Department of Education: Republic of The Philippines

Republic of the Philippines
Department of Education
REGION XI
SCHOOLS DIVISION OF DAVAO DEL NORTE
Annex 1
Learning Resource Request Brief

Purpose
A Request Brief is a written explanation - given to the development and production team by
a requesting party or client to describe the specific service required and the general design
requirements of the resource to be developed or produced.
The purpose of this document is to describe in detail the service required and the design
requirements of a client/user for an existing resource that is to be reproduced, digitized, or
redeveloped and for the design of new resources. The brief outlines the competencies, learning
outcomes, objectives, and activities of a learning/teaching PD resource, the intended user of the
resource and the context or environment in which a resource will be used. It would also include
information relating to production output format, distribution and modes of preferred access.
A more thorough and articulate Design Brief which is a critical part of the design process will be
prepared as part of the Development and Production process. It helps develop trust and
understanding between the client and designer - and serves as an essential point of reference for
both parties.
Title of resource: FANBOYS: Coordinating Conjunctions

Type: Activity Sheet Services
Intended for: Grade VI Subject area(s): ENGLISH Requested
Grade/Year Check all
level(s): that apply (
Author(s): Rutchel R. Rebosura √)
Publisher: DepEd DavNor
/ Reproduce print resource in current format
Distributor /
/
Supplier: Digitize print resource
Copyright / year: 2020 design and layout
Retain current No. of pages: 7
Design and layout may be modified
Create new version in print format
/ Reproduce off-line digital resource in current format
/ Re-develop an existing resource:
Edit or correct or update content
/ Retain all content
Incorporate multimedia elements
/ Redesign the existing resource by converting to:
/ Print Digital (online)
Audio tape Manipulative
DVD/VCD Blended technology
Translate existing resource into a different language:
Filipino English
Mother tongue (specify)Visayan
/ Design and develop a new resource
/ Print
Multimedia
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Address: Mankilam, Tagum City, Davao del Norte
Telephone Number: (084) 216 0188
Website: www.depeddavnor.ph | Facebook: DepEd Davao del Norte
REGION XI
Blended
Master copy or original copy of the resource is attached
/ Yes
No
Evaluation forms of the resource is attached
/ Yes
No
Number of copies requested:
Packaging and distribution/delivery instructions (if required)
Catalogue the resource in LRMDS

/ Yes
No
General Description of the resource

Check all that apply ( √ )
Nature of resource
/ Learning resource
Teaching resource
Professional development materials (Complete Section 3.3, 3.4 and 8)
Current format
/ Print
Offline digital
DVD CD
VCD Audio tape
Video tape Other (specify)
Owner/Originator:
Author/Writer/s Name: Rutchel R. Rebosura
Name of Institution (School, Division, Guadalupe ES, Division of Davao Del Norte
Region, Bureau) R-XI
Publisher’s name (if commercially
developed)
Copyright owner: DepEd ,DavNor
Address and contact numbers: Mankilam, Tagum City
Year published: 2020

Copyright year: 2020
Curriculum/subject area/domain: K-12/English-VI/Grammar
Target Users:
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Telephone Number: (084) 216-6742 | Telefax (084) 216-6506
REGION XI
/ Grade/Year level/s (specify) Grade VI
Adult learners in ALS:
ADMs (specify):
SPED (Specify):
Others (Specify):
Context in which the resource is intended to be used

ALS
/ Classroom:
/ Mono-grade Multi-grade
/ Special programs
Special Science curriculum SPED (specify)
Voc-tech / Other (Distance Learning)
Modular
Special program for the Arts or other programs for the gifted
Alternative delivery modes (indicate modality and or program in which
the resource will be used)
Other: e.g. EASE to be used as a print and offline digital resource
Suggestions for redesign and development of an existing resource

Please provide the necessary information:
Key learning/teaching ideas/activity
Describe the key activity in relation to the concept that is intended to be learned.
This module is created to promote awareness and understanding on the effects of COVID-
19 on one’s community. Learners in the Grade IV level are expected to acquire the desirable
attitudes and practices to keep away from being infected with the deadly virus.
Describe the active learning processes in relation to knowledge, skills associated with the
domain/discipline.
In this module, the learners will be made to analyze and identify current events happening in
their family and community during the pandemic. Contextualized storyboard will make the learners
feel and relate easily with the situations discussed.
Describe the pedagogical/andragogical approach, e.g., simulated investigation and proposed

student interaction with data and information to be included.
This module is designed to immerse the learners in the process of finding out how
vulnerable they are and what they can do to protect themselves from being infected with COVID-
19.Learners are made to reflect on their actual experiences to relate with the topic discussed.
Key learning/teaching ideas/activity Awareness on the Effects of COVID-19 in one’s

community
Add any suggestions in relation to the realization of data and information. For example, “it is
important that the process being described is represented visually through interactive animations, or
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REGION XI
including game format activities”, etc. It would be best if the module will be converted into an
E-book format to make it more interactive and applicable to online learners.
 Specific technical and/or accessibility requirements: (Example, specification of font

size and kind for visually impaired, etc.) Arial Font size 14
Professional Development Resource

