ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 01

As of March 31, 2019

Region: 1
Division: Ilocos Norte
School: Suba Elem. School
Address: Bgy. 15 Suba Paoay, Ilocos Norte
1st Quarter
School ID: 100193
Contact Nos.: _____________________ Email Address: _________________________

LEARNING ENVIRONMENT
DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. CLASSROOM

New Construction

Rehabilitation/Repair Paint 12 5,230.00 PTA Donation 3/10/2019

2. FURNITURE Wooden Conference Table 1 8,000.00 PTA Donation 3/18/2019

Wooden Teacher's Chair 1 2,000.00 PTA Donation 2/26/2019

Mr. & Mrs. William Baddion and

3. AUDIO-VISUAL LED TV 1 14,999.00 Mr. & Mrs. Sherwin Alonzo
3/15/2019

EDUCATIONAL MATERIALS

4 OTHERS PLS. SPECIFY Kitchen Utensils 1 set 500.00 Alumni Batch 1990 Donation
3/15/2019

TOTAL 30,729.00

* Please attach the following documents: Prepared by: Noted by:

1. Deed of Donation
2. Deed of Acceptance TERESITA BABY P. CACAYORIN
Head Teacher I ASP Division Coordinator

Approved by:
VILMA D. EDA, CESO V
Schools Division Superintendent
 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 02
As of March 31, 2018
Region: 1
Division: Ilocos Norte
School: Suba Elem. School
Address: Bgy. 15 Suba Paoay, Ilocos Norte
1st Quarter
School ID: 100193
Contact Nos.: _____________________ Email Address: _________________________

LEARNING SUPPORT
DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

Mr. & Mrs. William Baddion and

1. AUDIO-VISUAL LED TV 1 14,999.00 Mr. & Mrs. Sherwin Alonzo 3/15/2019
EDUCATIONAL MATERIALS

2. SCHOOL SUPPLIES

3. EDUCATIONAL FILM/
LIBRARIES

4. OTHERS PLS. SPECIFY

TOTAL 1 14,999.00

* Please attach the following documents: Prepared by: Noted by:

1. Deed of Donation
2. Deed of Acceptance TERESITA BABY P. CACAYORIN
Head Teacher I ASP Division Coordinator

Approved by:
 VILMA D. EDA, CESO V aspsch_form 02
Schools Division Superintendent
 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 03
As of June 30, 2018
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

TECHNOLOGY SUPPORT
DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. COMPUTER

2. ELECTRONIC LEARNING
MATERIALS

3. INTERNET CONNECTIVITY

4. OTHERS PLS. SPECIFY

TOTAL -

* Please attach the following documents: Prepared by: Noted by:

1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:
 aspsch_form 03
Schools Division Superintendent
 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 04
As of March 31, 2019
Region: 1
Division: Ilocos Norte
School: Suba Elem. School
Address: Bgy. 15 Suba Paoay, Ilocos Norte
1st Quarter
School ID: 100193
Contact Nos.: _____________________ Email Address: _________________________

HEALTH AND NUTRITION

DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. FEEDING PROGRAM

2. MEDICAL/DENTAL
MISSION/CHECK-UPS

3. DEWORMING
INTERVENTION

4. HEALTH SUPPLIES

Alumni Batch 1990

5. OTHERS PLS. SPECIFY Kitchen Utensils 1 set 500.00
Donation 3/15/2019

TOTAL 500.00

* Please attach the following documents: Prepared by: Noted by:

1. Deed of Donation
2. Deed of Acceptance TERESITA BABY P. CACAYORIN
Head Teacher I ASP Division Coordinator

Approved by:
VILMA D. EDA, CESO V
Schools Division Superintendent
 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 05
As of March 31, 2013
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

READING PROGRAM
DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. BOOKS

2. SUPPLEMENTARY
READING MATERIALS

3. OTHERS PLS. SPECIFY

TOTAL -

* Please attach the following documents: Prepared by: Noted by:

1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:
 aspsch_form 05
Schools Division Superintendent
 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 06
As of March 31, 2013
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

TRAINING AND DEVELOPMENT

DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. TEACHERS/PRINCIPAL TRAINING

2. STUDENT/PUPILS TRAINING
AND FIELD TRIP

3. OTHERS PLS. SPECIFY

TOTAL -

* Please attach the following documents: Prepared by: Noted by:

1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:
 aspsch_form 06
Schools Division Superintendent
 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 07
As of March 31, 2013
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

DIRECT ASSISTANCE
DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. STIPEND

2. OTHERS PLS. SPECIFY

TOTAL -

* Please attach the following documents: Prepared by: Noted by:

1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:
 aspsch_form 07
Schools Division Superintendent
 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT aspsch_form 08
As of March 31, 2013
Region:
Division:
School:
Address:
School ID:
Contact Nos.: _____________________ Email Address: _________________________

ASSITIVE LEARNING DEVICES FOR STUDENT WITH SPECIAL NEEDS

DONOR'S NAME DATE COMPLETED/
DONATIONS PARTICULARS QTY. AMOUNT
PRIVATE SECTOR LGU GOVERNMENT AGENCY INTERNATIONAL TURN-OVER

1. PENCIL GRIPS

2. SPECIAL CHAIRS

3. SPELLING CHECK DEVICES

4. HEARING AIDES

5. TALKING COMPUTERS

6. SPECIALIZED KEYBOARDS

8. BRAILLE (BOOKS)

9. COMPUTERIZED SYSTEMS

10. OTHERS PLS. SPECIFY

TOTAL -

* Please attach the following documents: Prepared by: Noted by:

1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC ASP Division Coordinator

Approved by:
 aspsch_form 08
Schools Division Superintendent
 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
As of December 31, 2018

Assistive
Learning Learning Technology Health and Reading Training and Direct
SCHOOL ID SCHOOL Learning TOTAL
Environment Support Suppport Nutrition Program Development Assistance
Devices

100193 SUBA ES 500.00 15,000.00 15,500.00

TOTAL 500.00 - 15,000.00 - - - - - 15,500.00

 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
As of September 31, 2018

Assistive
Learning Learning Technology Health and Reading Training and Direct
SCHOOL ID SCHOOL Learning TOTAL
Environment Support Suppport Nutrition Program Development Assistance
Devices

100193 SUBA ES 3,000.00 3,000.00

TOTAL - - - 3,000.00 - - - - 3,000.00

 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
As of June 30, 2018

Assistive
Learning Learning Technology Health and Reading Training and Direct
SCHOOL ID SCHOOL Learning TOTAL
Environment Support Suppport Nutrition Program Development Assistance
Devices

100193 SUBA ES 3,000.00 3,500.00 7,500.00 14,000.00

TOTAL 3,000.00 3,500.00 - 7,500.00 - - - - 14,000.00

 ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
As of March 31, 2019

Assistive
Learning Learning Technology Health and Reading Training and Direct
SCHOOL ID SCHOOL Learning TOTAL
Environment Support Suppport Nutrition Program Development Assistance
Devices

100193 SUBA ES 15,230.00 500.00 15,730.00

TOTAL 15,230.00 - - 500.00 - - - - 15,730.00