FORM C1: ACTION RESEARCH (SOLO GRANT)

COVER PAGE

Name of Proponent
(Last Name, First Name, M.I.)

Name and Address of HEI

Region and Province

Department
(Your affiliate department within
your institution)
Teaching Discipline
(for Faculty)
Current Senior High School
Teaching Load
(specify subject/s)
Action Research Title
(Specify proposed intervention)

INTRODUCTION
Discuss the following:
1. Research Problem. (What is the research all about?)
2. Theoretical and/or conceptual framework of the research. (What theories/frameworks/paradigms are
pertinent to your chosen research topic?)
3. Summary of previous researches that has been done on the topic. (What does the existing literature
say about your chosen topic?)
4. Alignment with or departure from existing researches on the topic. (How does it build upon and develop
or differ from researches already conducted on your research topic?)
5. Bibliographic citation of studies/researches related to your chosen research topic. (What references did
you use for your research?)

PROPOSED METHODOLOGY
Discuss the following:
1. Methodology of the research proposal.
2. Ethical considerations and appropriate steps to be taken.
3. Key sources of data (e.g.: data collected, analysis of other data sets, additional studies you intend to
use and explain how they will contribute to your analysis.)
 FORM C2: ACTION RESEARCH (SOLO GRANT)
WORK AND FINANCIAL PLAN

Work and Financial Plan Outline your expected tasks and key deliverable(s) per timeline and the funding
sources you currently have. Include work/collaboration with other researchers, if any, to include their specific
tasks or involvement. View the examples below. You may attach a separate sheet.

Name of Proponent
(Last Name, First Name, M.I.)

Name of HEI and HEI HEI - Academic department/college/program

unit/Department/Program

Start and End Date

Total Funding Support

Email Address of Proponent

Contact Number of
Proponent

___________________________________
Name and Signature of Proponent

Endorsed by:

___________________________________
Name and Signature of Department
Chair or College Dean

Date:

_________________________________
 C2b. BUDGET
ITEM Counterpart Funding Cost
(Please provide all requested information. (in PHP) (in PHP)
Use additional sheet if necessary.)

*Venue Rentals (Specify type)

(per day x ## days)

*Accommodations (Specify type)

(per day x ## days)

Food
(Number of meals/per day x ## days)

Honoraria of Researcher

*Transportation

Materials
Supplies
Printing and reproduction
Others, Specify:

Communications

Research
Books
Others, Specify:

Monitoring and Evaluation

Miscellaneous Specify

TOTAL:

TOTAL AMOUNT REQUESTED FROM CHED Php

*If applicable

I hereby certify that the above information is true and correct, accurately reflects the expenses projected
in the conduct of the grant I am applying for.

_________________________________________________

SIGNATURE OVER PRINTED NAME OF PROPONENT

 C2c. SCHEDULE AND DETAILS OF ACTIVITIES

Sample Template

Anticipated Needs
Research Activity Starting Date End Date Deliverables (in relation with the Work
and Financial Plan)

Snacks and meals for

resource person
Interview with Collated and organized Token for resource
experiential learning interview responses person
August 1 August 12
experts and//or Transportation to
practitioners interview venue

Internet
Review of related
Research on Access to libraries for
literature on
experiential learning August 1 August 15 books and journals
experiential learning
for science Printing
Preparation of Internet
experiential learning Lesson plans for Access to libraries for
lesson plans August 15 August 19 books and journals
Quarter 1
Teacher Observations
Student reflections and Materials for class
Implementation of assessments Reproduction of
experiential learning August 19 September 19 Evaluation of student student reflection forms
lesson plans in class performance on topics
discussed through
experiential learning
Writing of Action Action Research Paper Writing and printing
September 19 September 30
Research Report Revised REAP expenses
Presentation of Writing and printing
October October Revised Action expense
Results with co-
During inset During Inset Research Paper
faculty
 FORM C3: ACTION RESEARCH (SOLO GRANT)
RE-ENTRY ACTION PLAN

The Re-entry Action Plan (REAP) aims to capture how the action research engagement will benefit the
Higher Education Institution (HEI). Through the experiences of the faculty involved in this engagement,
HEIs are given an opportunity to have a clearer sense of how Senior High School is taught and handled,
enabling them to appropriately adjust curriculum and instruction in the tertiary level as they prepare for the
first batch of SHS Graduates in SY 2018 - 2019.

Name of Applicant
(Last Name, First Name, M.I.)

Name of HEI and HEI HEI - Academic department/college/program

unit/Department/Program

Title of Proposed Project

Type of Grant [ ] Unit Grant [ ] Solo Grant

Proposed Starting Date and

Expected Date of Completion

TO BE SUBMITTED WITH THE PROPOSAL, BEFORE THE ENGAGEMENT

What projects, innovations, or interventions could arise from this engagement? How
would these outputs address your issues and needs as indicated above? What
Outputs and
possible methodologies or best practices can you learn from this engagement? What
Outcomes
outcomes do you expect to observe within the given timeframe in terms of your
contribution to your HEI / discipline of study / region / country?