Complete this section for Requests to redesign and develop an existing Professional Development
resource.
Attach a copy of the existing resource to this Request.
NOTE: For Development and Production of a new Professional Development Resource a completed
Training and Development Program Design must be attached to this Request Brief.
Context in which this resource is to be used:

Mode of delivery
Face to face training with facilitator
/ Individualized/Self-paced learning
/ Mentoring
/ Coaching
Other (describe)Distance Learning
Target group:( identify) Grade VI Learners
NCBTS competencies: Specify, if not covered in NCBTS. Curriculum
Objectives to be covered: Composing Clear and Coherent Sentences Using Appropriate

Grammatical Structures: Coordinating Conjunctions
Topic/subject area Coordinating Conjunctions
Key Concepts Proper use of coordinating conjunctions
Request Brief prepared by: Rutchel R. Rebosura

Name of Requesting Party: DepEd Davnor
Contact details: 09674063989
Date: July 15, 2020
Annex 2
TEAM WORKPLAN
TITLE: FANBOYS: Coordinating Conjunctions
TEAM LEADER: Rutchel R. Rebosura
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REGION XI
TEAM ASSIGNMENT ASSIGNED DEADLINE SIGNATURE e-mail/Cell #
MEMBERS WRITERS/ MODULES
ILLUSTRATOR
EVALUATOR
Module 1 June 26, 2020
rutchel.rebos
Rutchel R. Writer ura@deped.g
Rebosura ov.ph/09066
912696
Module 1 July 3, 2020
Illustrator
Module 1 July 10, 2020
Evaluator
Annex 3
ILLUSTRATIONS SUMMARY AND APPROVAL SHEET

Title FANBOYS: Coordinating Conjunctions
Illustrator
Writer Rutchel R. Rebosura
Quarter 4 - Activity Sheet 1
Page No. Description Approved ( check Disapproved
Page 5 of 30
REGION XI
& affix date) Reason/s Suggestions
Page 2 Bird and butterfly / June 27, 2020
flying
Page 4 Big caterpillar directly / June 27, 2020
facing the learner with
emphasized body
sections
TOTAL NUMBER OF ILLUSTRATIONS: 3
Over-all Recommendations of Writer
All illustrations were approved and appropriate for the activities presented in the learning material.
This will be given by the writer to the illustrator as a reference and checklist for suggestions and
approval of assigned Illustrations.
RUTCHEL R. REBOSURA __________________________________

Writer (signature over printed name) Illustrator (signature over printed name)
Annex 4
Summary of Findings
Learning Area: English Region: XI

