Brigada Appendices2 Blank

Appendix B
BE Form 01 Republic of the Philippines

Department of Education
Negros Island Region
Division of Negros Occidental
VALLADOLID NATIONAL HIGH SCHOOL –AYUNGON ANNEX
School Year 2019-2020
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 Needed Materials Resources Needed Manpower Needed
( Check One) (e.g. repair, repainting, (Indicate kind and quantity) (Indicate quantity and
Replacement etc. nature of labor services
needed)
Satisfactory Unsatisfactory If unsatisfactory describe the problem
 Roof/ gutters /
 Ceilings /
 Walls
 Blackboards
 Chairs/desks/tables
 Water facilities
Drainage system
 Signage
 School Garden
 Lighting
 Windows
 Doors
 Comfort Rooms
 School Grounds
 School Clinic
 School Fence
 Others, please specify
Prepared by: Noted:
____________________ __________________________ MELJORIE C. MUYCO MARITESS B. RIVERA

School Physical Facilities Coordinator Date of Inspection Teacher In -charge Principal II
Appendix C

VALLADOLID NATIONAL HIGH SCHOOL-AYUNGON ANNEX
BRIGADA ESKWELA
SCHOOL WORK PLAN
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.
KRA Activities Timeline Person/s Responsible Materials Needed Budget
1. Advocacy and Marketing Paper, photocopier, printer
Cellphones; social media 100 Php
2. Resource Mobilization
3. Implementation Paints, thinner, PVC pipe, tee,

clip & elbow , paint brush,
roller, faucet, nails, vulca
sealwelding rod, sand & gravel
4. Monitoring and Evaluation
5. Reporting
Prepared by: Noted:
________________________________ _____________________________ _______________________________

Signature over Printed Name Date Prepared ASP Division Coordinator/ BE Coordinator
Appendix D

VALLADOLID NATIONAL HIGH SCHOOL- AYUNGON ANNEX
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 Persons/ Organization Strategies/ Plan of Action Person Responsible Status Remarks
to be Tapped
White latex
Roller
plastic faucet
nails
PVC pipe
PVC elbow
PVC tee
PVC clip
Vulcaseal
Paint brush
Black paint
Thinner
Bue tinting
Brown paint
Labor Skills/Volunteers Quantity Key Persons/ Organization Strategies/ Plan of Action Person Responsible Status Remarks
Needed to be Tapped
Prepared by: Noted by:
________________________________ MELJORIE C. MUYCO MARITESS B. RIVERA

Resource Mobilization Committee Chairperson Teacher In -charge Principal II
Appendix E
BRIGADA ESKWELA
DAILY ATTENDANCE OF VOLUNTEERS
Instruction: 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.
*NATURE OF
NAME POSITION/DESIGNATION ADDRESS/ORGANIZATION/ CONTACT TIME SIGNATURE TOTAL NUMBER VOLUNTEER
AFFILIATION NUMBER IN OUT OF HOURS SERVICES
SERVED RENDERED
Noted:
MELJORIE C. MUYCO MARITESS B. RIVERA
Teacher In-charge Principal II
Appendix F
BRIGADA ESKWELA
RECORD OF DONATIONS RECEIVED
(To be accomplished by the Documentation Committee)
ITEMS OR MATERIALS QUANTITY DATE RECEIVED NAME OF DONOR ASSUMED COST OF TOTAL
PER UNIT TOTAL
Bread 100 pcs May 20, 2019 Brgy. Batuan Council 2.00 200.00
Cracked Eggs 150 pcs May 20, 2019 V4 Farms 5.00 750.00
Paints 13 gallons May 20, 2019 Valladolid LGU 500.00 6500.00
Bread 100 pcs May 21, 2019 Guinturilan Council 2.00 200.00
Juice 9 pcs May 21, 2019 Guinturilan Council 24.00 216.00

Thinner 3 bottles May 21, 2019 Guinturilan Council 33.00 100.00
May 21, 2019 SB Rolando Gremio 100.00

