Republic of the Philippines Department of Education REGION lll-CENTRAL LUZON o WAY 171 2023 fue SEARCH FOR THE ANNUAL GAWAD PAG-GABAY “PAG-PUPUGAY SA GURONG ‘TAGA-HUBOG, PUNONG GURO AT BAYANING PINUNONG MAG-AARAL” REGIONAL MEMORANDUM No. 205, s. 2023 To: Schools Division Superintendents Chiefs, School Governance and Operations Division (SGOD) Project Development Officers I Division Child Protection Coordinators Public School Heads/Principals ‘Teacher-Advisers of Clubs/Organizations Student Leaders All Others Concerned 1. The Department of Education (DepEd) Region Il through the Education Support Services Division (ESSD) shall conduct the Search for the annual Gawad Pag-Gabay “Pag-pupugay sa Gurong Taga-Hubog, Punong Guro at Bayaning Pinunong Mag-aaral”. 2. The Gawad Pag-Gabay is derived from the Filipino word “Gabay” that translates the youth formation programs guiding the learners to become responsible, agents of change and productive citizens embodied in the Filipino core values Maka- Diyos, Maka-Tao, Makakalikasan at Makabansa. Thus, Gawad Pag-Gabay aims to recognize the outstanding performance, accomplishments and _ significant contributions of school heads, teacher-advisers, student leaders and youth formators in delivering accessible, safe and quality education for all. 3. Further, Gawad Pag-Gabay specifically aims the following. a. Recognize and appreciate the outstanding performance and accomplishments and significant contributions of school heads, teachers-advisers, student leaders and youth formators in implementing relevant and responsive youth formation programs contributing to the delivery of accessible and quality basic education for all; b, Encourage and motivate youth program implementers to plan and implement significant youth programs, project and activities responsive to address the pressing issues concerning today’s learners and; c. Sustain and promote high impact youth programs, projects and activities that lead leaners to become agents of change and responsible citizens. 4. The timeframe coverage of youth formation programs, projects and activities implemented /accomplished shall be within the school year from August to July of the current year and succeeding year respectively. ot ‘Address: Matalino St. DM. Government Center, Maimpis, City of San Fernando (P) AJA 4B Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] SainsDepartment of Education REGION II-CENTRAL LUZON 5. For the 2023 Gawad Pag-Gabay Search, youth formation programs, projects and activities implemented /accomplished from August 2022 to July 2023 shall be considered. 6. __ The Scarch is open to all public elementary and secondary schools, school heads, teacher-advisers, student leaders and division youth formation coordinators who are excellently implementing the Youth Formation Flagship Programs namely, Student Government Program, National Greening Program, Barkada Kontra Droga and Child Protection Policy and Advocacy. 7. The annual Awarding Ceremony for Gawad Pag-Gabay shall be done every December of each year during the Education Week Celebration, 8. __ All expenses incurred in the conduct of this Search by the participants and the search committee shall be charged against local funds, subject to the usual accounting and auditing rules and regulations. 9. Attached are the enclosures for reference. Guidelines and Mechanics for the Search Timetable of the Search Composition of Regional /Division Selection Committee Category of Awards Endorsement and Application Forms Criteria and Score Sheet per Category reaoge 10. Immediate and widest dissemination of this Memorandum is desired. For the Regional Director: J L. AMIN, EdD, CESO V Assistant Regional Director ote a he epee ‘ihe aang ei ot ‘Address: Matalino St. D.M. Government Center, Maimpis, Cty of San Fernando (?) AJA 4B ephone Number: 045) 598-8560 to 89; Email Address [email protected] aeSZ Republic of the Philippines Department of Education REGION IIl-CENTRAL LUZON Annual Search Flow for Gawad Pag-Gabay Guidelines and Mechanics Search Flow ‘Submission of the Application and documentary requirements of Eniries u Division Level Evaluation and Validation u Announcement of Division Winners and Submission of Division Champion per Category to Regional Office vu Regional Level Evaluation and Validation | u Announcement of Regional Winners, (if there will be a National Search for Gawad Siklab, the Regional Champion per category shall represent the Region to National Search) Regional