Grade Level: VI
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REGION XI
Paragraph / Lesson Number Brief description of Actions Taken
Line / Page errors/
number (in findings/observations
chronological
order)
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REGION XI
Let Us try/Page 1 The verb in the The previous verb
1/Item number sentence is incorrect was replaced with
2 the correct verb
tense as in “love”
from “loves”
Evaluator_____________ ___________________
Signature over Printed Name Date accomplished:
____________________________________
Position
ANNEX 5-A
WRITER’S/ARTWORK ASSIGNMENT AGREEMENT
This Agreement is made and entered this ___15th__ day of May 2020 by and between Rutchel R. Rebosura ,___Master Teacher I__ of
____Guadalupe Elementary School________ at _____Brgy, Guadalupe, Carmen, Davao del Norte__, hereinafter referred to as “Writer”;
The Department of Education, a government entity mandated by law, B.P. 232, otherwise known as the “Education Act of 1982”, as
amended by Republic Act No. 9155, otherwise known as “Governance of Basic Education Act of 2001”, with office address at DepEd Complex,
Meralco Avenue, Pasig City, represented herein by its Secretary, LEONOR MAGTOLIS BRIONES, hereinafter referred to as “DepEd”.
WHEREAS, Assignor is the copyright holder and owner of all proprietary interest in _____Brief description of Artwork to be assigned (to be filled our
by the BLR)_____ hereinafter referred to as “Work”.
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REGION XI
NOW THEREFORE, in consideration of the mutual promises, covenants, warranties, and good consideration set forth herein, the Parties agree as
follows:
1. Assignment of the Work. Assignor hereby irrevocably assigns to DepEd all right, title, and interest to the Work, including all copyright
ownership and interest in the creation of the Work. DepEd shall be the exclusive owner of the Work and of the copyright in the Work from
the date of this Agreement forward, and shall have the exclusive owner right to secure registration of the copyright of the Work with the
Intellectual Property Office. No rights in the work, or in the copyright in the Work, shall be retained by Assignor, nor shall there be any
reversion of those rights to Assignor in the future.
2. Consideration. In consideration of the assignment made by Assignor, as well as Assignor’s premises, representations, covenants, and
warranties under this Agreement, DepEd shall issue a Certificate of Recognition to Assignor and indicate the latter’s name as the
illustrator/author of the Work.
3. Assignor’s Representations and Warranties. Assignor represents and warrants as follows:
a. Assignor has the legal authority to grant the assignment of the Work, including all copyright and propriety interest therein, as
set forth in Section 1.
b. There are currently no licenses outstanding granting any other person or entity the right to enjoy or lay claim to any copyright
privileges in the Work, nor will Assignor attempt to grant ay such licenses at any time in the future. The Work, and all
copyright interest in the Work, is free and clear of any liens, security interests, or other encumbrances.
c. The Work does not infringe upon the rights, copyright or otherwise, of any other person or entity.
d. There are no claims currently pending or threatened, nor does Assignor have any reason to believe in the future, against
Assignor’s right, ownership or interest in the Work.
4. Indemnification. Assignor agrees to indemnify and hold harmless DepEd for any claims, suits, damages, actions, or other costs arising out
of any breach of Assignor’s warranties set forth in Section 3.
5. Choice of Law and Venue. This Agreement is governed by law and shall be construed in accordance with the laws of the Philippines. In
case of litigation, both parties agree that the venue should be the component Courts of Pasig City to the exclusion of all other courts.
6. Separability Clause. If any of the provisions of this Agreement becomes invalid, illegal, or unenforceable in any respect under any law, the
validity, legality, and enforceability of the remaining provisions shall not in any way be affected or impaired.
7. Effectivity. This agreement shall take effect immediately upon signing by the parties and shall supersede and replace any prior agreement
signed between the parties.
WAIVER OF RIGHTS
I waive all the rights, including any right of prior approval, and release the Department of Education from, and will neither sue nor bring any
proceeding against the Department of Education for, any claim or cause of action, whether now known or unknown, for defamation, copyright
infringement, and invasion of the rights to privacy, publicity, or personality or any similar matter, or based upon or relating to the use and exploitation
of the Content.
I agree that there is no obligation to use the authorization granted by me hereunder. The terms of this authorization commence on the date below and
continue in perpetuity.
RUTCHEL R. REBOSURA __________________________________________

Printed Name Signature
Writer ____ __ _Guadalupe Elementary School___________

Designation School/Office Address
_____________June 22, 2020____________ rutchel.rebosura@deped.gov.ph 09674063989

Date Email and contact number
ANNEX 5-B
This Agreement is made and entered this ___22nd__ day of June 2020 by and between _______________ ,__________ __ of
_________________ at _______________________________ __, hereinafter referred to as “Illustrator”;
Page 9 of 30
REGION XI
follows:
1. Assignment of the Work. Assignor hereby irrevocably assigns to DepEd all right, title, and interest to the Work, including all copyright ownership
and interest in the creation of the Work. DepEd shall be the exclusive owner of the Work and of the copyright in the Work from the date of this
Agreement forward, and shall have the exclusive owner right to secure registration of the copyright of the Work with the Intellectual Property
Office. No rights in the work, or in the copyright in the Work, shall be retained by Assignor, nor shall there be any reversion of those rights to
Assignor in the future.
2. Consideration. In consideration of the assignment made by Assignor, as well as Assignor’s premises, representations, covenants, and warranties
under this Agreement, DepEd shall issue a Certificate of Recognition to Assignor and indicate the latter’s name as the illustrator/ author of the
Work.
a. Assignor has the legal authority to grant the assignment of the Work, including all copyright and propriety interest therein, as set
forth in Section 1.
privileges in the Work, nor will Assignor attempt to grant ay such licenses at any time in the future. The Work, and all copyright
interest in the Work, is free and clear of any liens, security interests, or other encumbrances.
d. There are no claims currently pending or threatened, nor does Assignor have any reason to believe in the future, against Assignor’s
right, ownership or interest in the Work.
4. Indemnification. Assignor agrees to indemnify and hold harmless DepEd for any claims, suits, damages, actions, or other costs arising out of any
breach of Assignor’s warranties set forth in Section 3.
5. Choice of Law and Venue. This Agreement is governed by law and shall be construed in accordance with the laws of the Philippines. In case of
litigation, both parties agree that the venue should be the component Courts of Pasig City to the exclusion of all other courts.
6. Separability Clause. If any of the provisions of this Agreement becomes invalid, illegal, or unenforceable in any respect under any law, the validity,
legality, and enforceability of the remaining provisions shall not in any way be affected or impaired.
7. Effectivity. This agreement shall take effect immediately upon signing by the parties and shall supersede and replace any prior agreement signed
between the parties.
WAIVER OF RIGHTS
of the Content.
_____________________________ __________________________________________
Illustrator ____ __ ________________________ ___________

