Appendix B BE Form 01: Condition (Check One) Remarks

Appendix B
BE Form 01
Republic of the Philippines
Department of Education
Region I
Division I
School Buenlag National High School
School Year 2010-2011
BRIGADA ESKWELA
PHYSICAL FACILITIES REPAIR AND MAINTENANCE NEEDS ASSESSMENT FORM
(To be accomplished by the School Physical Facilities Coordinator)
Instruction: Conduct an ocular inspection of the school physical facilities listed below. Then provide the needed information to facilitate the improvement to be done on these
identified facilities. (If needed, you may use separate forms for each classroom or the school facility.)
FACILITIES Condition Remarks Nature of Improvement Materials Resources Manpower Needed

(Check One) Needed Needed (Indicate quantity and
Satisfactory Unsatisfactory If Unsatisfactory (e.g. repair, repainting, (Indicate kind and nature of labor
describe the problem Replacement etc quantity) services needed)
Roof/gutters
Ceilings
Walls
Blackboards
Chairs/desks/tables
Water facilities
Drainage system
Signage
School garden
Lighting
Windows
Doors
Comfort rooms
School ground
School canteen/clinic
School fence
Others, please
specify
Prepared by: Noted:
_______________________________ ______________________ CHONA C. SAMSON__

School Physical Facilities Coordinator Date of Inspection TIC/Head Teacher/Principal
Appendix C
BE form 02
Region I
Division I
BRIGADA ESKWELA
SCHOOL WORK PLAN
(To be accomplished by the School Head)
Instruction: List down all the specific activities that you will be undertaking in relation to the conduct of Brigada Eskwela in your school and fill in the required information. Add
another sheet if needed. One completed, submit a copy to the Adopt-A-School Program coordinator of your division on or before January 31.
KRA Activities Timeline Person/s Materials Needed Budget

Responsible
1.Advocacy and Marketing
2. Resource Mobilization
3.Implementation
4.Monitoring and
Evaluation
5. Reporting
Prepared by: Noted by:
______________________________________ ______________________ __________________________________

Signature over Printed Name Date Prepared ASP Division Coordinator/BE Coordinator
Appendix D
BE Form 03
Region I
Division I
BRIGADA ESKWELA
RESOURCE MOBILIZATION FORM
(To be accomplished by the Resource Mobilization Committee)
Instruction: Using the completed BE form 01: Physical Facilities Needs Assessment Form as basis, summarize the resources )materials and manpower) needed and list down the
potential source or partners to be tapped. Add Additional sheet if needed. The Status and Remarks columns should be updated regularly to determined progress in acquiring resources
needed.
Materials Needed Quantity Key Strategies/Plan of Person Responsible Status Remarks

Persons/Organization to Action
be Tapped
Labor Quantity Key Strategies/Plan of Person Responsible Status Remarks

Skills/Volunteers Persons/Organization to Action
Needed be Tapped
Prepared by: Noted:
______________________________________ CHONA C. SAMSON

Resource Mobilization Committee Chairperson TIC/Head Teacher/Principal
Appendix E
BE Form 04
Region I
Division I
BRIGADA ESKWELA
DAILY ATTENDANCE OF VOLUNTEERS
Instructions: Volunteers themselves should personally fill in the details required by this form under the supervision of any of the committee members. * For the last column, indicate if
masonry, carpentry, plumbing, painting, electrical, gardening/landscaping, ordinary labor, or others.
TIME TOTAL *NATURE OF

NAME POSITION/DESIGNATION ADDRESS/ CONTACT NUMBER OF VOLUNTEER
ORGANIZATION/AFFILIATION NUMBER IN OUT SIGNATURE HOURS SERVICES
SERVED RENDERED
Noted:
CHONA C. SAMSON ____________________

School Head Date
Appendix F
BE Form 05

Region I
Division I
Buenlag National High School
BRIGADA ESKWELA
RECORD OF DONATIONS RECEIVED
(To be accomplished by the Documentations Committee)
ITEMS OR MATERIALS QUANTITY DATE RECIEVED NAME OF DONOR ASSUMED COST OF

TOTAL
PER UNIT TOTAL
Prepared by: Noted:

____________________________________ CHONA C. SAMSON
Committee on Documentation Chair/Member School Head
Appendix G
BE Form 06
Region I
Division I
Buenlag National High School
BRIGADA ESKWELA
DAILY ACCOMPLISHMENT REPORT
(To be accomplished by the Program Implementation Committee)
DAY 1 2 3 4 5 6 DATE:
Instruction: List down all the activities that needs to be undertaken for each day of the Brigada Eskwela week. At the end of each day, please mark the appropriate
column that corresponds to the status of each activity. Cite reasons for non-completion.
Activities STATUS REMARKS/RECOMMENDATIONS

