Form 2 OES Proposal Form - Bridge Engg

Republic of the Philippines
Sorsogon State University

Office of Extension Services
Sorsogon City
Tel. No. (056) 211 0178 – 211 0200; oes@sorsogonstatecollege.edu.ph
EXTENSION PROJECT PROPOSAL
Section A. Basic Information of the Proponent
EXTENSION PROJECT TEAM
Name: Designation in the project Faculty Rank
Engr. Percival H. Olivar
Contact Number: Team Leader Instructor
Email Address:
Name:
Engr. Eric E. Floresca Member Assistant Prof. III
Contact Number:
Email Address:
Name:
Engr. Jerry Jake June B.

Hayagan
Contact Number:
Email Address:
Name:
Mark Alex Nogales
Contact Number:
Email Address:
Name:
________________________
1
FM-EXT-002 Revision. No. 01 Effective August 15, 2021
Sorsogon City
Contact Number:
Email Address:
Name: Student
________________________
Designation (in the project):
Contact Number:
(May use more rows for more

members)
Student
Student
Student
Date Submitted:
OES Monitoring Code:
OES Received Date:
SECTION B. Information on the Project Proposal
1. General Information of the Project
Program Title : (if applicable) Programang Umusbong Para sa Sorsoganong Oragon

(PUSO)
Project Title
Project Duration
2
Sorsogon City
(mm/dd/yy - mm/dd/yy)
Project Location
Project Focus Area (RDE Agenda) Smart Analytics, Architecture and Engineering
Innovations (Build resilient infrastructure, promote
inclusive and sustainable industrialization and foster
innovation)
No. and Type/nature of Target

Beneficiaries (specify)
Implementing Partner
Amount of Partner Agency Share
Amount of SSC Share
Amount of other Sources of Fund

(if applicable)
2. Project Background and Rationale
Context and State the relevant scenarios /cases in the local level and describe the challenges
Background
3
Sorsogon City
3. Project State your goal/s (Describe the major outcome of the project)
Goals and
Objectives 1.
2.
State your objectives
1.
2.
3.
4.
4
Sorsogon City
RESULTS FRAMEWORK
Goal Outcome Activities (Defined Key Output/s / Indicators

Indicator(Project’s based on the
(Long term Key Components problems and (No. of / % Increase)
Objectives ) challenges identified) Measurable Results of
activities and progress
towards outcomes
Ex.
1 Sustainable Livelihood 1.1 Applied Food Safety 1.1.1 Orientation – No. of beneficiaries provided with
Program & Mgmt Practices Awareness on Food Safety awareness on food safety
benefits
1.1.2 Seminar on food

handling techniques % of comparable decrease in the
occurrence of waterborne/foodborne
1.1.3 Installation of diseases in the area ex. diarrhea
handwashing area
No. of beneficiaries served/utilizing

the handwashing area
1.2 Increased skills on 1.2.1 Community % of beneficiaries given training

Meat Processing for local organizing with newly installed rolling stores
entrep serving processed meat and poultry
1.2.2 Training –workshop products
on meat processing
a. tocino making
% of increase in income from year
b. siomai making 1-3.
c. etc. etc.
4. Project Application Effectiveness
How does the project contribute to the local development plans / regional / national in relation
to addressing challenges cited?
5
Sorsogon City
SorSU: What are the strategies you will use to attain the major output?
1.
2.
3.
4.
Partner Agency : What are their roles and contributions? Refer to the attached MOA
1.
2.
3.
4.
5. Project Implementation Plan (May use quarterly for long term program/project)
Year 1 - 2023
Key Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Activities/Workplan
Pre-Launching
1.
2.
6
Sorsogon City
Launching
1.
2.
3.
Implementation Phase
1.
2.
3.
Project Monitoring
and Assessments
1.
2.
Project Closure
Feedbacking and
Turn-Over Activities
6. Project Sustainability Plan
Are there follow-up plans after the proposed project? (Please indicate)
Is there an operations and maintenance plan? (Discuss and indicate the responsibility of SSC
and partner agency )
Is there a possibility that your project can also be done in other areas? ( Please indicate how)
7
Sorsogon City
SECTION C. Information of the Implementing Partner/s
Name of the Contact Details (Address; Indicative Roles /

Institution/Partner Agency Contact Number/ Email Commitment
SECTION D. Budgetary Requirement

PARTICULARS Qty Unit AMOUNT SSC Share Partner Agency
Share
A. PERSONNEL SERVICES
(Honoraria)
1. Project Team
Leader
2. Project
Coordinator
3. Trainer
4. Consultant
5. Guest Resource
Speakers
SUBTOTAL:
B. EQUIPMENT
8
Sorsogon City
1. Computer
2. Projector
3. Camera
C. MOOE
1. Gasoline, Oil,
Lubricants
2. Transportation
3. Accommodation
and Lodging
4. Office Supplies and

Materials
5. Meals and Snacks
6. Venue Rental
7. Documentation
Notarial Fees
8. Communications
SUBTOTAL :
TOTAL :
9
Sorsogon City
Submitted by:
_________________________
Name and Designation
Signed and Endorsed by : Campus Extension Review Committee (ERC)
Signature:
Name:
Designation : Extension Coordinator Program Dean Campus Administrator
========================================================================================
VI. Over-all Assessment of the College’s Research and Extension Council (SSC-RECO)
Approved per RECO Resolution No. ______, s. 2018 held at __________________

on ___________________________________________________________.
Deferred but the proponent attached the Compliance Form per recommendations
of the RECO Resolution No. ______, s. 2018 held at __________________ on
__________________________________________.
10

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Republic of the Philippines

Sorsogon State University

EXTENSION PROJECT PROPOSAL

Section A. Basic Information of the Proponent

EXTENSION PROJECT TEAM

Name: Designation in the project Faculty Rank

Engr. Percival H. Olivar

Contact Number: Team Leader Instructor

Engr. Eric E. Floresca Member Assistant Prof. III

Engr. Jerry Jake June B.

Mark Alex Nogales

Designation (in the project):

(May use more rows for more

OES Monitoring Code:

OES Received Date:

SECTION B. Information on the Project Proposal

1. General Information of the Project

Program Title : (if applicable) Programang Umusbong Para sa Sorsoganong Oragon

No. and Type/nature of Target

Amount of Partner Agency Share

Amount of SSC Share

Amount of other Sources of Fund

2. Project Background and Rationale

State your objectives

Goal Outcome Activities (Defined Key Output/s / Indicators

1.1.2 Seminar on food

No. of beneficiaries served/utilizing

1.2 Increased skills on 1.2.1 Community % of beneficiaries given training

4. Project Application Effectiveness

6. Project Sustainability Plan

SECTION C. Information of the Implementing Partner/s

Name of the Contact Details (Address; Indicative Roles /

SECTION D. Budgetary Requirement

4. Office Supplies and

5. Meals and Snacks

Signed and Endorsed by : Campus Extension Review Committee (ERC)

Designation : Extension Coordinator Program Dean Campus Administrator

Approved per RECO Resolution No. ______, s. 2018 held at __________________

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Approved per RECO Resolution No. , s. 2018 held at ____________