_____________June 22, 2020______________ ______________________________

ANNEX 5-C
This Agreement is made and entered this ___15th__ day of July 2020 by and between _______________ ,__________ __ of
_________________ at _______________________________ __, hereinafter referred to as “Evaluator”;
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REGION XI
follows:
1. Assignment of the Work. Assignor hereby irrevocably assigns to DepEd all right, title, and interest to the Work, including all copyright ownership
and interest in the creation of the Work. DepEd shall be the exclusive owner of the Work and of the copyright in the Work from the date of this
Agreement forward, and shall have the exclusive owner right to secure registration of the copyright of the Work with the Intellectual Property
Office. No rights in the work, or in the copyright in the Work, shall be retained by Assignor, nor shall there be any reversion of those rights to
Assignor in the future.
2. Consideration. In consideration of the assignment made by Assignor, as well as Assignor’s premises, representations, covenants, and warranties
under this Agreement, DepEd shall issue a Certificate of Recognition to Assignor and indicate the latter’s name as the illustrator/ author of the
Work.
a. Assignor has the legal authority to grant the assignment of the Work, including all copyright and propriety interest therein, as set
forth in Section 1.
privileges in the Work, nor will Assignor attempt to grant ay such licenses at any time in the future. The Work, and all copyright
interest in the Work, is free and clear of any liens, security interests, or other encumbrances.
d. There are no claims currently pending or threatened, nor does Assignor have any reason to believe in the future, against Assignor’s
right, ownership or interest in the Work.
4. Indemnification. Assignor agrees to indemnify and hold harmless DepEd for any claims, suits, damages, actions, or other costs arising out of any
breach of Assignor’s warranties set forth in Section 3.
5. Choice of Law and Venue. This Agreement is governed by law and shall be construed in accordance with the laws of the Philippines. In case of
litigation, both parties agree that the venue should be the component Courts of Pasig City to the exclusion of all other courts.
6. Separability Clause. If any of the provisions of this Agreement becomes invalid, illegal, or unenforceable in any respect under any law, the validity,
legality, and enforceability of the remaining provisions shall not in any way be affected or impaired.
7. Effectivity. This agreement shall take effect immediately upon signing by the parties and shall supersede and replace any prior agreement signed
between the parties.
WAIVER OF RIGHTS
of the Content.
_____________________________ __________________________________________
Evaluator ____ __ ________________________ ___________

_____________July 15, 2020____________ ______________________________

Annex 6-A
CONTENT EVALUATION TOOL
DepEd-developed Learning Resource
Learning Area: English
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REGION XI
Title : FANBOYS: Coordinating Conjunctions
Grade Level : VI
Review the learning resource based on the following criteria. Tick the appropriate column
found beside each criterion item. If your answer is NO, cite specific pages, briefly indicate
the errors found, and give your recommendations in the attached Summary of Findings
form. Based on the requirement indicated under each criterion put a check () mark in
the appropriate column for complied or not. Write Not Applicable (NA) for items that are
not appropriate in the material evaluated.
Criterion Items Yes No
I. Intellectual Property Rights Compliance
1. The learning resource has no copyright violations.
2. The LR is free from plagiarism.
3. The copyrighted materials used in the LR are cited.
4. The copyrighted materials used in the LR are
accurately cited.
Compli Not
ed Compli
(Note: At least 3 items are YES to comply the criterion)
ed
II. Learning Competencies

Content is consistent with the targeted DepEd Learning
Competencies intended for the learning area and grade
level.
Compli Not
ed Compli
(Note: The item is YES to comply the criterion)
ed
III. Instructional Design and Organization of Material

1. Content is suitable to the learner’s level of
development, needs, and experience.
2. Content reinforces, enriches, and / or leads to the
mastery of the targeted learning competencies
intended for the learning area and grade level.
3. Content is logically developed and organized
throughout the material.
4. The LR contains useful introductions, reviews,
summaries, and other devices that facilitate smooth
progression from one lesson to another.
5. Development of lessons allows for review, comparison,
and integration with previous lessons.
6. The LR develops higher cognitive skills (e.g., critical
thinking skills, creativity, learning by doing, problem
solving) and 21st century skills.
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REGION XI
7. The LR enhances the development of desirable values
and traits such as. (Mark the appropriate box with an
“X” applicable values and traits only)
7.1 Pride in being a 7.2 Scientific attitude
Filipino and reasoning
7.3 Desire for excellence 7.4 Love for country
7.5 Helpfulness, 7.6 Unity
teamwork, cooperation
7.7 Desire to learn new 7.8 Honesty &
things trustworthiness
a. Ability to know right 7.10 Respect
from wrong
7.11 Critical and creative 7.12 Productive work
thinking
7.13 Others (Please specify)
____________________________
Compli Not
(Note: At least 5 items are YES to comply the ed Compli
criterion) ed
III. Instructional Quality