Awarding Ceremony oh Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) J Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] SaasRepublic of the Philippines Department of Education REGION II-CENTRAL LUZON ‘Timetable for the 2023 Search for Gawad Pag-Gabay Date T Activity: ‘Office In charged | re Submission of Entries Division Search pa ee eee from the Schools Committee- Secretariat ‘2h or 3% Week of August 2023 Division Level Evaluation and Validation of Entries Division Search Committee 4th Week of August 2023 Announcement of Division Winners ‘School Division Office- Division Search Committee. September 7, 2023 Deadline of Submission of Entries to Regional Office Regional Search ‘Committee- Secretariat September 11-15, 2023 Regional Level Table ‘Validation and Evaluation of Entries Regional Search Committee September to November 2023 Onsite validation and evaluation of Entries Regional Office- Regional ‘Search Committee | November 2023 ‘Announcement of Regional Winners Regional Office- Regional ‘Search Committee December 2023 ‘Gawad Pag-Gabay Awarding Ceremony Regional Office- Regional ‘Search Committee ‘ote: the Same timetable shal be folowed inthe succeeding years. Address: Matalin St. D.M. Government Center, Maimpis, Cty of San Fernando (P) J Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] SSassat oeRepublic of the Philippines Department of Education REGION IIl-CENTRAL LUZON Composition of the Search Committee for Gawad Pag-Gabay Division Level Search Committee Chairperson Chief, School Governance and Operations Division (SGOD) Vice Chairperson | Project Development Officer | Senior Education Program Specialist (Socmob) Senior Education Program Specialist (Monitoring and | Mentbers, Evaluation) Education Program Supervisor (SGOD) (Secretariat Project Development Officer I [ Regional Level Search Committee Chairperson Chief Education Supervisor (ESSD} ‘Vice Chairperson _| Project Development Officer IV, ESSD. | Members Education Program Supervisor, QAD. Project Development Officer Il, ESSD Education Program Supervisor, CLMD Secretariat Project Development Officer IV, ESSD_ General Guidelines for the Search Committee 1 2. ‘The composition of the Search Committee for Gawad Pag-Gabay shall strictly follow the prescribed composition indicated. ‘The Chairperson shall lead the Search Committee. He/She must be present. in all the scheduled paper evaluation and validation. ‘The Search Committee must have a quorum to proceed with the paper evaluation and validation. ‘The Secretariat shall arrange all the documents of entries and other materials needed by the Search Committee. The Secretariat shall prepare/record the Minutes of the Meeting transpired during the evaluation and validation by the Search Committee. The Secretariat shall consolidate the results of evaluation and validation and prepare a Memorandum announcing the winners. SCHOOL LEVEL 1, The student leaders, teacher-advisers and school heads who have implemented youth formation flagship programs are encouraged to join the Search. 2. The Teacher-Adviser and/or School Head in charged shall submit the Application Form, Documentary Requirements and Means of Verification (MOVs) to their respective Division Level Search Committee. ‘Address: Matalino St. D.M. Government Center, Maimpis, ity of San Fernando (P) ‘Telephone Number: (045) 598-8580 to 89; Email Address: [email protected]Republic of the Philippines Department of Education REGION I-CENTRAL LUZON 3. The deadline of submission of the entries shall set by the Schools Division Office (SDO) earlier than Regional Level Evaluation and Validation. 1. DIVISION LEVEL 1, The Chief of SGOD shall be the chairperson of the Division Search Committee as indicated in composition of Search Committee. He/She must lead all the activities related to the Search. 2. The Schools Division Office through the Division Search Committee shall receive all Entries from the participating schools. Thus, the Secretariat shall notify the participating schools if all the needed requirements were met and their lacking requirements. 3. The Division Search Committee shall conduct the paper evaluation and validation of submitted documents using the given criteria per category. 4. The Division Search Committee shall use the score sheet provided by the Regional Office. 5. The Schools Division Office through the Division Search Committee shall submit their champion per category to the Regional Office for Regional Level evaluation and validation. 