Republic of the Philippines Document Code:

Department of Education Revision:

Region I Effectivity date:
SCHOOLS DIVISION OFFICE I PANGASINAN Reference Number: ___________
Lingayen, Pangasinan
SCHOOL& DISTRICT TRAINING / Name of Office: SGOD-HUMAN
PROJECT PROPOSAL RESOURCE DEVELOPMENT

REFERENCE NO:
ACTIVITY DESIGN

I. TITLE: SCHOOL LEARNING ACTION CELL ON

RESUMPTION OF IMPLEMENTATION OF THE POLICY
ON CHECKING OF SCHOOL FORMS AS PRESCRIBED
IN DEPED ORDER NO. 11, S. 2O18

II. PROPONENTS: ANTHONY E. RICO, School Head

JACKIE LOU D. CAYABYAB, Teacher III

III. PROPOSED DATE: JUNE 08-10, 2022

IV. PROPOSED VENUE: MANAMBONG SUR ELEMENTARY SCHOOL

V. RATIONALE:

Among the critical activities conducted at the end of every School

Year are the preparation and checking of school forms to ensure the quality
and consistency of learner information. As the COVID-l9 situation in the
country continues to get better resulting to gradual easing of restrictions, the
Department is resuming the onsite conduct of the annual checking of school
forms for SY 2O21-2O22 with the participation of the Division Checking
Committee (DCC).

In support to the implementation of Basic Education-Learning Continuity

Plan (BE-LCP), the Department of Education (DepEd) issued the Interim
Guidelines on the Preparation, Submission, and Checking of School Forms for
the School Year (SY) 2020-2021 through DepEd Memorandum (DM) No. 014,
s.2021. The interim guidelines introduced the customized set of school forms
that gather information relevant to the delivery of distance learning through
various modalities at the school level. These interim guidelines suspended the
conduct of physical checking of school forms and only allowed the
virtual/online checking instead at the school level by the School Checking
Committee (SCC) as a measure to protect the health and wellness of school
personnel against COVID 19. (DM 37,s.2022)

This school learning action cell will help and update teachers on the
different forms to be prepared for the school checking and division checking for
consistency and uniformity which is in line with DepEd Memo No.37,s.2022.

QM - Page 1 of 5
 Republic of the Philippines Document Code:
Department of Education Revision:
Region I Effectivity date:
SCHOOLS DIVISION OFFICE I PANGASINAN Reference Number: ___________
Lingayen, Pangasinan
SCHOOL& DISTRICT TRAINING / Name of Office: SGOD-HUMAN
PROJECT PROPOSAL RESOURCE DEVELOPMENT

VI. LEGAL BASES:

DepEd Order: (Nos. 032, s.2021;020 and 11, s. 2018; 58, s. 2017;
54 and 47, s. 2016 and 4, s. 2014)
DepEd Memorandum (No. 014, s.2O21)

VII. OBJECTIVE/S:

1. To orient the teachers on the DepEd Memorandum

No.37,s.2022- RESUMPTION OF IMPLEMENTATION OF THE
POLICY ON CHECKING OF SCHOOL FORMS AS PRESCRIBED
IN DEPED ORDER NO. 11, S. 2O18
2. To discuss and clarify issues and concerns on the implementation of
DM No.37,s.2022
3. To establish clear guidelines for resuming the conduct of physical
annual checking of school forms for School Year 2021 – 2022

VIII. LIST OF PARTICIPANTS

1 School Head & 9 Teachers of Manambong Sur Elementary School

IX. DETAILED FINANCIAL REQUIREMENTS

Unit Item Description Quantity Estimated Estimated

Unit Cost Total Cost
pack A4 WORK BOARD 200G L10'S 3 30.00 90.00
pcs A4 folder 10 12.00 120.00
Total P 210.00

X. SOURCE OF FUNDS: Canteen Fund

XI. TRAINING MATRIX (to be attached)

Day 1: June 08, 2022

Time Persons Involved/
Program of Activities
Speakers/Trainers
2:00-2:30 A. Opening Program
1. National Anthem Audio-Visual Presentations
Prayer Analiza L. Barroga, T-I
Pangasinan Hymn
Bayambang Hymn
2. Roll Call of Participants Janet B. Diocares, T-III