1. The LR contributes to the achievement of specific
objectives of the learning area and grade level for
which it is intended.
2. Level of difficulty is appropriate for the intended user.
3. Material arouses interest of target learner.
4. The LR is free from any social content violations.
5. Content and information are accurate and up-to-date.
6. LR is free from factual errors.
7. LR is free from computational errors.
8. LR is free from grammatical errors.
9. LR uses various types of teaching and learning
strategies responsive to individual learning styles.
10.Adequate warning/cautionary notes are provided in
topics and activities where safety and health are of
concern. ( For applicable LR)
Compli Not
criterion) ed
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REGION XI
IV. Assessment
1. The LR provides useful measures and information that
help the teacher evaluate learner’s progress in
mastering the target competencies.
2. Assessments are suitable, aligned with the objectives
and content.
3. The LR provides “self-checks,” ready-made
achievement tests, and/or periodic review activities.
4. The LR provides variety of assessments types.

5. Activities, exercises, and tasks provide for varying
learning arrangements such as individual, dyad, triad,
and others.
6. Assessments have clear demonstration / examples,
instructions, and/or rubrics to serve as guide on how
these will be used.
7. Variety of activities within the LR are utilized to
ensure active engagement of the learners.
Compli Not
criterion) ed
II. Presentation and Organization

1. Presentation is interesting, engaging, and
understandable.
2. There is logical and smooth flow of ideas.
3. Vocabulary level is adapted to target users’ experience
and understanding.
4. Length of sentences is suited to the comprehension
level of the target user.
5. Sentences and paragraph structures are varied and
appropriate to the target user.
Compli Not
(Note: At least 3 items are YES to comply the
ed Compli
criterion)
ed
III. The Teacher’s Support Material or TSM (if
applicable):
1. Gives enough general guidance to the teacher.
2. Gives enough information about the methodology.
3. Explains the rationale behind the activities, exercises,
and tasks.
4. Tells the teacher how to plan each lesson.
5. Provides practical tips on teaching the skills and
subskills.
6. Encourages / allows the teacher to use their own
sources / ideas / techniques.
7. Is easy to use.
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REGION XI
Compli Not
(Note: At least 4 items are YES to comply the
ed Compli
criterion)
ed
Recommendation: (Please put a check mark ( ) in the appropriate box.)
 Minor revision. This material is found compliant to all criteria. However,

minimal revision is recommended following the summary of findings and LR with
marginal notes.
 Major revision. This material is non-compliant to any of the criteria thus, major
revision is recommended following the summary of findings and LR with
marginal notes.
 For field validation. This material is found compliant to all criteria with NO
corrections.
I / We certify that this summary report and recommendation(s) are my / our own and
have been made without any undue influence from others.
Evaluators(s): ________________________________________________________
Signature(s): ________________________________________________________
Date accomplished: ___________________________
Annex 6- B
LANGUAGE EVALUATION TOOL

Learning Area: English Grade: VI
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REGION XI
Title: FANBOYS: Coordinating Conjunctions

I. Coherence and Clarity of Thought
1. Do the statements / phrases make sense?
2. Do the sentences in the paragraph contribute to one
idea?
3. Are the thoughts / ideas logically sequenced?
4. Are conjunctions and transitional phrases used to
link sentences or paragraphs?
5. Is the choice of words / expressions appropriate?
6. `Are the sentences too long or complex?
7. Is the language appropriate for the target readers?
8. Are the headings or titles appropriate to the content?
9. Is there proportional or equal treatment of topics of
the same importance?
Compli Not
(Note: At least 7 items are YES to comply the criterion) ed Compli
ed
II. Grammar and Syntax

1. Is there
agreement between subject and verb ?
2. Is their
misplaced modifier?
3. Are there
unclear antecedents?
4. Is there faulty
parallel construction?
5. Are there split
infinitives?
6. Are there
overuse of certain words?
7. Are there
redundancies
Compli Not
ed
III. Spelling and Punctuation
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REGION XI
1. Are words, whether local or foreign, correctly
spelled?
2. Are the right punctuations in the right places?
3. Is the use of the serial comma (comma before
and and or) observed?
(Note: At least 2 items are YES to comply the criterion) Compli Not
ed Compli
ed
IV. Consistency in Style

1. Where alternative spellings are permitted, was a
choice made and used consistently throughout the
materials?
2. Are main heads, subheads, sections, and
subsections consistently classified?
3. Is the need for the same tense or person observed?
4. Are the rules on capitalization, hyphenation,
setting off in italics or boldface followed?
5. Is there consistence in phraseology of titles,
presentation or introduction of new chapters or units?
Compli Not
ed
Translation (for Contextualized LRs)

1. Original text is accurately rendered. Nuances of
meaning are precisely captured.
2. Translation is fluent, smooth, and readable for the
target user.
3. Vocabulary and idioms respond accurately to the
original text.
4. Vocabulary is adapted to the target user’s experience
and understanding.
5. Correct syntax and orthography are followed.
6. Lessons, instructions, exercises, questions, and
activities are clear to the intended user.
7. Right mechanics of writing is followed.
8. Sentences are clear, short, and simple.
Compli Not
ed Compli
(Note: At least 6 items are YES to comply the criterion) ed
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REGION XI
 Minor revision. This material is found compliant to all criteria. However, minimal
revision is recommended following the summary of findings and LR with marginal
notes.
revision is recommended following the summary of findings and LR with marginal
notes.
corrections.
(Please sign below and at the back of each previous page.)