6. The Division Search Committee through the Secretariat shall submit the list of champion per category together with documentary requirements and means of verifications to the Regional Office on or before the deadline set by the Regional Office. 7. The Schools Division Offices through the School Governance and Operations Division (SGOD) are encouraged to conduct an awarding ceremony to formally recognize the winners. Moreover, all non-winning entries shall receive a certificate of participation. I. REGIONAL OFFICE 1. The Chief Education Supervisor of the Education Support Services Division (ESSD) shall serve as a Chairperson of the Regional Search Committee as indicated in the composition of the Search Committee. He/She must lead all the activities relative to the Search. 2. The Regional Office through the Regional Search Committee shall receive all Entries submitted by the Division Office. Thus, the Secretariat shall notify the Division Search Committee on the completeness and the lacking requirements submitted. 3. The Regional Search Committee shall conduct the paper evaluation and validation of all the documents submitted per category using the criteria provided by this Office. Furthermore, the schedule of the field evaluation for the Top 5 Best School Implementer per category shall be announced in a separate Memorandum. ‘Address: Matalino St. D.M. Government Center, Maimpis, ity of San Fernando (P) Telephone Number: (045) 598-8580 to 89; Email Address: [email protected]Republic of the Philippines Department of Education REGION ILCENTRAL LUZON 4. The score obtained of the entry /ies from the Division Search Committee submitted to the Regional Search has no bearing on the scoring of the Regional Search Committee. Thus, an entry obtained the highest score per category shalll be declared as Regional Champion. Moreover, for the Best School Implementer winners. The School Coordinator and School Head shall be awarded as Most Outstanding School Coordinator and Most Outstanding School Head respectively. In addition, the Project Development Officer I who handled the program shall be awarded as Most Outstanding PDO Program Implemente: 5. To determine the Most Outstanding Schools Division Office YF Program Implementer, shall be ranked based on the points obtained by their respective winner/s. 5 points = Champion or Awarded as Most Outstanding/Best Implementer 4 points = 1* Runner Up 3points = 2! Runner Up 2 points = 3“ Runner Up 1 point = 4%” Runner Up 6. The Hall of Fame Award shall be given to a school that has been awarded as Champion (Best School Implementer) for three (3) consecutive times. Further, the regional office through the evaluation team (RSC) will conduct unannounced visit to the school to ensure the sustainability of the program. 7. The Regional Office through the Education Support Services Division (ESSD] shall conduct an Awarding Ceremony to formally recognize the winners. Thus, all non-winning entries shall receive a certificate of recognition as finalist. 8. In case, the National Search for Gawad Siklab will push through, the Regional Champion per category shall be representative of the Region on the said Search. eh) Address: atalino St. .M, Government Center, Maimpis, Cty of San Fernando {®) Ja AB ee ‘Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] Saas“ Cetcanonatiar?Republic of the Dbilippines Department of Education REGION lllCENTRAL LUZON Category of Awards Categories [Student Government (SPG/SSG) Award for both Elementary and Secondary Best Implementer- Maka-Diyos, 1st Runner Up, 2nd Runner Up,3rd Runner Up [Best Implementer- Makakalikasan, ist Runner Up,2nd Runner Up, Srd Runner Up| Best Implementer- Maka-Tao, 1st Runner Up, 2nd Runner Up, Srd Runner Up ‘Best Implementer- Makabansa, 1st Runner Up, 2nd Runner Up, 3rd Runner Up [Most Outstanding Student Leader, 1st Runner Up, 2nd Runner Up, 3rd Runner Up | Most Outstanding Teacher-Adviser, Ist Runner Up, 2nd Runner Up, 3rd Runner Up Most Outstanding School Head, ist Runner Up, 2nd Runner Up, 3rd Runner Up ‘Youth for Environment in Schools (YES-O) Award for both Elementary and | Secondary | Most Outstanding YES-O School Implementer, Ist Runner Up, 2nd Runner Up, 3rd Runner Up Most Outstanding YES-O Student Leader, Ist Runner Up, 2nd Runner Up, 3rd Runner Up. Most Outstanding YES-O Teacher-Adviser, Ist Runner Up, 2nd Runner Up, 3rd Runner Up. Most Outstanding School Head, Ist Runner Up, 2nd Runner Up, 3rd Runner Up Barkada Kontra Droga