Person :
Name Of Public School: Balangasan Central Elementary School
Address Of School: Consolacion Street, Balangasan, Pagadian City
FORM OF INTERVENTION: (Choose any of the two or you can choose both.)
a. Donations-in-kind for: (please check desired donation)
____Repainting the roofs (adds two or more years to the life of the roof)
____Concreting of existing footpaths and drains
____Repair of leaking water pipes
____Repair of comfort rooms and toilets
___ Repainting of interior & exterior walls of school building
____Repair or replacement of ceiling boards
____Repair, refinish or repainting of chairs, desks and furniture
____Cleaning-up the gardens
____Repair or replacement of broken windows, jalousies, doors
____Repair of classroom partition wall
____Replacement of School Signage
____Repainting of Perimeter fence & school gate
____Improvement & Beautification of School ground
____Painting of flagpole platform
____Repair and improvement of Grade three makeshift classroom
____Replacement of lighting facilities and fixtures
(See attached list of materials for the identified repair & improvement needed)

b. Volunteer man-days/labor support:

Nature of volunteer services _____________
Time and date/s of availability ____________

Please submit filled-out form to the principals office of the school.