Republic of the Philippines

Department of Education
Region VIII
Division of Samar
District of Basey I
BASEY NATIONAL HIGH SCHOOL
Basey, Samar

SCHOOL MEMORANDUM
No. s. 2022

To : Head Teachers/Grade Level Coordinators

Class Advisers
All Others Concerned

From : RELDIN R. CAJES PhD

School Principal

Date : June 08, 2022

Subject: Checking of School Forms for School Year 2021-2022

______________________________________________________________________________

1. To facilitate the timely, consistent and quality checking of School Forms for School Year
2021-2022, this Office organizes School Checking Committee (SSC) for every Grade Level
and Curricular Programs. The school checking shall be conducted on June 13-14, 2022
inside the school campus.

2. The assignment of checkers are as follows:

Overall Chairperson : Reldin R. Cajes

Overall Co-Chairperson : Rafaela Baclea-an

Cluster 1
Chairperson : Elena M. Cabugayan
Group A (Chastity, Courage, Diligence, Sincerity)
Co-Chairperson : Anita G. Pacula
Members : Nympha D. Fernandez
Adesyll Delovino
Glenda Duque
Francis Mark Gongora
Joseph Kenneth Costelo

Group B (Unity, Honesty, Humility, Loyalty)

Co-Chairperson : Myraflor N. Adona
Members : Salvador Apolinar
Mary Ann Bacoto
Jessil Cabab
Reblona Lucelo

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 Group C (Wisdom, Charity, Love)
Co-Chairperson : Delia G. Buenvenida
Members : Richard N. Sabulao
Marilou Yanto
Rona Guarino
Salvador G. Apolinar
Cluster 2
Chairperson : Eva H. Adona
Group D (Grapes, Guava, Melon, Mango, Pomelo)
Co-Chairperson : Wilhelma Estorninos
Members : Rusty Charles Gaddi
Ariel Amante
Remedios Bacha
Ruth Patricia P. Gomez

Group E (Avocado, Banana, Caimito, Cherry, Durian)

Co-Chairperson : Ronald Lavendia
Members : Joy Dasig
Luchie Vallejo
Miguelito Pagonasan
Lyn Abiertas
Rafael Ballais

Cluster 3
Chairperson : Ma. Nympha J. Oquiño
Group F (Archimedes, Aristotle, Edison, Fleming, Franklin)
Co-Chairperson : Joel C. Manacpo
Members : Lynell Woodmore
Rovie Nablo
Leah Luangco
Ma. Fretchie Cabale
Clarivic D. Oñate

Group G (Galileo, Newton, Perkin, Pythagoras, Rutherford)

Co-Chairperson : Marilyn Academia
Members : Angelo Manacpo
Lenore Colminar
Myra Echaque
Rosalina Buagayan
Lalaine P. Gabriela

Cluster 4
Chairperson : Concordio C. Bacayo
Group H (Galileo, Newton, Perkin, Pythagoras, Rutherford)
Co-Chairperson : Ma. Victoria M. Astorga
Members : Ma. Shiela C. Adona
Joseph Maranga
Lemuel Orbeta
Ma. Victoria Estillero
Crisanta P. Taburnal

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 Group I (Archimedes, Aristotle, Edison, Fleming, Franklin)
Co-Chairperson : Rizza Rosa Adona
Members : Ritchie Taganna
Adelina C. Mueva
Kristine Joy Germones
Gerand D. Leonido
` Nicolai D. Merida

Cluster 5
Group J (Excellence, Apple, Einstein, Diamond)
Chairperson : Wilma C. Bacayo
Members : Mercedes T. Consus
Christopher J. Llegado
Francisco J. Labitigan
May Florence Baclayo
Ronald Bacayo

Group K (Creativity, Artistry, Harmony, Aesthetics)

Chairperson : Hannah E. Viojan
Members : Bernadeth B. Gundran
Eleanor P. Darang
Sofie Alana A. Caberic
Aljun Anthony C. Palencia
Sheryl Ann Valenzuela

Cluster 6
Group L (HUMSS and ABM)
Chairman : Maria Rica B. Abarratigue
Co-chairman : Eric L. Abia
Members : Fenita P. Pugay
Leahlyn O. Taliptip
Bernadeth C. Dellosa