Award for Secondary only Best Barkada Kontra Droga Implementer, Ist Runner Up, 2nd Runner Up, 3rd Runner Up i | Most Outstanding Barkada Kontra Droga Student Leader, Ist Runner Up, 2nd | Runner Up, 3rd Runner Up ‘Most Outstanding Barkada Kontra Droga Teacher-Adviser, Ist Runner Up, 2nd Runner Up, 3rd Runner Up Most Oulstanding School Head, 1st Runner Up, 2nd Runner Up, Sxl Runner Up ‘Child Protection Award for both Elementary and Secondary Best Child Protection Policy School Implementer, 1st Runner Up, 2nd Runner Up, | 8rd Runner Up. Most Outstanding Child Protection Policy Coordinator- School Level, Ist Runner Up, 2nd Runner Up, 3rd Runner Up Most Outstanding School Head, ist Runner Up, 2nd Runner Up, 3rd Runner Up Division Youth Formation Coordinator Award Most Outstanding Division Youth Formation Coordinator Most Outstanding Division YFC Implementer «Student Government Program (SSG /SPG) ‘*_ National Greening Program (YES-O) [} Barkada Kontra Droga ‘* Child Protection Policy ‘Most Functional Social Media Award Ist Runner Up, 2nd Runner Up, 3rd Runner up Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) 5. R Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] SiaRepublic of the Philippines Department of Education REGION II-CENTRAL LUZON Most Innovative Youth Formation PPAs Award (Division Level Only) Ist Runner Up, 2nd Runner Up, 3rd Runner up ‘Most Outstanding Schools Division Office YF Program Implementer is Runner Up, 2nd Runner Up, 3rd Runner up eh) > ‘Address: Matalino St. 0.M. Government Center, Maimpis, City of San Fernando (P) J. Telephone Number: (045) 596-8580 to 89; Email Address: [email protected] iBRepublic of the Bbilivpines Bepartment of Education REGION II-CENTRAL LUZON Date MAY B. ECLAR, PhD, CESO IIT Regional Director DepEd Region II Matalino St., Diosdado Macapagal Government Center, Maimpis, City of San Fernando, Pampanga Subject: Endorsement of the Division Entries for 2023 Gawad Pag-Gabay Dear Director Eclar: Greetings of peace and blessings be unto yout After thorough evaluation, may we respectfully endorse the following Division Entries for the 2023 Gawad Pag-Gabay “Pag-pupugay sa Gurong Taga-Hubog, Punong Guro at Bayaning Pinunong Mag-aaral” for the following categories, to wit: [No (Category Name of Nominee (1 “Best Implementer- Makabansa_ __| Jose Rizal Elementary School 2. | Most Outstanding Leader- SSG. Carlos C. Rizal 3.__| Most Outstanding Yes-O Teacher- Adviser_| Bonifacio M. Zamora Attached are the copy of the submitted documents by the nominees and vetted score sheets by the Division Search Committee. ‘Thank you and God bless. Very truly yours; Name and Signature of the SDS a [Address: Matalino St. DM. Government Center, Maimpis, City of San Fernando (P) ya 74 Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] Seas”Republic of the Philippines Department of Education REGION Il-CENTRAL LUZON Form 2 Application Porm for 'SSG/SPG Region: Division: Profile ‘Contact Number: Email address: Total Enrollment: Information of Contact Person (if applicable) Full Name: Surname Given Name Middle Initial Name Extension Home Address: a the Organi Contact Number: Project Profile | Project Tite: | Project Brief Description (3 sentences only) Project Timeframe Implemented: Category ( Please Check One Only) Maka- Diyos (Belief and Tradition)-School Maka-Tao (Human Development, Health, Well-Being)-School Makakalikasan (Environment and Disaster Risk Reduction Management)-School ‘Makabansa(Heritage, Culture, Nationalism, Patriotism and Volunteerism)-School Most Outstanding Student Leader ‘Most Outstanding Teacher-Adviser Most Outstanding School Fead Thereby certify upon my honor that all facts and information indicated herein are true and correct to the best of my knowledge and abilities. I further declare that any information given that proves to be untrue may constitute a ground for disqualification in the search ‘and prosecution for perjury. Further, I subscribe and agree that the Department of Education Region Ill have the sole prerogative to select the winners, and thet their decision is final and executory. In witness hereof, I am executing and signing this statement voluntarily and without compulsion. Signature over Printed Name fey) et | GQ *) Address: Matalino St. D.M. Government Center, Maimpls, ty of Son Femnando(®) ya ZA %, a Telephone Number: (045) 598-8580 to 89; Email Address: [email protected]_ CetcaeNe AAIDepartment of Education REGION II-CENTRAL LUZON Form 3 Application Porm