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BE Form 01
Republic of the PhilippinesDepartment of Education
Region IVDivision of Oriental Mindoro
PUERTO GALERA NATIONAL HIGH SCHOOL SAN ISIDRO EXTENSIONSchool Year 2011-2012
BRIGADA ESKWELAPHYSICAL FACILITIES REPAIR AND MAINTENANCE NEEDS ASSESSMENT FORM
(To be accomplished by the Resource Mobilization Committee)
Instruction: Conduct an ocular inspection of the school facilities listed below. Then provide the needed information to facilitate the improvement to be done on these identified facilities. (If needed, you may use separate form for each classroom or school facility.)
FACILITIES
Condition(Check One)
Remarks Nature of Improvement Needed
(e.g. repair, repainting, replacement, etc.)
Material Resources Needed
(Indicate kind and quantity)
Manpower Needed(Indicate quantity and
nature of labor services needed)Satisfactory
UnsatisfactoryIf unsatisfactory,
describe the problem.Roofs/gutters /Ceilings / Dusty Cleaning Rags, water,1 pc. laundry
soap, 1 pc. Plastic pail5
Walls /Blackboards /Chairs/desks/tables / Need to be repainted Repainting 3 Liters paint, 2 bottles
thinner, 2 pcs. Paint brush, 5 pcs sand paper
15
Water facilities / Drainage System
/ No water supply available.
Lighting /Windows / Dusty Cleaning Rags, water, laundry
soap, 1 pc. Plastic pail5
Doors /School grounds / Weedy The weeds are to be
pulled out/removedGrass cutter 10
Others. Floor / Dusty Cleaning 20 boxes floorwax 5Prepared by: Noted by:
DINAH B. DUMLAO May 22,2009 RIZALINA T. MANZANOMaster Teacher I Date of Inspection Secondary School Principal II
BE Form 03Republic of the PhilippinesDepartment of Education
Region IDivision of Ilocos Norte
DON SALUSTIANO AQUINO MEMORIAL NATIONAL HIGH SCHOOLSchool Year 2009-2010
BRIGADA ESKWELARESOURCE MOBILIZATION FORM
(To be accomplished by the Resource Mobilization Committee)
Instruction: Using the completed BE Form 01: Physical Facilities Needs Assessment Form as basis, summarize the resources (materials and manpower) needed and list down the potential source or partners to be tapped. Add additional sheet if needed. The Status and Remarks columns should be updated regularly to determine progress in acquiring resources needed.
Materials Needed QuantityKey Persons / Organizations
to be TappedStrategies/Plan of Action Person Responsible Status Remarks
Paint 3 gal. I-Cherry Blossoms Fund Purchased Miss Dinah B. Dumlao For repaintingPaint brush 4 pcs. I-Cherry Blossoms Fund Purchased Miss Dinah B. Dumlao For repaintingThinner 2 bot. I-Cherry Blossoms Fund Purchased Miss Dinah B. Dumlao For repaintingSand Paper 5 pcs. I-Cherry Blossoms Fund Purchased Miss Dinah B. Dumlao For cleaningPlastic pail
2 pc I-Cherry Blossoms Fund Purchased
Miss Dinah B. DumlaoFor cleaning, forwatering plants
Floor wax 20 box. Floor wax
I-Cherry Blossoms Fund Purchased
Miss Dinah B. DumlaoFor cleaning
Soft broom1 pc. Jerry Tadeo
PurchasedMiss Dinah B. Dumlao
For cleaning the surroundings
Labor Skills/Volunteers Needed
QuantityKey Persons / Organizations
to be TappedStrategies/Plan of Action Person Responsible Status Remarks
Painting of the cabinets, blackboards, chairs and bulletin boards
5
Raffy GeronimoKarl Loie BataraFerlyn Cayaban
Jerald Jhun AgustinRandell Dan B. Luna
Text the parents of these students
Miss Dinah B. Dumlao Job well done
Prepared by: Noted by:
DINAH B. DUMLAO May 22,2009 RIZALINA T. MANZANOMaster Teacher I Date of Inspection Secondary School Principal II
BE Form 06
Republic of the PhilippinesDepartment of Education
Region IDivision of Ilocos Norte
DON SALUSTIANO AQUINO MEMORIAL NATIONAL HIGH SCHOOLSchool Year 2009-2010
BRIGADA ESKWELADAILY ACCOMPLISHMENT REPORT
(To be accomplished by the Program Implementation Committee)
Instruction: List down all the activities that needs to be undertaken for each day of the brigade Eskwela week. At the end of each day, please mark the appropriate column that corresponds to the status of each activity. Cite reasons for non-completion.
ActivitiesSTATUS
REMARKS/RECOMMENDATIONSCompleted Started but not yet completed Note done
Day 1 – May 18,2009 Inspection of facilities and surroundings of Cherry Blossoms room.
