Erpat Forms (Autorecovered)

APPENDIX B
ERPAT ASSOCIATION OF _________________________
Name of Organization: ___________________________________________________
Address: _______________________________________________________________
Name of Worker: ________________________________________________________
No. Name Position Age Address Siganture
10
11
12
13
14
15
16
17
18
19
20
Noted by:
ERPAT PRESIDENT ERPAT SECRETARY
APPENDIX C
Empowerment Reaffirmation of Paternal Abilities Registration Form
Identifying Data
Name:
Age: Sex: Status:
Date of Birth: Married
Place of Birth: Separated
Occupation: Widower
Religion: Guardian
Home Address: Solo Parent
Telephone Number:
Family Composition
Name Sex Relationship Age
Page 3 of 14
Educational Attainment
Elementary:
High School:
Vocational:
College:
Others:
Special Abilities
Skills/Talents:
Hobbies:
Other Skills:
Community Involvement
School:
Civic:
Community:
Workplace:
Others:
Seminars/Trainings Attended
Title:
Date:
Organizers:
Signature over Printed Name
Page 4 of 14
APPENDIX D
RECORDING OF ERPAT SESSIONS
ERPAT SESSION NO: TOPIC:

DATE:
BARANGAY :
1. NAME OF PARTICIPANTS PRESENT: (Please see attached attendance sheet)

2. OBJECTIVE OF THE SESSION:
3. REPORT OF RESULTS OF ACTIVITIES CARRIED OUT AT HOME IN RELATION TO PREVIOUS

TOPICS ATTENDED:
4. LEARNING HIGHLIGHTS/INSIGHTS IDENTIFIED BY PARTICIPANTS :
5. PLAN OF ACTION/HOME ASSESSMENT OF EACH PARTICIPANT RELATIVE TO TOPIC

DISCUSSED IN THE SESSION (REFER TO APPLICATION)
6. WORKER’S APPLICATIONS
DATE OF NEXT SESSION:

TOPIC:
Worker/Volunteer's Signature
APPENDIX E
QUARTERLY ACCOMPLISHMENT REPORT
ERPAT HIMAMAYLAN CITY
JANAURY 2024
Month/Year
DATE NO.OF
ACTIVITIES /
CONDUCTE PERSON PERSON / AGENCY INVOLVED REMARKS
PROJECTS
D SERVED
ELECTED ERPAT OFFICERS
CSWDO FOCAL PERSON, ERPAT (PRESIDENT, VICE
ELECTION OF FEDERATION PRESIDENT, PRESIDENT, SECRETARY,
1/17/2024 43
OFFICERS BARANGAY 2 OFFICIALS, TREASURER, AUDITOR,
COMMUNITY FATHERS PUBLIC RELATION OFFICER,
PEACE COURTING OFFICER)
CONDUCTED ORIENTATION
ORIENTATION CSWDO FOCAL PERSON, ERPAT
1/23/2024 30 ON ERPAT MANUAL AND
& PLANNING FEDERATION PRESIDENTS
ANNUAL PLANNING
ISSUES/CONCERNS/RECOMMENDATIONS
Prepared and Submitted by:
Noted by:
APPEDNIX F
OATH OF COMMITMENT
We the members and officers of the ERPAT Association of

Barangay ______________________________________ do hereby
pledges to perform our duties and responsibilities, abide with the
Constitution and By-laws of ERPAT Association and serves as the role
model in our community.
We further commit ourselves to render volunteer service in

responding to the issues/concerns affecting our family and to support the
implementation of ERPAT program in the community.
So help me GOD.
Signed on_______________________________________202__ at
(Day and Month)
Name and Signature of Members

Republic of the Philippines
Region VI
Province of Negros Occidental
City of Himamaylan
ELECTION MEETING MINUTES FORM
ERPAT ASSOCIATION OF BARANGAY _________________________
Minutes of meeting held on: ____________________________________________________________

Present: (Please see attached attendance sheet)
Meeting called to order at ____________________ am/pm by______________________________
Motion to open nominations for President made by _______________________________________

Seconded by _______________________________________ Vote: For ___________ Against ________
Nominations for President: ______________________________________________________________
Motion to close nominations made by ______________________, seconded by __________________

Election for President
Candidate _______________________________________________-___________ # of votes
__________________________________________________________ is elected President
Motion to open nominations for Vice President made by _______________________________________


__________________________________________________________ is elected Vice President
Motion to open nominations for Secretary made by _______________________________________


__________________________________________________________ is elected Secretary
Motion to open nominations for Treasurer made by _______________________________________

Region VI
City of Himamaylan
__________________________________________________________ is elected Treasurer
Motion to open nominations for Auditor made by _______________________________________


__________________________________________________________ is elected Auditor
Motion to open nominations for Public Relations Officer made by _______________________________________


_______________________________________________________ is elected Public Relations Officer
Motion to open nominations for Peace Courting Officer made by _______________________________________


_______________________________________________________ is elected Peace Courting Officer
Motion to adjourn by _________________________seconded by __________________________

