Annex 1

JOINT DELIVERY VOUCHER PROGRAM FOR SENIOR HIGH SCHOOL

TECHNICAL VOCATIONAL LIVELIHOOD SPECIALIZATION (JDVP-TVL)

APPLICATION FORM FOR JDVP-TVL PARTNER

SY 2022-2022

Region: NATIONAL CAPITAL REGION

Division: SCHOOL DIVISION OFFICE - VALENZUELA
OUR LADY OF LOURDES COLLEGE INC.
School Name:
(FORMERLY: OUR LADY OF LOURDES LEARNING CENTER, INC.)
School ID (if applicable): 407184

School Address: 5031

City or Municipality:
Province:
Contact Number/s:
Email:
TESDA Accreditation
Number
No. of Kilometers to the
nearest and accessible
Public DepEd SHS:
TVL
Specializations/Training
Offered
Attach the following documents:
GEN. T. DE LEON
VALENZUELA CITY
METRO-MANILA
922-00-77
Ollc_informationtechnology@yahoo.com / cmnv.ollci.tvimis@gmail.com
CTPR No. 2017137TRBAR213150
CTPR No. 20171317TRBPP209151
CTPR No. 20171317TRCOK214152
CTPR No. 2017137TRFBS213153
CTPR No. 2017137TRHSK213166
(1 minute) 200  Meters away from GEN. T. DE LEON NATIONAL HIGH SCHOOL via
Gen. T. de Leon
(12 minutes) 1.3  Kilometers away from SITERO FRANCISCO MEMORIAL
NATIONAL HIGH SCHOOL via Gen. T. de Leon & Que Grande
(10 minutes) 3.0   Kilometers away from VALENZUELA NATIONAL HIGH SCHOOL
via independence
(12 minutes) 3.4   Kilometers away from CARUHATAN NATIONAL HIGH SCHOOL
via Gen. T. de Leon Road
(24 minutes) 6.1   Kilometers away from DALANDANAN NATIONAL HIGH SCHOOL
via Karuhatan Road & MacArthur Highway
HOME ECONOMICS
 Bartending NC II
 Bread and Pastry Production NC II
 Cookery NC II
 Food & Beverage Services NC II
 Housekeeping NC II

1. For private SHS/non-DepEd public SHS, certified true copy of the Provisional Permit to offer SHS-TVL issued by
DepEd;
2. For private TVI, certified true copy of TESDA accreditation;
3. For both, Board Resolution indicating the intention to participate and to comply with SHS-TVL Curriculum
Learning Standards, including absorptive capacity of 25 learners per class, Pedagogical Requirements, and Policies
on Assessment and Rating System based on DepEd Order No. 8, s. 2015; and
4. For both, attestation that there is a maximum four-kilometer distance between the listed qualified DepEd public
SHS and the applicant partner.
Annex 1

JOINT DELIVERY VOUCHER PROGRAM FOR SENIOR HIGH SCHOOL

TECHNICAL VOCATIONAL LIVELIHOOD SPECIALIZATION (JDVP-TVL)

ATTESTATION

I certify that my answers are true and complete to the best of my knowledge.

I am aware that the information supplied in this document shall be retained by DepEd on a database and shall be
processed in compliance with the Data Protection Act of 2012.

I consent that the information herein may be used for reports both internally and to the Department of Education.

__DR. ADELIA C. DEMETILLO__ _______July 7, 2022_______

School Head/ Date Signed
Authorized Representative
(Signature over Printed Name)