Completed Started but not yet Not done
completed
Prepared by: Noted by:

__________________________________________ ___________________ CHONA C. SAMSON
Program Implementation Committee Chair/Member Date Prepared School Head
Appendix H
BE Form 07
DEPARTMENT OF EDUCATION
BRIGADA ESKWELA
SCHOOL ACCOMPLISHMENT REPORT
(To be accomplished by the School Head)
DIVISION: REGION:
SCHOOL: SCHOOL ID:
SCHOOL ADDRESS:
(Please check appropriate box)

Level: Type of School:
Elementary Central School
High School Non-Central School
Multigrade
Primary School
Integrated School
SCHOOL HEAD CONTACT NO.
PTCA PRESIDENT CONTACT NO.
A. SCOPE OF REPAIR AND MAINTENANCE WORK COMPLETED(Please check appropriate column)
Repaired Repainted Replaced Others

(Brief Description)
1. Roofs
2. Ceilings
3. Walls
4. Windows and doors
5.Chairs/Desk, Tables and
Blackboard
6.Comfort Rooms
7.Leeking Pipes
8. School Grounds/Landscaping
9. School Signs
10. Others (specify
B. DONATIONS/MATERIAL RESOURCES GENERATED (Use separate sheets, if needed
Type of Donations Source Estimated Cost
Total
BE Form 07
VOLUNTEER SERVICES
Type of Volunteer Name of No. of Volunteers
individuals/Organization Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Total
(Use separate sheets, if
needed
1.PTCA Member
2.Barangay Officials
3. Municipal/City
Government
Officials
4. Provincial
Government
Officials
5. NGOs Civic
Organizations
6. Private Citizens
7. Private
Companies/Corps
8. Other
Government offices
9. Parents
10.Teachers
11. Pupils/Students
12. Others (specify)
13. Prominent
Volunteers
Total
BE Form 07
D. ESTIMATED COST OF VOLUNTEER SERVICES RENDERED. Refer to Guide for Computing Labor Cost
(Use separate sheets, if needed)
Type of Service Total Number of Volunteers Total Number of Hours Rendered Total Estimated Costs
Masonry
Carpentry
Plumbing
Electrical/Electronic
Landscaping/Gardening
Painting
Ordinary Labor
Others
Total
E. SIGNICANT EVENTS / EXPERIENCES (Use separate sheets, if needed)

What is/are important contribution to
What happened? Who were involved? When? the operation of the school or to the
existing needs of the school?
F. ISSUES AND CONCERNS (Describe briefly problems encountered and how resolved)
G. LESSONS LEARNED / BEST PRACTICES
BE FORM 07
H. SUGGESTIONS TO STRENGTHEN BRIGADA ESKWELA PROJECT (Include support needed from Central Region, and Division Office that can
increase the impact of Brigada Eskwela Project in your school.)
I. EVIDENCES / ATTACHMENTS
a. Photos (before, during and after)
b. Photocopy of all completed BE Forms (check if attached)
____________ Form 01 _________ Form 05
____________ Form 02 _________ Form 06
____________ Form 03
____________ Form 04
Prepared by: Date:
CHONA C. SAMSON
Principal I
Name and Designation

Appendix B BE Form 01: Condition (Check One) Remarks

Încărcat de

Informații document

Descriere originală:

Titlu original

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

Appendix B BE Form 01: Condition (Check One) Remarks

Încărcat de

Drepturi de autor:

Formate disponibile

Appendix B

FACILITIES Condition Remarks Nature of Improvement Materials Resources Manpower Needed

___________ CHONA C. SAMSON

KRA Activities Timeline Person/s Materials Needed Budget

__

Materials Needed Quantity Key Strategies/Plan of Person Responsible Status Remarks

Labor Quantity Key Strategies/Plan of Person Responsible Status Remarks

Prepared by: Noted:

______________________________________ CHONA C. SAMSON

TIME TOTAL *NATURE OF

CHONA C. SAMSON ____________________

Republic of the Philippines

ITEMS OR MATERIALS QUANTITY DATE RECIEVED NAME OF DONOR ASSUMED COST OF

Prepared by: Noted:

Activities STATUS REMARKS/RECOMMENDATIONS

Prepared by: Noted by:

(Please check appropriate box)

A. SCOPE OF REPAIR AND MAINTENANCE WORK COMPLETED(Please check appropriate column)

Repaired Repainted Replaced Others

E. SIGNICANT EVENTS / EXPERIENCES (Use separate sheets, if needed)

Prepared by: Date:

S-ar putea să vă placă și