All in favor ________________Opposed _________________Abstentions _________________
Meeting adjourned at ________________________am/pm by _____________________________
Minutes submitted by,

Region VI
City of Himamaylan
Region VI
City of Himamaylan
Region VI
City of Himamaylan
ERPAT ASSOCIATION OF BARANGAY _______________________
RESOLUTION NO. ____ S. 2024
A RESOLUTION APPROVING AND DECLARING THE ELECTED OFFICERS OF BARANGAY

_____________ ERPAT ASSOCIATION OFFICIAL HELD ON _______________, 2024 AT BARANGAY GYM,
BARANGAY __________________, HIMAMAYLAN CITY, NEGROS OCCIDENTAL
WHEREAS, the Department of Social Welfare and Development (DSWD) recognizes the role of fathers in their
family as an important need to be addressed in the effort to achieve shared parenting tasks in the performance
of familial responsibilities
WHEREAS, Empowerment and Reaffirmation of Paternal Abilities (ERPAT) is a service developed in 2014 by
DSWD's Social technology Bureau that gives importance and emphasis on the development and enrichment of
knowledge, attitudes and skills of fathers in performing their paternal roles and responsibilities
WHEREAS, Communities in Himamaylan City believes that the roles and responsibilities of fathers in nurturing
and caring of children, promoting positive family life, and promoting active participation in community
development is essential
WHEREAS, The ERPAT association of Barangay ____________________ was organized to serve as a venue
for collective action and participation founded in the principles of cooperation, trust, good commuication and
commitment to the promotion of the important roles of fatjhers in the family and in promoting the social-wellbeing
of families as a whole
WHEREAS, the ERPAT association assembly of Barangay ____________________ held an election of their
Officers for their ERPAT Assocaition and hereby elected the following:
Names Position
--- PRESIDENT
--- VICE PRESIDENT
--- SECRETARY
--- TREASURER
--- AUDITOR
--- PUBLIC RELATIONS OFFICER
--- PEACE COURTING OFFICER
WHEREAS, Association Officers will facilitate the organizational tasks and responsibilities of ERPAT and
represent their ERPAT Association at all levels in the barangay, city, regional, and national.
NOW THEREFORE, on motion made by the Federation President of Associations of ERPAT Eddie Colimbo,
duly seconded by ERPAT Association President _______________________ and approved by the en masse,
RESOLVED FURTHER, that copies of this resolution be furnished to the City Social Welfare and Development
Office, Barangay Local Government Unit, and to Barangay ERPAT Association.
UNANIMOUSLY APPROVED.
I hereby certify that the foregoing Resolution No. 1 S. 2024 was approved by the ERPAT Association Assembly
during its Assembly Meeting held on ___________________, 2024.
Secretary
Attested:
President

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APPENDIX B

ERPAT ASSOCIATION OF _________________________

Name of Organization: ___________________________________________________

Name of Worker: ________________________________________________________

No. Name Position Age Address Siganture

Empowerment Reaffirmation of Paternal Abilities Registration Form

Age: Sex: Status:

Date of Birth: Married

Place of Birth: Separated

Home Address: Solo Parent

Signature over Printed Name

RECORDING OF ERPAT SESSIONS

ERPAT SESSION NO: TOPIC:

1. NAME OF PARTICIPANTS PRESENT: (Please see attached attendance sheet)

3. REPORT OF RESULTS OF ACTIVITIES CARRIED OUT AT HOME IN RELATION TO PREVIOUS

4. LEARNING HIGHLIGHTS/INSIGHTS IDENTIFIED BY PARTICIPANTS :

5. PLAN OF ACTION/HOME ASSESSMENT OF EACH PARTICIPANT RELATIVE TO TOPIC

DATE OF NEXT SESSION:

Prepared and Submitted by:

We the members and officers of the ERPAT Association of

We further commit ourselves to render volunteer service in

Name and Signature of Members

ELECTION MEETING MINUTES FORM

ERPAT ASSOCIATION OF BARANGAY _________________________

Minutes of meeting held on: ____________________________________________________________

Motion to open nominations for President made by _______________________________________

Motion to close nominations made by ______________________, seconded by __________________

Motion to open nominations for Vice President made by _______________________________________

Motion to close nominations made by ______________________, seconded by __________________

Motion to open nominations for Secretary made by _______________________________________

Motion to close nominations made by ______________________, seconded by __________________

Motion to open nominations for Treasurer made by _______________________________________

Motion to open nominations for Auditor made by _______________________________________

Motion to close nominations made by ______________________, seconded by __________________

Motion to open nominations for Public Relations Officer made by _______________________________________

Motion to close nominations made by ______________________, seconded by __________________

Motion to open nominations for Peace Courting Officer made by _______________________________________

Motion to close nominations made by ______________________, seconded by __________________

Motion to adjourn by _________________________seconded by __________________________

Minutes submitted by,

ERPAT ASSOCIATION OF BARANGAY _______________________

RESOLUTION NO. ____ S. 2024

A RESOLUTION APPROVING AND DECLARING THE ELECTED OFFICERS OF BARANGAY

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