Group M (EIM and CSS)

Chairman : Ma. Mae C. Bacayo
Co-chairman : Corazon B. Manuel
Members : Elvira G. Camposano
Azuncion Gandia
George B. Lauron

Group N (EPAS, Tourism, Computer Programming, Automotive)

Chairman : Virgilio L. Manog
Co-chairman : Melba B. Cabab
Members : Analiza C. Reynera
Frank A. Ocop
Ruel C. Calinao

3. The SCC shall convene to conduct a review or a reorientation on the guidelines stipulated
in DepEd Order No. 11, s. 2018.

4. The SCC shall be responsible for checking the school records, make necessary adjustment,
and affix their signature in the School Form 5 (Report on Promotion)

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 5. The SCC shall take note and check the following:

a. Before the start of checking, see to it that all School Forms are properly organized
and accomplished.

b. A Checklist shall be attached at the back of the SF10 Cover (see Annex 1b)

c. Checking shall be based from the Grade Sheets and NOT from the SF 9 or SF10.

6. After checking the school forms, the SCC shall submit to the Overall Chair copies of the
following forms on or before June 15, 2022.

a. SF 4 for the month of June 2022

b. SF 5 Report on Promotion

c. SG 6 Summarized Report and Level of Proficiency

d. SFCR 1 School Form Checking Report (see Annex 1a)

7. All other School Forms shall be forwarded to Records Section on or before July 15, 2022.

8. For immediate dissemination and strict compliance.

Enclosures: SF CR1 – School Form Checking Report

References: As stated
To be indicated in the perpetual index under the following subjects:
School Forms SFs Repository

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Report Code: SFCR1 Annex 1a

SCHOOL FORMS CHECKING REPORT

School Name: BASEY NATIONAL HIGH SCHOOL School ID: 303592 District: Basey 1
Table 1: Learner Records Examined/ Reviewed

No. with Inconsistency or Incomplete

Grade Date No. of Examined/ Reviewed
Section Name of Adviser Supporting Documents % Accuracy**
Level Checked
Male Female Total Male Female Total

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Table 2. Learner Records with Inconsistency/ ies or Errors
No. of Examined/ Reviewed
Grade With Incomplete SCC Observation/ Comment or
Section Name of Adviser With Inconsistency/
Level Supporting Total Technical Assistance Provided
Error
Documents
M F M F

*Do not include Temporarily Enrolled Learners as defined in DepEd Order No. 3, s. 2018
**%Accuracy refers to the percentage of correct/ consistent records over total records examined or reviewed.

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Report Code: SFCR1 Annex 1a

Table 3. For Transferred In/ Moved In

With SF10 Without SF10
(For Temporarily Enrolled)
Grade DCC Observation/ Comment or
Section Name of Adviser Received Received From Public
Level From Private Technical Assistance Provided
within 30 beyond 30 School/ SUC/
School
days days LUC

***Do not include PEPT/ PVT or ALS-A&E Certificate holders

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Table 4. Transferred In/ Moved In Learners Without SF10 (formerly Form 137)

Name of Name of Originating School Division/

Grade Level Section LRN Name of Learner
Adviser School ID Region

Type of Checking Committee: School Checking Committee Division Checking Committee

Prepared by:

Chair Vice Chair

Member Member Member

------------------All field below are solely for the use of the Division Checking Committee (DCC------------------
Conforme:

School Head/ SCC Chair Date Completed (Division Level)

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 Annex 1b

Republic of the Philippines

Department of Education
Region VIII
Division of Samar
District of Basey I
BASEY NATIONAL HIGH SCHOOL
Basey, Samar
School ID: 303592

SF 10 ATTACHMENT CHECKLIST
School Year: 2020-2021
Grade Level: 10 Section: TOPAZ
Name of Students LRN Birth Certificate Form 137/ SF10 Gen Remarks
Ave
No. LAST FIRST MIDDLE PSA NSO Baptismal

1 . 87 Promoted
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35

Prepared by: Attested by:

Adviser Grade Level Coordinator

Basey, Samar @BaseyNHSofficialpage
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