LEGAZPI INC.

SERVICE SCHOLARSHIP PROGRAM (SSP)

SERVICE-DELIVERABLES FORM
SUB: Area:
SY: 20 - 20 | Semester:
For the month of 20
Name of Scholar: Mark Jefferson C. Luna CH/SSP ID:
rd
Course: Bachelor of Science in Nursing Major: Year Level: 3 Year
A. CORRESPONDENCE-RELATED DELIVERABLES
(Required. To be determined by SDW.)
Name/No. of
Name of SDW
Deliverables SPMs/Participants
SH Signature
Assisted
Group
 Mixxa Franchezka_Regular
 Assist, check, & send at least 5 sponsored members’ letters Letter
 Leonor_Regular Letter
 Maria_Regular Letter GFC
 Corazon_Regular Letter
 Teresa_Regular Letter
 Felisa_Farewell Letter
 Assist, check, & send at least 1 sponsored member’s video
message

 Assist, check, & send at least 3-5 sponsored members’

annual
photos
 Co-facilitate discussion/orientation/reorientation of
correspondence topic*:

 Others:

*Attendance sheet required

B. COURSE/TRACK-RELATED SERVICE
(Required. To be determined by Service Scholar.)
No. of
Place of Service Date/s Superviso
Service SPMs/Part
Accomplishe r
icipants
d Signature
Assisted
 On-the-job-training, practice teaching and other relative-
N/A
learning experiences
Urban Poor Pacol, October 14, 40
 COMMUNITY HEALTH TEACHING ABOUT FAMILY Naga City 2023
PLANNING
 COMMUNITY ORGANIZING PARTICIPATORY ACTION Urban Poor Pacol, September 2, 40
RESEARCH (COPAR) Naga City 2023

Sta. Maria Josefa October 16,

 CLINICAL DUTY (OPERATING ROOM) Hospital Foundation, 2023
Inc. (Iriga City)
Sta. Maria Josefa October 17,
 CLINICAL DUTY (DELIVERY ROOM) Hospital Foundation, 2023
Inc.
Bicol Medical Center
 CLINICAL DUTY (OR WARD) (Naga City)

Service Scholar Social Development Worker