Evaluators(s): ________________________________________________________
Signature(s): ________________________________________________________
Date accomplished: ___________________________
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REGION XI
Annex 6- C
EVALUATION TOOL FOR LAYOUT AND FORMAT

Learning Area: English Grade: VI

Title: FANBOYS: Coordinating Conjunctions

1. Physical Attributes
1.1 Cover Page
1.1.1 Cover art is appropriate, relevant, and
interesting.
1.1.2 Cover elements are correct and complete.(i.e.,
w/ grade indicator & learning area, book title &
type (LM, TG), cover art, DepEd text entries,
spine entries, back cover entries (feedback box
and ISBN)
1.2 Front matter
1.1.2 All necessary elements are complete: title page,
copyright page, table of contents, and
introduction / preface (optional)
1.2.2 Page numbers are set in 12 points lowercase
roman numerals; centered at the bottom of the
page; no page numbers on the title and
copyright pages
1.3 Inside pages
1.3.1 All beginning pages for units / chapters
consistently fall on the right-hand pages.
1.3.2 Pagination is set in 12 points Arabic numerals
and centered at the bottom of the page.
1.3.3 There are no lines which are too loose or too
tight; consistent spaces between lines; too big or
too small spaces between words and
paragraphs.
1.3.4 Page endings do not end with a hyphenated
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REGION XI
word or an awkward page turn. (i.e., There are at
least two lines of text below a text head at the
foot of a page)
1.3.5 Texts in each page are of the same length.
1.3.6 There are a maximum of only three consecutive
hyphenated words in a paragraph.
1.3.7 Pages have no bad breaks which affect
readability.
1.4 Back Matter Pages
Has useful back matter pages (e.g., glossary,
bibliography, index, appendix, etc.)
Compl Not
(Note: At least 10 items are YES to comply the criterion) ied Complie
d
2. Book Layout and Design

2.1 Unit/chapter/lesson titles & subheads are
consistent in style
2.1 Attractive and pleasing to look at
2.2 Simple (i.e., does not distract the attention of the
reader)
2.3 Adequate illustration in relation to text
2.4 Harmonious blending of elements (e.g.,
illustrations & text)
2.5 Interesting
2.6 Suitable to the target users
Compl Not
(Note: At least 5 items are YES to comply the criterion) ied Complie
d
3. Typographical Organization (e.g., size of letters, choice

of font, use of boldface and italics, etc.)
1.1 Size of letters is appropriate to the intended user.
1.2 Font styles used are appropriate for the target user
and easy to read.
1.3 Size of letters and choice of font enable the target
users to easily identify themes / ideas and rank
them in order of importance?
3.4 The use of boldface and italics are relevant and
appropriate to the text.
3.5 Spaces between letters and words facilitate reading.

Compl Not
ied Complie
(Note: At least 3 items are YES to comply the criterion)
d
Page 20 of
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REGION XI
2. Visuals (e.g., illustrations, photographs, maps, tables,
graphs, etc.)
7.3.1 Visuals illustrate and clarify the concept / lesson
and facilitate comprehension.
7.2 Visuals are relevant to the learner’s age, culture,
life situation, and gender.
7.3 Visuals are artistically appealing, simple, and
easily recognizable.
7.4 Visuals sustain interest and do not distract the
learner’s attention.
7.4 Visuals are consistently clear in content and detail.
7.5 Visuals are realistic and use appropriate color
(optional) where needed.
7.6 Supplement body text are found on the same page
as the text citation.
7.7 Visuals are placed appropriately in the page and
are in their intended final size.
7.8 Visuals are in greyscale (black-and-white)
illustrations for black-and-white reproduction.
7.9 Visual are not shaded to avoid poorly and blotchy
printed pages.
7.10 Visuals have captions (if needed) and credits (or
sources) indicated along with the text.
7.11 Illustrations of animals and people are not facing
outside the page.
7.12 Illustrations of a process involving separate steps
or actions should have at least as many individual
pictures or frames.
Compl Not
(Note: At least 3 items are YES to comply the ied Complie
criterion) d
 Minor revision. This material is found compliant to all criteria. However,

minimal revision is recommended following the summary of findings and LR with
marginal notes.
revision is recommended following the summary of findings and LR with
marginal notes.
corrections.
Page 21 of
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REGION XI
(Please sign below and at the back of each previous page.)
Evaluators(s): ______________________________
Signature(s): ______________________________
Date accomplished: ______________________________
Page 22 of
30
REGION XI
Annex 7
COPYRIGHT ORIGINALITY FORM
Entered here are contents originally developed for the learning resource assigned. As agreed, the copyright will be
assigned to DepEd with all considerations listed in LRC Forms 1 (Writer’s Assignment Agreement) and 2 (Artwork
Assignment Agreement).
Title of Learning Resource: FANBOYS: Coordinating Conjunctions