QM - Page 2 of 5
 Republic of the Philippines Document Code:
Department of Education Revision:
Region I Effectivity date:
SCHOOLS DIVISION OFFICE I PANGASINAN Reference Number: ___________
Lingayen, Pangasinan
SCHOOL& DISTRICT TRAINING / Name of Office: SGOD-HUMAN
PROJECT PROPOSAL RESOURCE DEVELOPMENT

3. Orientation/Overview Jackie Lou D. Cayabyab, T-III

4. Opening Remarks Mr. Anthony E. Rico,
School Head
2:30-3:30 SLAC Proper
Topic No. 1. Revisiting DepEd Order
No. 11,s.2018 (Guidelines on the Rebecca D. Venterez, T-I
Preparation and Checking of School
Forms)
3:30-3:45 Ice Breaker
3:45-4:45 Guidelines on the Preparation and
Rebecca D. Venterez , T-III
Checking of School Forms
4:45-5:00 Evaluation/Feedback/Reflection
Day 2: June 09, 2022
Persons Involved/
Time Program of Activities
Speaker/Trainer
2:00-2:30 1. Roll Call of Participants Johnedna Faye M. Mendoza, T-I
2. Unfreezing
2:30-3:30 Topic No. 2. Revisiting DepEd
Memorandum No. 14,s.2021 (Interim
Guidelines on the Preparation, Jocelyn B. Gulapa, T-III
Submission and Checking of School
Forms)
3:30-3:45 Ice Breaker
3:45-4:45 Interim Guidelines on the Preparation,
Submission and Checking of School Jocelyn B. Gulapa, T-III
Forms
4:45-5:00 Evaluation/Feedback/Reflection
Day 3: June 10, 2022
Persons Involved/
Time Program of Activities
Speaker/Trainer
2:00-2:30 1. Roll Call of Participants
Elenor P. Frias, T-I
2. Unfreezing
2:30-3:45 Topic No. 3. DepEd Memoramdum No.
37,s.2022 (Resumption of
Implementation of the Policy on Jackie Lou D. Cayabyab, T-III
Checking of School Forms As Prescribed
in Deped Order No. 11, S. 2018)
3:45-4:00 OPEN FORUM
4:00-5:00 Summing-Up/Closing Program/Awarding of Certificates

QM - Page 3 of 5
 Republic of the Philippines Document Code:
Department of Education Revision:
Region I Effectivity date:
SCHOOLS DIVISION OFFICE I PANGASINAN Reference Number: ___________
Lingayen, Pangasinan
SCHOOL& DISTRICT TRAINING / Name of Office: SGOD-HUMAN
PROJECT PROPOSAL RESOURCE DEVELOPMENT

XII. MONITORING AND EVALUATION

Checking of Attendance
CATHERINE A. LASQUITE, Teacher III
ELENOR P. FRIAS, Teacher I

Training Evaluation Form

CHRISTOPHER C. MORTERA, Master Teacher I

Prepared by:
JACKIE LOU D. CAYABYAB
Teacher III

Noted by:

ANTHONY E. RICO
School Head

Approved:

MARY JOY C. AGSALON, EdD

Public Schools District Supervisor

QM - Page 4 of 5
 Republic of the Philippines Document Code:
Department of Education Revision:
Region I Effectivity date:
SCHOOLS DIVISION OFFICE I PANGASINAN Reference Number: ___________
Lingayen, Pangasinan
SCHOOL& DISTRICT TRAINING / Name of Office: SGOD-HUMAN
PROJECT PROPOSAL RESOURCE DEVELOPMENT

SCHOOL LEARNING ACTION CELL ON RESUMPTION OF

IMPLEMENTATION OF THE POLICY ON CHECKING OF SCHOOL
FORMS AS PRESCRIBED IN DEPED ORDER NO. 11, S. 2O18
June 08-10, 2022
ATTENDANCE SHEET

Grade Level Signature

Name of Participants Taught
Day 1 Day 2 Day 3
1. CATHERINE A. LASQUITE Kindergarten
2. JOCELYN B. GULAPA Grade I
3. ANALIZA L. BARROGA Grade II
4. JANET B. DIOCARES Grade II
5. REBECCA D. VENTEREZ Grade III
6. ELENOR P. FRIAS Grade IV
7. JOHNEDNA FAYE M. MENDOZA Grade V
8. CHRISTOPHER C. MORTERA Grade VI
9. JACKIE LOU D. CAYABYAB Relieving Teacher

Prepared by:

JACKIE LOU D. CAYABYAB

Teacher III

Noted:

ANTHONY E. RICO
School Head

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