To be filled out by the organizer:

APPLICATION FORM No: _______________ Date received: ___________________

Category: Elementary School Junior High School

Vocational School Senior High School

Complete Name of School: LIBERTAD ELEMENTARY SCHOOL

Type of
School: Public School: Private School
Applican
t Type:

First Time Applicant； Consecutive 2nd Time Applicant； Consecutive 4th Time Applicant；
Not Consecutive，_______ Time Application
Region
VIII/Leyte
No. of Students：524 No. of Classes：16 Region/Division： Division

Repair of the Two

Gender Sensitive
Title of Proposal (15 words maximum)： Comfort Rooms

Executive Team（Please add rows if needed）:

No. Name Position School Tel No. Ext Mobile E-mail

No. No.
vivelyn.luma
niog@deped
1 Vivelyn A. Lumaniog P-I 09088726576 .gov.ph

Generene.en
age@deped.
2 Generene C. Enage T-III 09606529429 gov.ph

Genevieve.in
dic@deped.g
3 Genevieve S. Indic T-III 09464754668 ov.ph

Jenesis.sala
@deped.gov.
4 Jenesis M. Sala T-II ph
09663025153
Lourdmarier.
Lourdmarie D. pacatang@d
5 Pacatang T-III 09485167432 eped.gov.ph

Contact Person（Email will be the main source of contact so please fill in correctly）

Name School Phone No. E-mail Mobile No.

vivelyn.lumaniog@deped.g
VIVELYN A. LUMANIOG ov.ph 09088726576
School Email：libertades@deped.gov.ph
School Website/URL：Libertad ES
Postal Address: Brgy. Libertad Palo, Leyte 6501

For submission and inquiries, please send an e-mail to fgstag@gmail.com.

PRINCIPAL’S ENDORSEMENT:

Name of School Principal: ____________________________________________________________

Signature of Principal: _______________________________________________________________

Date signed: __________________________

Submit this form together with the following:

(1) Supporting documents showing as a DEPED recognized institution
(2) Project proposal
(3) Recommendation letter from the School Division Superintendent
Additional requirements for Private Schools:
(1) Valid SEC registration
(2) School profile (VM statement & core values)
(3) Copy of Official Receipt

Kindly make sure all requirements are complete.

DEADLINES & OTHER IMPORTANT DATES

FOR ALL REGIONS IN THE PHILIPPINES
Submission of
Terminal Report for Cycle 7

Deadline of Submission of New

Proposal for Cycle 7

Announcement of accepted
Proposals

Awarding Ceremony
and Forum

Project implementation:
September, 2023 to March 31, 2024

Submit via e-mail: foguangshanph@gmail.com or fgstag@gmail.com

Subject: Three Acts of Goodness School Applicant: <Name of School>
Submit via drop-off or postal: FGS Mabuhay Temple, 656 Pablo Ocampo Street., Malate,
Manila **Enclose all documents in a brown envelope and address to FGS International Group.

For submission and inquiries, please send an e-mail to

foguangshanph@gmail.com , fgstag@gmail.com
www.mabuhaytemple.com/sanhaogrant