Republic of the Philippines

Department of Education
Schools Division of Albay
Legazpi City
ACKNOWLEDGEMENT FORM
Delivery of Commercial Milk and NFP Commodities
District: Guinobatan East District School Head: Ofelia F. Ocfemia Week No./Inclusive Dates: __________ ____________________
School: Catomag Elementary School School Feeding Coordinator: Christine A. Repata Date of Delivery: _______________________________________
Commodities Total
NS Nutty Fruity Bar Nutripack Nutricookie
No. Name of Recipient Commercial E-Nutribun Quantity Signature
Grade and Category Cereals BISKID
Milk Iron Fortified Received
Section Sweet Potato Squash Carrot Rice Chocolate Honey Champorado Arroz Caldo Chocolate Ube

1 Jaydie M. Llona GR.1-Dalton

2 Joshua N. Palamara GR.1-Dalton
3 Tania O. Olavario GR.1-Dalton
4 Bea Orlina GR.1-Dalton
5 Jelian P. Papina GR.1-Dalton
6 Laurence O. Camania GR. 2-Plato
7 Mhories O. Olavides GR. 2-Plato
8 Jay M. Oraa GR. 2-Plato
9 Estephanie M. Nabo GR. 2-Plato
10 Nichole O. Palenzuela GR. 2-Plato
11 Jhamaica Jane R. Cardoso GR. 3- Aristotle
12 Rachelle C. Sarasa GR. 3- Aristotle
13 Aj O. Olavario GR. 3- Aristotle
14 Ayesha Coline L. Orfano GR. 3- Aristotle
15 John Samuel O. Camania Gr.4-Euclid
16 Jeanrey M. Dela Cruz Gr.4-Euclid
17 Karla A. Oliquino Gr.4-Euclid
18 Nica Mae E. Purinio Gr.4-Euclid
19 June D. Oxina Gr.5-Newton
20 Jurish B. Hernedia Gr.5-Newton
21 Mark James B. Elumba Gr.6-Einstein
22 Lovely Gine O. Sario Gr.6-Einstein

Prepared by: Checked by: Noted by:

CHRISTINE A. REPATA ELOISE MARIE P. VASQUEZ OFELIA F. OCFEMIA
School Feeding Coordinator District Nurse School Head