Gawad Kampilan Nomination Form 2 (School Category)

Category:

THE NOMINEE
School:
School Address:
Sub-office: Mobile No.:
DepED Email Address:

SCHOOL/OFFICE HEAD
Name: Position:
Email Address:
Telephone/Mobile No:

NOMINATOR
Name: Position:
Office: Telephone/Mobile No.:
Email Address:
Office Address:
ADDITIONAL INFORMATION ABOUT THE NOMINEE
Was your school a previous Gawad Kampilan Nominee? __Yes __No
If yes, what year?________ What award ategory? _________________________________

Was your school a previous Gawad Kampilan Semi-finalist __Yes __No

If yes, what year? ________. What award category? ______________________________

Was your school a previous Gawad Kampilan Winner? __Yes __No

If yes, what year? __________. What award category? ____________________________

NOMINATION WRITE-UP
 (Maximum of 10 pages, A4 size bond paper, Century Gothic #11 font, including executive summary)

Category:
School: Sub-Office:

I. Executive Summary- Outstanding Accomplishments Description of the Contribution/s

or Innovation/s done that have significantly impacted the performance of the learner/ school / school
community/district/schools division or region with relevance to the current situation. Indicate problems
addressed, people/office benefited, and transactions facilitated.

II. Significant Accomplishments- 25 Points (Project/Work Accomplished, number of

strategies/activities done that have significantly impacted the performance of the school; number of accomplished
work/projects that benefited the community)

III. Impact of Accomplishments- 20 Points (Scope/Replicability of the program/ project/

activity, number of people/office benefited and transactions facilitated, level of attainment per identified PIs)

IV. Innovation- 25 Points (Original creative PPAs made/implemented in the last two years in
connection to the award category, and the extent to which it//they are being used, and the results; number of
persons who benefited; scope/replicability of the innovation, level of attainment per identified PIs).

V. Awards and Membership- 15 Points (Major Awards/Citations received by the school in

connection to the award)

DATA PRIVACY NOTICE: Data and information in this form are intended exclusively for the purpose of this
activity. This will be kept by the process owner for the purpose of verifying and authenticating identity of the
nominee. Serving other purposes not intended by the process owner is a violation of Data Privacy Act of 2012. Data
subjects voluntarily provided these data and information explicitly consenting the process owner to serve its purpose.