Adopt A School Program Quarterly Report Forms

ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT
aspsch_form 01
As of March 31, 2015

Region:
Division:
School:
Address:
School ID:
Contact Nos.:
LEARNING ENVIRONMENT
DONATIONS
PARTICULARS
QTY.
AMOUNT
DONOR'S NAME
PRIVATE SECTOR
LGU
GOVERNMENT AGENCY
INTERNATIONAL
DATE COMPLETED/
TURN-OVER
aspsch_form 01
TOTAL
*
Please attach the following documents:
GPTA
Prepared by:
Noted by:
1. Deed of Donation
2. Deed of Acceptance
School Head/Principal/OIC
ASP Division Coordinator

Approved by:
Schools Division Superintendent
aspsch_form 02

Region:
Division:
School:
Address:
School ID:
Contact Nos.:
LEARNING SUPPORT
DONATIONS
PARTICULARS
QTY.
DONOR'S NAME
AMOUNT
PRIVATE SECTOR
LGU
GOVERNMENT AGENCY
INTERNATIONAL
1.
2.
3.
4.
TOTAL
*
Prepared by:
Noted by:
1. Deed of Donation

Approved by:
DATE COMPLETED/
TURN-OVER
aspsch_form 02
aspsch_form 03

Region:
Division:
School:
Address:
School ID:
Contact Nos.:
_____________________ Email Address: _________________________
TECHNOLOGY SUPPORT
DONATIONS
PARTICULARS
QTY.
AMOUNT
DONOR'S NAME
PRIVATE SECTOR
LGU
GOVERNMENT AGENCY
1. COMPUTER
2. ELECTRONIC LEARNING
MATERIALS
3. INTERNET CONNECTIVITY
4. OTHERS PLS. SPECIFY
TOTAL
*
Prepared by:
Noted by:
INTERNATIONAL
DATE COMPLETED/
TURN-OVER
aspsch_form 03
1. Deed of Donation

Approved by:
aspsch_form 04

Region:
Division:
School:
Address:
School ID:
Contact Nos.:
_____________________ Email Address: _________________________
HEALTH AND NUTRITION

DONATIONS
PARTICULARS
QTY.
AMOUNT
DONOR'S NAME
PRIVATE SECTOR
LGU
GOVERNMENT AGENCY
INTERNATIONAL
1. FEEDING PROGRAM
2. MEDICAL/DENTAL
MISSION/CHECK-UPS
3. DEWORMING
INTERVENTION
4. HEALTH SUPPLIES
TOTAL
*
Prepared by:
Noted by:
1. Deed of Donation
DATE COMPLETED/
TURN-OVER
Approved by:
aspsch_form 04
aspsch_form 05

Region:
Division:
School:
Address:
School ID:
Contact Nos.:
_____________________ Email Address: _________________________
READING PROGRAM
DONATIONS
PARTICULARS
QTY.
DONOR'S NAME
AMOUNT
PRIVATE SECTOR
LGU
GOVERNMENT AGENCY
INTERNATIONAL
1. BOOKS
2. SUPPLEMENTARY
READING MATERIALS
TOTAL
*
Prepared by:
Noted by:
1. Deed of Donation

Approved by:
DATE COMPLETED/
TURN-OVER
aspsch_form 05
aspsch_form 06

Region:
Division:
School:
Address:
School ID:
Contact Nos.:
_____________________ Email Address: _________________________
TRAINING AND DEVELOPMENT

DONATIONS
PARTICULARS
QTY.
DONOR'S NAME
AMOUNT
PRIVATE SECTOR
LGU
GOVERNMENT AGENCY
INTERNATIONAL
1. TEACHERS/PRINCIPAL TRAINING
2. STUDENT/PUPILS TRAINING
AND FIELD TRIP
TOTAL
*
Prepared by:
Noted by:
1. Deed of Donation

Approved by:
DATE COMPLETED/
TURN-OVER
aspsch_form 06
aspsch_form 07

Region:
Division:
School:
Address:
School ID:
Contact Nos.:
DIRECT ASSISTANCE
DONOR'S NAME
DONATIONS
PARTICULARS
QTY.
AMOUNT
PRIVATE SECTOR
LGU
GOVERNMENT
AGENCY
INTERNATIONAL
1. STIPEND
TOTAL
* Please attach the following documents:
1. Deed of Donation
Noted by:
Approved by:
DATE
COMPLETED/
TURN-OVER
aspsch_form 07
aspsch_form 08

Region:
Division:
School:
Address:
School ID:
Contact Nos.:
_____________________ Email Address: _________________________
ASSITIVE LEARNING DEVICES FOR STUDENT WITH SPECIAL NEEDS

DONATIONS
PARTICULARS
QTY.
DONOR'S NAME
AMOUNT
PRIVATE SECTOR
LGU
GOVERNMENT AGENCY
INTERNATIONAL
1. PENCIL GRIPS
2. SPECIAL CHAIRS
3. SPELLING CHECK DEVICES
4. HEARING AIDES
5. TALKING COMPUTERS
6. SPECIALIZED KEYBOARDS
8. BRAILLE (BOOKS)
9. COMPUTERIZED SYSTEMS
TOTAL
*
Prepared by:
Noted by:
1. Deed of Donation

Approved by:
DATE COMPLETED/
TURN-OVER
aspsch_form 08

SCHOOL ID
TOTAL
SCHOOL
Learning
Environment
Learning
Support
Technology
Suppport
Health and
Nutrition
Reading
Program
Training and
Development
Direct
Assistance
Assistive
Learning
Devices
TOTAL

Region:
Division:
School:
Address:
School ID:
Contact Nos.:
_____________________ Email Address: _________________________
LEARNING SUPPORT
DONOR'S NAME
DONATIONS
PARTICULARS
1.
AUDIO-VISUAL
EDUCATIONAL MATERIALS
2.
SCHOOL SUPPLIES
3.
EDUCATIONAL FILM/
LIBRARIES
4.
OTHERS PLS. SPECIFY
QTY.
AMOUNT
TOTAL
*

1. Deed of Donation
PRIVATE
SECTOR
LGU
GOVERNMENT
AGENCY
INTERNATIONAL
Prepared by:
Noted by:

Approved by:
DATE COMPLETED/
TURN-OVER

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Adopt A School Program Quarterly Report Forms

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ADOPT-A-SCHOOL PROGRAM QUARTERLY REPORT

As of March 31, 2015

Please attach the following documents:

ASP Division Coordinator