Annex D

Republic of the Philippines

DEPARTMENT OF EDUCATION

REGION/DIVISION/DISTRICT: ______________________________________________________________________________
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________

SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT

LIST OF AUTHORIZED CONSIGNEES

NAME & DESIGNATION TEL. NO. MOBILE NO. EMAIL ADD SPECIMEN
SIGNATURE
1 (School Head)

2 (School Feeding Coordinator)

3 (School Property Custodian)

Note: This form shall be filled-up by School Drop-off points to be given to the NDA/Dairy Cooperative supplier on the first
delivery of milk. Only authorized consignees are allowed to receive the goods.
Annex F

Republic of the Philippines

DEPARTMENT OF EDUCATION

REGION/DIVISION/DISTRICT: REGION V, DIVISION OF CAMARINES SUR, NABUA WEST DISTRICT

NAME OF SCHOOL: ANGUSTIA ELEMENTARY SCHOOL
SCHOOL ID NO.: 112830

SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT

LIST OF BENEFICIARIES
Classification of Students in terms of Milk Tolerance
(Please check one)
Without milk With milk Not allowed by
intolerance and will intolerance but parents to
Name Grade & Section participate in milk willing to participate participate in milk
feeding in milk feeding feeding

1 Fermante, Kevin Kinder /

2 Gabarda, Joshmine Kinder /
3 Nillo, Eriane Jane Kinder /
4 Sombrero, Jhon Rey Kinder /
5 Cate, James Ezekiel Grade I /
6 Colico, Keshier Grade I /
7 Mollino, John Cedric Grade I /
8 Odtujan, Edison Grade I /
9 Aceron, Angelie Grade I /
10 San Juan, Erica Grade I /
11 Bayrante, Nicholas James Grade II /
12 Belmonte, Nestor Philip Grade II /
13 Reparip, Jobert Grade II /
14 Salvador, Rainer Grade II /
15 Daza, Kaethlene Grade II /
16 Odtujan, Edilyn Grade II /
17 Laguardia, Mark Daniel Grade III /
18 Masayda, Joemer Grade III /
19 Regadillo, Eugene Grade III /
20 Santos, Marvin Grade III /
21 Sarsozo, Carlian Rex Grade III /
22 Rabeje, Mathew Grade III /
23 Bayrante, John Michael Grade IV /
24 Burao, Rhynel Grade IV /
25 Dayao, John Cedric Grade IV /
26 Elcano, Jhon Lloyd Grade IV /
27 Escuro, Steve Josh Grade IV /
28 Reparip, Joel Grade IV /
29 Masayda, Julie Rose Grade IV /
30 Clorado, Andrey Grade V /
31 Lascano, Adam Gabriel Grade V /
32 Morada, Jhon Carl Grade V /
33 San Juan, Jhon Kieth Grade V /
34 Pebres, Andrei Ash Grade V /
Annex F

35 Parilla, Jhon Helvin Grade VI /

36 Lerio, Colino Grade VI /
37 Malanyaon, Angel Grade VI /

Prepared by: APPROVED BY:

SALIMA G. ROSALES FRUCTOUSA JULIETA D. AZURIN

School Feeding Coordinator MT II/Officer In-Charge