Food
3 pcs May 21, 2019 Ma. Angelene Paderna 100.00
Roller Brush
Prepared by: Noted:

_________________________ Teacher In- charge Principal II
Appendix F

BRIGADA ESKWELA
RECORD OF DONATIONS RECEIVED
(To be accomplished by the Documentation Committee)
ITEMS OR MATERIALS QUANTITY DATE RECEIVED NAME OF DONOR ASSUMED COST OF TOTAL
PER UNIT TOTAL
School Supplies May 22, 2019 Pamela Yanos 1000.00
Bread 50 pcs May 22, 2019 BFP 2.00 100.00
Paint 1 liter May 23, 2019 Anthony Paul Tayo 200.00 200.00
Vulcanic Soil 1 truck load May 23, 2019 Engr. Romel P.Yogore 3500.00 3500.00
Notebooks 20 pcs May 23, 2019 Erene Joy Carbaquel 15.00 300.00
School Supplies May 24, 2019 SB Roel Yogore 2000.00
Stand Fan 1pc. May 24, 2019 Ruby Pamplega 800.00 800.00
Total
Prepared by: Noted:

Appendix G

BRIGADA ESKWELA
DAILY ACCOMPLISHMENT REPORT
(To be accomplished by THE Program Implementation Committee).
DAY 1 2 3 4 5 DATE:
Instruction: List down all the activities that needs to 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/RECOMENDATIONS
Completed Started but not yet Not Done
completed
Prepared by: Noted:

Appendix H
BRIGADA ESKWELA
DAILY ACCOMPLISHMENT REPORT
DIVISION:Negros Occidental REGION:VI
SCHOOL:Valladolid National High School- Ayungon Annex SCHOOL ID:
SCHOOL ADDRESS:Brgy. Ayungon, Valladolid, Negros Occidental
(Please check appropriate box)

Level: Type of School:
Elementary Central School
High School Non-Central School
Multigrade
Primary School
Integrated School
SCHOOL HEAD: Meljorie C. Muyco CONTACT NO.
PTCA PRESIDENT: Fernando Oberio 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
DEPARTMENT OF EDUCATION
C. VOLUNTEER SERVICES
No. of Volunteers
Type of Volunteer Name of individuals/organization ( Use Day 1 Day 2 Day 3 Day 4 Day 5 Day 6 Total
separate sheets, if needed
1. PTCA Member
2. Barangay Officials
3. Municipal/ City Government

Officials
4. Provincial Government Officials
5. NGO’s Civic Organization
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
DEPARTMENT OF EDUCATION
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. SIGNIFICANT EVENTS/EXPERIENCES (Use separate sheets, if needed)

What happened? Who were involved? When? What is/are important contribution to 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

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Appendix B

BE Form 01 Republic of the Philippines

____________________ __________________________ MELJORIE C. MUYCO MARITESS B. RIVERA

BE Form 02 Republic of the Philippines

Cellphones; social media 100 Php

3. Implementation Paints, thinner, PVC pipe, tee,

Prepared by: Noted:

________________________________ _____________________________ _______________________________

BE Form 03 Republic of the Philippines

________________________________ MELJORIE C. MUYCO MARITESS B. RIVERA

Paints 13 gallons May 20, 2019 Valladolid LGU 500.00 6500.00

Juice 9 pcs May 21, 2019 Guinturilan Council 24.00 216.00

May 21, 2019 SB Rolando Gremio 100.00

Prepared by: Noted:

BE Form 05 Republic of the Philippines

Prepared by: Noted:

BE Form 06 Republic of the Philippines

Prepared by: Noted:

(Please check appropriate box)

B. DONATIONS/MATERIAL RESOURCES GENERATED (Use separate sheets, if needed

3. Municipal/ City Government

5. NGO’s Civic Organization

8. Other Government Offices

12. Others (specify)

13. Prominent Volunteers

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

G. LESSONS LEARNED/BEST PRACTICES

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______ MELJORIE C. MUYCO MARITESS B. RIVERA

__________________ _ _________________