/
Day 2 – May 19,2009 Cleaning and re-structuring the room and cleaning the window blades
/
Day 3 – May 20, 2009 repainted the chairs, tables, cabinets .
/
Day 4 – May 21,2009 Cleaning, fixing and planting at the frontage of the room.
/
Day 5 – May 22,2009 Making the report
/
PreparPrepared by: Noted by:
DINAH B. DUMLAO May 22,2009 RIZALINA T. MANZANOMaster Teacher I Date of Inspection Secondary School Principal II
BE Form 2Republic of the PhilippinesDepartment of Education
Region IDivision of Ilocos Norte
DON SALUSTIANO AQUINO MEMORIAL NATIONAL HIGH SCHOOLSchool Year 2009-2010
BRIGADA ESKWELASCHOOL WORK PLAN
(To be accomplished by the School Head)
Instruction: List down all the specific activities that you will be undertaking in relation to the conduct of Brigada Eskwela in your school and fill in the required information. Add another sheet if needed. Once completed, submit a copy to the Adopt-A-School Program coordinator or Brigada Eskwela coordinator of your school/division on or beforeJanuary 31.
KRA Activities Timeline Person/sResponsible Materials Needed Budget1. Advocacy and Marketing
Inform the students and parents during the enrolment.
April-May, 2009TeacherParentsStudents
2. Resource MobilizationMake a listing of donated materials.Conduct a physical inspection of the physical facilities.
April-May, 2009 Teacher
List of donated materials
3. ImplementationConduct the Brigada Eskwela program.
May 18-22,2009TeacherParentsStudents
4. Monitoring and EvaluationCheck the outputs and account the persons involved in the program.
May 22, 2009TeacherParentsStudents
5. ReportingPrepared the report on the finished work.
May 25, 2009 Teacher
Encoding, printing of the report
P 100.00
Prepared by: Noted by:
DINAH B. DUMLAO May 22,2009 RIZALINA T. MANZANOMaster Teacher I Date of Inspection Secondary School Principal II
BE Form 07Republic of the PhilippinesDepartment of Education
Region IDivision of Ilocos Norte
DON SALUSTIANO AQUINO MEMORIAL NATIONAL HIGH SCHOOLSchool Year 2009-2010
BRIGADA ESKWELASCHOOL ACCOMPLISHMENT REPORT(To be accomplished by the School Head)
DIVISION: Ilocos Norte REGION: ISCHOOL: Don Salustiano Aquino Memorial National High School SCHOOL I.D.School Address: Brgy. 06, Tonoton, Piddig, Ilocos Norte(Please check appropriate box)Level: ( ) Elementary ( / ) High School
Type of School: ( ) Central School ( ) Non- Central School (complete) ( ) Multigrade ( ) Primary School/ Incomplete ( ) Integrated
SCHOOL HEAD: Mrs. RIZALINA T. MANZANO CONTACT NUMBER:PTCA PRESIDENT: Mr. Eduardo Toribio CONTACT NUMBER:
A. SCOPE OF REPAIR AND MAINTENACE WORK COMPLETED ( Please check appropriate column)What was done?
Repaired Repainted Replaced Others (Brief Description)1. Roofs2. Ceilings Cleaned3. Walls4.Windows and Doors Cleaned5. Chairs/Desks, Tables, and Blackboards / /6.Comfort Rooms7. Leaking Pipes Cleaned8. School Grounds/ Landscaping9. School Signs10. Others (Specify)
Prepared by: Noted by:
DINAH B. DUMLAO May 22,2009 RIZALINA T. MANZANOMaster Teacher I Date of Inspection Secondary School Principal II
B. DONATIONS/ MATERIAL RESOURCES GENERATED (Use separate sheets, if needed)Type of Donations Source Estimated Cost
3 liters paint Donation/ I-Cherry Blossoms Students 390.004 paint brush Donation/ I-Cherry Blossoms Students 150.002 bots. Thinner Donation/ I-Cherry Blossoms Students 60.005 pcs. Sand Paper Donation/ I-Cherry Blossoms Students 100.002 pcs. Plastic pail Donation/ I-Cherry Blossoms Students 80.0020 boxes floor wax Donation/ I-Cherry Blossoms Students 100.001 pc. Soft broom Donation-Jerry Tadeo 50.00Total P 930.00
C. VOLUNTEER SERVICESType of Volunteer Name of
Individuals/ Organization Day 1
Number
Day 2
of
Day 3
Volunteers
Day 4 Day 5 Day 6Total
1. PTCA Members2. Barangay Officials 0 0 0 0 0 0 03. Municipal/ City Government Officials 0 0 0 0 0 0 04.Provincial Gov’t. Officials 0 0 0 0 0 0 05. NGO’s, Civic Organizations 0 0 0 0 0 0 06. Private Citizens 0 0 0 0 0 0 07. Private Companies/ Corp. 0 0 0 0 0 0 08. Other government offices 0 0 0 0 0 0 09. Parents10. Teachers 1 1 1 1 1 1 111. Pupils/ Students12. Others: (specify) (Family Members) 15 5 5 5 10 5 4513. Prominent Volunteers
TOTAL 16 6 6 6 11 6 46Prepared by: Noted by:
DINAH B. DUMLAO May 22,2009 RIZALINA T. MANZANOMaster Teacher I Date of Inspection Secondary School Principal II
D. SIGNIFICANT EVENTS / EXPERIENCES
What happened? Who were involved? WhenWhat is/are important contribution to the operation of
the school or to the existing needs of the school?