Grade Level/ Program: Grade VI
Type of Learning Resource: Self-Learning Activity Sheet in English VI
Title/Description of the Work Creator Conditions of Use (Not outlined in

LRC Forms 1 and 2)
FANBOYS:Coordinating Rutchel R. Rebosura Reproduce the material

Conjunctions- Self-Learning Writer
Activity Sheet in English VI
Illustrator
Evaluator
Prepared by
RUTCHEL R. REBOSURA
Writer
Page 23 of
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REGION XI
Annex 8
LEARNING RESOURCE MANAGEMENT AND DEVELOPMENT SYSTEM (LRMDS)
General Technical Educational Rights Comments

General
* Indicates Required Field
Title* FANBOYS: Coordinating Conjunctions
Language* English
Keyword FANBOYS
Description* This material tells the different coordinating conjunctions and how to make
grammatically correct sentences using them.
General Technical Educational Rights Comments

Educational
Material ____/_ Curriculum _____ Professional Development
Type*
Education Elementary School

Type*
Grade Level* VI
Intended User Learners
Learning Area* Grade VI- English
Content / Topic* Grade VI- Coordinating Conjunctions
Content Standards Grade VI – English Grammar –Demonstrates command of the conventions of

Standard English grammar and usage when writing or speaking
Performance Grade VI – English Grammar –Speaks and writes using good command of the
Standards conventions of Standard English
Competencies Grade VI – English Grammar –Compose clear and coherent sentences using
appropriate grammatical structures: Conjunctions (Coordinating Conjunctions)
Resource Type* Learning Material, Print Material, Activity Sheet
Objective/s Composing Clear and Coherent Sentences Using Appropriate Grammatical

Structures: Coordinating Conjunctions
Page 24 of
30
REGION XI
Accessibility LRMS DepEd Davao del Norte
General Educational Rights

Rights
* Indicates Required Field
Developer Rutchel R. Rebosura
Copyright*
Copyright Owner* DepEd Davao del Norte
Page 25 of
30
REGION XI
Annex 9
INVENTORY OF THIRD-PARTY CONTENTS
This inventory is separate from the Development Catalog, whose sole purpose is to aid
decision-making on whether to enter into an agreement with collective management
organizations.
Title of Learning Resource: ________________________________________

Grade Level/ Program: _____________________
Type of Learning Resource: _______________________________
Title/ Creator Copyright Source and Nature of Conditions of

Description Holder Contact Copying Use
of Third- Detail
party
Content
Prepared by:
________________________
Writer
Page 26 of
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REGION XI
Annex 10
PROFORMA COMMUNICATIONS SEEKING PERMISSION TO COPY
[Date]
[Name of Copyright Owner]
[Address of Copyright Owner]
Subject: Request for Copyright Permission
Dear [Name of Copyright Owner or Agent]:
We are writing to ask for permission to use [specific title of work or content of work to be
copied] from your work entitled [title of book or the work from where the specific content
will be copied from].
The said content/s will be essential in attaining the objectives of the learning resource
[title of assigned learning resource] for use by public school learners in the Philippines.
Use of selected work includes distribution in printed and digital forms and conversion
into other formats such as, among others, ebook, interactive material, and radio-based
material, subject to the following limitations:
1. Rightful owners will be attributed properly.
2. Learning resource produced is purely educational and noncommercial.
3. Copied contents will not violate moral rights of the rightful owners.
4. Copying is only for the specified learning resources.
5. Copyright remains with their rightful owners.
Please complete and return the conforme slip at your earliest convenience.
Thank you very much.
Sincerely yours,
[Name of Developer, Position, and Contact Information]

CONFORME:
Page 27 of
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REGION XI
Annex 11
MODEL RELEASE FORM
Name of person photographed

Address
Telephone
Email
Date(s) of Photoshoot
Location(s) of Photoshoot
THIS MODEL AGREEMENT AND RELEASE is dated __________________________________

and is between ____________________(Photographer) and __________________ (model).
Agreement as follows:
I hereby grant the above mentioned Photographer permission to photograph me. I further
give him/her my irrevocable consent to use, reuse, publish, republish, the photographs in
whole or in part in printed learning resources. I waive any rights to intellectual property,
royalties, or other compensation arising from or related to the use of the photos.
Model Name
Address
Email
Model’s Signature and Date
*If the Model is under 18 years of age, a parent or legal guardian must also sign.
PARENT/GUARDIAN SIGNATURE:
DATE:____________________________________
Annex 12
Page 28 of
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REGION XI
SPECIALTY CLEARANCE
CERTIFICATION
This is to certify that the Self Learning Activity Sheets- (FANBOYS:

