Professional Documents
Culture Documents
Department of Education
Region ___
Note: This form shall be prepared by the school before the start of feeding to be compiled by the SDO.
SBFP Form 2 (2020)
Department of Education
Region ___
Division/Province: ______________________________________
School District/City/ Municipality : ____________________________
Name of District
Name of Schools BEIS ID No. School Address Name of Barangay Contact Number or & Total
Supervisors/
Email Address Beneficiaries
School Principal or OICs
Note: This form shall be prepared by the SDO before the start of feeding, for final consolidation by the RO.
SBFP Form 3 (2020)
Department of Education
Region ___
SCHOOL-BASED FEEDING PROGRAM (SBFP) SUMMARY OF BENEFICIARIES & START OF FEEDING (SY________)
Division/Province: ______________________________________
City/ Municipality/Barangay : ____________________________
Name of School / School District : _________________________
School ID Number: _________________________
Date of Start of Feeding: __________________________
Last Mile School: ___Y ___N
Nutritional Status at Start/End of Feeding No. of Secondary Targets No. of 4 No. of 4 Ps No. of Pupils
Learners Beneficiaries who are
SW W N OW+O SS S N T No. of Pupils- No. of No. of No. of Dewormed beneficiaries
Number of Undernourished School at-risk-of- in previous
Children by Grade Level Stunted/ Indigent Indigenous
dropping-out years
Severely Learners Peoples (IPs) (Repeaters)
(PARDOs) Stunted
1. Kinder
2. Grade I
3. Grade II
4. Grade III
5. Grade IV
6. Grade V
7. Grade VI
Total
______________________________________
School SBFP Coordinator School Head
Note: This form shall be prepared by the school before the start of feeding and after feeding, to be compiled by the SDO, and for final compilation by the RO, for submission to DepEd BLSS-SHD
Date Feeding
Started/Ended
DepEd BLSS-SHD
SBFP Form 4 (2020)
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL:
Prepared by:
__________________________
B. Deworming D. Actual Feeding
Feeding Teacher / School Nurse
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/M2/(H/M2)) - Present, served twice
Note: This form shall be prepared by the school to be consolidated using the Revised OKD Form A.
Page 5
SBFP Form 4 (2020)
ACTUAL FEEDING
NAME OF PUPIL
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL:
D. Actual Feeding
page 2
SBFP Form 4 (2020)
ACTUAL FEEDING
NAME OF PUPIL
61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL:
D. Actual Feeding
page 3
SBFP Form 4 (2020)
ACTUAL FEEDING
ATTENDANCE
NAME OF PUPIL No. of No. of
Days Feeding Percentage
Present Days
### 102 ### ### ### ### ### ### ### ### ### 112 113 114 115 116 117 118 119 120 (A) (B) (A/B)*100
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
TOTAL: AVERAGE:
D. Actual Feeding
page 4
SBFP Form 5 (2020)
DEPARTMENT OF EDUCATION
Region ____
REGION/DIVISION/DISTRICT: ____________________________________________________________________
NAME OF SCHOOL: ____________________________________________________________________
SCHOOL ID NO.: ____________________________________________________________________
NAME & DESIGNATION TEL. NO. MOBILE NO. EMAIL ADD SPECIMEN
SIGNATURE
1 (School Head)
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.
SBFP Form 5 (2020)
SBFP Form 6 (2020)
DEPARTMENT OF EDUCATION
Region ___
REGION/DIVISION/DISTRICT: ______________________________________________________________________________
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________
DEPARTMENT OF EDUCATION
Region ___
REGION/DIVISION/DISTRICT: ______________________________________________________________________________
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________
MENT OF EDUCATION
Region ___
VERIES (SY________)
Remarks
SBFP Form 7 (2020)
DEPARTMENT OF EDUCATION
Region ___
REGION/DIVISION/DISTRICT: ______________________________________________________________________________
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________
TOTAL:
8
9
10
TOTAL:
3
4
5
6
7
8
9
10
TOTAL:
ENT OF EDUCATION
Region ___
Number of Milk
Allocation
DEPARTMENT OF EDUCATION
Region ___
Region/Division: ____________________
Financial Status
Status of Implementation
(when Amount Liquidation Remarks (state if
Target No. Actual No. % Status of
No. of SDO started, completed, Downloaded fully/partially
Division/Schools of SBFP of SBFP downloading of
Schools (SBFP discontinue, for Amount to /Received liquidated &
Schools Schools Schools/SDO funds to Schools Disbursed
Schools) continuation or number of Allocated by SDOs or reason)
or to NDA/PCC for
feeding days completed) NDA/PCC 1st 2nd
milk
for milk
RO/SDO Accountant