Republic of the Philippines

Department of Education
Cordillera Administrative Region
SCHOOLS DIVISION OFFICE OF ABRA
Date: _____________
Indorsement for Quality Assurance

Respectfully indorsed for the quality assurance of this harvested

curriculum instructional material of ,

Name of the Developer: _______________________________________________

School: _________________________________ District:____________________
Title: ___________________________________ Type: ______________________
Grade level assigned: ______ Learning Area: _____________________________
Language Medium: _____________________ LC Code: _____________________

Signed: (LR Personnel Only)__________________________________

Respectfully returned the completed quality assurance of the said material with
the following attachments and reports:
☐ Copy of the print material with marginal notes for modification
☐ Evaluation Report on RBI/ Video-based Lessons Scripts (Content/Language)
☐ Level 2 DepEd Evaluation Rating Sheet for Audio and Video Recordings
☐ CO Form 7.6 Evaluation for the New Print Resources
☐ CO Form 7.1.4 Social Content Evaluation
☐ Evaluation Report for Story Book

Number of Revisions:
☐1 Date of Retrieval : _______ Dates of Modification: _____________________
☐2 Date of Retrieval : _______ Dates of Modification:_____________________
☐3 Date of Retrieval : _______ Dates of Modification:_____________________
☐4 Date of Retrieval : _______ Dates of Modification:_____________________

Initial/Signature of the Evaluators: ( Write NA if not applicable)

A. Print and Scripts ( Content and Language)
Choose an item. Evaluator 1
Choose an item.Evaluator 2
B. Print and Non-print/ Print Social Content Guidelines
Choose an item. LR Core Evaluator
C. Print -Format, Presentation/Organization , Accuracy and Up-to-datedness
Choose an item.LR Core Evaluator
D. Evaluation Rating sheet for Audio and Video Recordings
Choose an item.Findings of Learning Area content and alignment
Choose an item.Technical: Content, Format/Technical Design,Presentation/Organization,
Accuracy and Up-to-datedness
E. Evaluation Report for Authored Storybooks
Choose an item.Evaluator 1
Choose an item.Evaluator 2
VERIFIED:
RONALD T. MARQUEZ
Address: Actividad-Economia St., Zone 2(Consiliman), Bangued, Abra
Telephone Nos.: (074) 614-6918
Doc. Ref. Code QF-CID-LRMS-EPS-15 Rev 00
Email Address: abra@deped.gov.ph Effectivity 09.20.21 Page 1 of 2
Website: http://www.depedabra.com
 Republic of the Philippines
Department of Education
Cordillera Administrative Region
SCHOOLS DIVISION OFFICE OF ABRA
Education Program Supervisor

Address: Actividad-Economia St., Zone 2(Consiliman), Bangued, Abra

Telephone Nos.: (074) 614-6918
Doc. Ref. Code QF-CID-LRMS-EPS-15 Rev 00
Email Address: abra@deped.gov.ph Effectivity 09.20.21 Page 2 of 2
Website: http://www.depedabra.com