Coordinating Conjunctions) for Grade VI developed by Development TEAM underwent
quality assurance to check that all recommended revisions are correctly and sufficiently
implemented in the ready-to-print copy of the LR. The said LR is found to be free of
content, language, and layout and format errors, and suitable for use.
This certification is issued on ____________ for whatever legal purpose it may serve.
QA/Review team members:
__________________________ ________________________
__________________________
__________________________ ________________________
__________________________
Approved by:
DEE D. SILVA, DPA, CESO V

Schools Division Superintendent
Annex 13
Page 29 of
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REGION XI
Certification
This is to certify that the following Grade 6 Self Learning Activity Sheet reviewed, validated
and finalized are free from content, language, layout and format errors, plagiarism and
copyright infringement. Hence, the undermentioned learning resources are deemed ready
to print and ready for conversion to other formats.
Learning Resource Name of Digital File

Grade VI- Quarter 4 Activity Sheet 1 FANBOYS
Issued this 20th day of August, 2020.
Recommending approval:
DR. EDUARD C. AMOGUIS

CID- Chief
Approved by:
DEE D. SILVA, DPA, CESO V

Schools Division Superintendent
Not valid without the dry seal
Page 30 of
30

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Learning Resource Request Brief

Title of resource: FANBOYS: Coordinating Conjunctions

Catalogue the resource in LRMDS

General Description of the resource

Year published: 2020

Context in which the resource is intended to be used

Suggestions for redesign and development of an existing resource

Describe the pedagogical/andragogical approach, e.g., simulated investigation and proposed

Key learning/teaching ideas/activity Awareness on the Effects of COVID-19 in one’s

 Specific technical and/or accessibility requirements: (Example, specification of font

Professional Development Resource

Context in which this resource is to be used:

NCBTS competencies: Specify, if not covered in NCBTS. Curriculum

Objectives to be covered: Composing Clear and Coherent Sentences Using Appropriate

Topic/subject area Coordinating Conjunctions

Key Concepts Proper use of coordinating conjunctions

Request Brief prepared by: Rutchel R. Rebosura

TEAM LEADER: Rutchel R. Rebosura

Module 1 July 3, 2020

Module 1 July 10, 2020

ILLUSTRATIONS SUMMARY AND APPROVAL SHEET

TOTAL NUMBER OF ILLUSTRATIONS: 3

Over-all Recommendations of Writer

RUTCHEL R. REBOSURA __________________________________

Learning Area: English Region: XI

WRITER’S/ARTWORK ASSIGNMENT AGREEMENT

RUTCHEL R. REBOSURA __________________________________________

Writer ____ __ _Guadalupe Elementary School___________

_____________June 22, 2020____________ rutchel.rebosura@deped.gov.ph 09674063989

WRITER’S/ARTWORK ASSIGNMENT AGREEMENT

Illustrator ____ __ ________________________ ___________

_____________June 22, 2020______________ ______________________________

WRITER’S/ARTWORK ASSIGNMENT AGREEMENT

Evaluator ____ __ ________________________ ___________

_____________July 15, 2020____________ ______________________________

II. Learning Competencies

III. Instructional Design and Organization of Material

III. Instructional Quality

4. The LR provides variety of assessments types.

II. Presentation and Organization

Recommendation: (Please put a check mark ( ) in the appropriate box.)

 Minor revision. This material is found compliant to all criteria. However,

LANGUAGE EVALUATION TOOL

Learning Area: English Grade: VI

Criterion Items Yes No

II. Grammar and Syntax

III. Spelling and Punctuation

IV. Consistency in Style

Translation (for Contextualized LRs)

Recommendation: (Please put a check mark ( ) in the appropriate box.)

(Please sign below and at the back of each previous page.)

EVALUATION TOOL FOR LAYOUT AND FORMAT

Learning Area: English Grade: VI

Criterion Items Yes No

2. Book Layout and Design

3. Typographical Organization (e.g., size of letters, choice

3.5 Spaces between letters and words facilitate reading.

Recommendation: (Please put a check mark ( ) in the appropriate box.)

 Minor revision. This material is found compliant to all criteria. However,

Date accomplished: ______________________________

COPYRIGHT ORIGINALITY FORM

Title of Learning Resource: FANBOYS: Coordinating Conjunctions

Writer __ _Guadalupe Elementary School___________

_June 22, 2020 rutchel.rebosura@deped.gov.ph 09674063989

Illustrator ____________ _

_June 22, 2020 ____________________

Evaluator ____________ _

_July 15, 2020 __________________