Republic of the Philippines

Department of Education
Region IV-A
SCHOOLS DIVISION OF QUEZON PROVINCE

Field Technical Assistance Tool

Quarter 3, FY 2022
Date: _______________________

School: _________________________ School Head: _________________________

District: _________________________ PSDS: ______________________________
Areas/PAPs Findings/Observations Action Points Completion Date/
(Points for Technical Assistance) (Agreed upon by the TA Recipient and the TA Deadline
Providers)

*Replicate this page as necessary.

I, ______________________________________ of _______________________________, __________________________, hereby

(Name of School Head) (Name of School) (School District)
express my full commitment to the mandate of the Department of Education (DepEd) towards continuous improvement through the
support provided by the Schools Division of Quezon. All MOVs of Action Points shall be emailed to the SGOD through the SMME on
the date provided.
_____________________________________
Signature Over Printed Name of TA Recipient

________________________________________ SMME Email: sdo.quezon.smme@deped.gov.ph

DEPEDQUEZON-SGO-SME-04-010-004

“Creating Possibilities, Inspiring Innovations”

Address: Sitio Fori, Brgy. Talipan, Pagbilao, Quezon
Trunkline #: (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321
Email Address: quezon@deped.gov.ph
Website: www.depedquezon.com.ph
 Republic of the Philippines
Department of Education
Region IV-A
SCHOOLS DIVISION OF QUEZON PROVINCE

Signature Over Printed Name of TA Team Leader

DEPEDQUEZON-SGO-SME-04-010-004

“Creating Possibilities, Inspiring Innovations”

Address: Sitio Fori, Brgy. Talipan, Pagbilao, Quezon
Trunkline #: (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321
Email Address: quezon@deped.gov.ph
Website: www.depedquezon.com.ph