Impact to HEI
What information and insights will you be able to gain from this engagement to
Curriculum and
contribute to the adjustment of HEI curriculum and instruction?
Instruction

What specific issues does your HEI unit have regarding curriculum and instruction?

Are there similarities and differences in the methods and approaches in teaching the
Curricular and
General Education Courses and Introductory Courses now introduced as Core,
Instructional
Applied and Specialized Subjects in Grades 11 and 12 of Senior High School from
Needs of HEI
how they were taught in college?

What partnership opportunities are available for your HEI unit to establish and continue
with the Senior High School/s that your proponent/s will work with?
Continuous
Partnerships How will these partnerships impact your HEI units curriculum and instruction?
TO BE SUBMITTED AFTER THE ENGAGEMENT

Updated Outputs Are there any additional projects, innovations, or interventions that you plan on
and Outcomes implementing in your HEI after the engagement?

Summary of the What activities did the proponent/s do? What were the major insights that the
Engagement proponent/s learned? What was the impact of the engagement on SHS?

__________________________ __________________________
Signature of Proponent Date

I hereby certify that the above information is true and correct, and that
___(Name of University)___ has committed to the above reentry plan for
____(Name of Proponent)_______.

____________________________ ____________________________
Name and Signature of Dean Name of HEI
 CHED K to 12 Transition Program
Solo Grants
FORM C4.CURRICULUM VITAE TEMPLATE

I. Personal Information

Name of Faculty Click here to enter text.

Mailing Address Click here to enter text.

Telephone No. Click here to enter text.

Mobile No. Click here to enter text.

E-mail Address Click here to enter text.

Date of Birth (mm/dd/yyyy) Click here to enter text.

II. Educational Attainment (add rows if necessary)

Bachelor's Degree Attained Click here to enter text.

Course Click here to enter text.

Field of Specialization Click here to enter text.

Date Graduated
(mm/yyyy) Click here to enter text.

Honors/Awards Received Click here to enter text.

School / Institution Click here to enter text.

Degree Obtained
(Masters Degree / Doctoral Degree) Choose an item.

Course / Degree Click here to enter text.

Field of Specialization Click here to enter text.

Date Graduated Click here to enter text.

(mm/yyyy)

Honors/Awards Received Click here to enter text.

School / Institution Click here to enter text.

III. Work Experience (add rows if necessary; include existing post in Sending HEI )

Position Click here to enter text.

 Company Click here to enter text.

Period Covered Click here to enter text.

General Job Description Click here to enter text.

Position Click here to enter text.

Company Click here to enter text.

Period Covered Click here to enter text.

General Job Description Click here to enter text.

IV. Publications (add rows if necessary; start from the most recent publication)

Publication Type
(Book, Journal, Commissioned
Report) Click here to enter text.

Name of Publication Click here to enter text.

Title Click here to enter text.

Short Description of Work Click here to enter text.

Date Published Click here to enter text.

V. Academic Paper Presentations (add rows if necessary; start from the most recent
presentation)

Title Click here to enter text.

Short Description of Paper Click here to enter text.

Name of Conference Click here to enter text.

Date of Presentation Click here to enter text.

VI. Social Work and/or Community Extension Activities

(add rows if necessary; start from the most recent engagement)

Institutional Affiliation Click here to enter text.

Position Held Click here to enter text.

Brief Description of Position Click here to enter text.

Period Covered Click here to enter text.

VII. Training Programs Attended
(add rows if necessary, start from the most recent engagement)

Title of Training Click here to enter text.

Inclusive Dates of Attendance Click here to enter text.

Number of Hours Click here to enter text.

Conducted / Sponsored by Click here to enter text.

VIII. Professional Licenses and Certification

License Type
(e.g. Professional Teacher,
Registered Nurse) Click here to enter text.

Date of First Issuance

(mm/yyyy) Click here to enter text.

Expiry Date Click here to enter text.

IX. Other Information

Special Skills / Hobbies Click here to enter text.

Non-Academic Distinctions /
Recognition (write in full) Click here to enter text.

Membership in Association /
Organization (write in full) Click here to enter text.

I certify that the information provided herein is true and correct.

________________________ ________________________
Name and Signature Date
 CHED K to 12 Transition Program
CMO no. 9, series of 2016
Solo Grants

FORM C5.Applicant Employment Status

Name of HEI:

Name of Faculty:

Position/Designation:

Tenure: [ ] Permanent [ ] Non-permanent

Employment Status: [ ] Full-time [ ] Part-time

Inclusive dates of Start date of Employment: End date of Employment

Employment: (MM/DD/YYYY) (for non-permanent faculty):
(MM/DD/YYYY)

Current SHS teaching load 1.

(please specify subjects 2.
areas): 3.

This certifies that the above information is true and correct.

________________________________________

Name and Signature of Department Chair/ College Dean