Students, teachers and parents actively participated in the implementation of the Brigada Eskwela.
TeachersParentsStudents
May 18-22,2009The implementation of the program helped in preparing the school for the opening of classes.
E. ISSUES AND CONCERNS (Describe briefly problems encountered and how resolved)
The common problem encountered was the funding needs of the program. But through the resourcefulness of the persons involved, it was properly solved.
E LESSONS LEARNED / BEST PRACTICES
The practices learned were resourcefulness and the implementation of the “bayanihan” spirit among the people in the community.
F. SUGGESTIONS TO STRENGTHEN BRIGADA ESKWELA PROJECT (Include support needed from Central, Region, and Division Office that can increase the impact of Brigada Eskwela Project in your school)
There must be an allocated funds for the implementation of the program especially for major repairs of the physical facilities of the school.
Prepared by: Noted by:
DINAH B. DUMLAO May 22,2009 RIZALINA T. MANZANOMaster Teacher I Date of Inspection Secondary School Principal II
D. ESTIMATED COST OF VOLUNTEER SERVICES RENDERED
Type of Service Total Number of Volunteers
Total Number of Hours Rendered
Total Estimated Cost
Carpentry 5 8 1250
Ordinary Labor 40 4 2000
G. EVIDENCES / ATTACHMENTS a. Photos (before, during, after) b. Photocopy of all completed BE Forms (check if attach) ______ Form 01 _______ Form 05 ______ Form 02 _______ Form 06 ______ Form 03 ______ Form 04 Prepared by:
DINAH B. DUMLAO Master Teacher I Name and Designation
Date:
May 22,2009
Submit copy of this completed form to ADOPT-A-SCHOOL PROGRAM DISTRICT COORDINATOR or District Supervisor on or before June 15.
Form 5Republic of the PhilippinesDepartment of Education
Region IDivision of Ilocos Norte
DON SALUSTIANO AQUINO MEMORIAL NATIONAL HIGH SCHOOLSchool Year 2009-2010
BRIGADA ESKWELA
RECORD OF DONATIONS RECEIVED
Items or Materials Quantity Date Received Name of Donor Assumed Cost Of ItemsPer Unit (Php) Total(Php)
Paint 3 gal. May 12,2009 I-Cherry Blossoms Funds 130.00 390.00
Paint brush 4 pcs May 12,2009 I-Cherry Blossoms Funds 37.50 150.00
Paint thinner 2 bottles May 12,2009 I-Cherry Blossoms Funds 30.00 60.00
Sand paper 5 pcs. May 12,2009 I-Cherry Blossoms Funds 20.00 100.00
Plastic pail 2 pc. May 12,2009 I-Cherry Blossoms Funds 40.00 80.00
Floor wax 20 boxes May 18,2009 I-Cherry Blossoms Funds 5.00 100.00
Soft broom 1 pc. May 18,2009 Jerry Tadeo 50.00 50.00
Total 930.00
Prepared by: Noted by:
DINAH B. DUMLAO May 25 ,2009 RIZALINA T. MANZANOMaster Teacher I Date of Inspection Secondary School Principal II
Republic of the PhilippinesDepartment of Education
Region I
Division of Ilocos NorteDON SALUSTIANO AQUINO MEMORIAL NATIONAL HIGH SCHOOL
School Year 2009-2010
REPORT ON BRIGADA ESKWELAMay 18-22,2009
Submitted by:
DINAH B. DUMLAO Adviser, I-Cherry Blossoms
The students of I-Cherry Blossoms are busy repainting the chairs.
The chairs that need to be repainted
The students are using sand paper in removing dirt and old paint of the chairs
Cleaning the window blades and doors
“We need to repaint the concrete bench and make signage too.”
G. EVIDENCES / ATTACHMENTS a. Photos (before, during, after) b. Photocopy of all completed BE Forms (check if attach) ______ Form 01 _______ Form 05 ______ Form 02 _______ Form 06 ______ Form 03 ______ Form 04 Prepared by:
DINAH B. DUMLAO Master Teacher I Name and Designation
Date:
May 22,2009
Submit copy of this completed form to ADOPT-A-SCHOOL PROGRAM DISTRICT COORDINATOR or District Supervisor on or before June 15.