for YES. Region’ Division: (Name of Nomines: [School Address: ‘Contact Number: Email address: Total Enrollment: Tnformation of Contact Person (applicable) Given Name Middle Initial Name Extension Position in the Organization: Contact Number: Project Profile Project Title: Project Brief Description (3 sentences only) He | Project Timetrame Implemented: Category ( Please Check One Only) ‘Most Outstanding YES-O School Implementer ‘Most Outstanding YES-O Student Leader ‘Most Outstanding YES-O Teacher-Adviser ‘Most Outstanding YES-O School Head Thereby certify upon my honor that all facts and information indicated herein are true and correct to the best of my knowledge and abilities. I further declare that any information given that proves to be untrue may constitute a ground for disqualification in the search and prosecution for perjury. Further, I subscribe and agree that the Department of Education Region III have the sole prerogative to select the winners, and that their decision is final and executory. In witness hereof, I am executing and signing this statement voluntarily and without compulsion. Signature over Printed Name Goer & Cee: ‘Addrats: Matalin St, DM, Goverment Center, Maimpl, Cy ofan Ferando (°) sa ZAP EA eo ‘Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] “Republic of the Philippines Department of Education REGION II-CENTRAL LUZON Region: Division: Profile [Name of Nomin [School Address: (Contact Number: ‘Email address: eee Information of Contact Person (If applicable) TRullName: | Surname. Given Name Middle Initial Name Extension [Home Address: (Date of Birth: Position in the Organization: Contact Number: Project Profile [ | Project Tide: Project Brief Description (3 sentences only) Project Timeframe Implemented: (Category ( Please Check One Only) ‘Best Barkada Kontra Drogra School Implementer Most Outstanding Student Leader Most Outstanding Teacher-Adviser Most Outstanding School Head Thereby certify upon my honor that alll facts and information indicated herein are true and correct to the best of my knowledge and abilities. I further declare that any information given that proves to be untrue may constitute a ground for disqualification in the search and prosecution for perjury. Further, I subscribe and agree that the Department of Education Region Il have the sole prerogative to sclect the winners, and that their decision is final and executory. In witness hereof, I am executing and signing this statement voluntarily and without compulsion. Signature over Printed Name Address: Matalin St..M. Government Center, Maimpis, City of San Fernando (P) 34. > B ‘Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] SesRepublic of the Philippines Bepartment of Education REGION II-CENTRAL LUZON Form 5 Application Form for CPP Best Implementer Region: Division: Profile Name of Nominee: — ‘School Address: Contact Number: Email address: Total Enrollment: Information of Contact Person (If applicable) Full Name: Surname Given Name Middle Initial Name Extension [Home Address: (Date of Birth: Position in the Organization: ‘Contact Number: =a Project Profile | Project Title: | Project Brief Description (3 sentences only) | Project Timeframe Implemented: Category (Please Check One Only) IEEE Best Child Protection Policy School Implementer ‘Most Outstanding Child Protection Policy School Coordinator Most Outstanding School Head Thereby certify upon my honor that all facts and information indicated herein are true and correct to the best of my knowledge and abilities. I further declare that any information siven that proves to be untrue may constitute a ground for disqualification in the search and prosecution for perjury. Further, I subscribe and agree that the Department of Education Region III have the sole prerogative to select the winners, and that their decision is final and executory. In witness hereof, | am executing and signing this statement voluntarily and without compulsion. Signature over Printed Name ah ‘Address: Matalino St, D.M, Government Center, Maimpis, City of San Fernando () asa ZAR Telephone Number: (045) 598-8580 to 83; Email Address: [email protected] ans VN"w We Republic of the Philippines Department of Education REGION II-CENTRAL LUZON Region: Division: I Profile Name of Noi School Address: Contact Number: Email address: Total Enrollment: Information of Contact Person (If applicable) Fall Name: ‘Surname Given Name Middle Initial Name Extension Home Address: Date of Birth: Position in Project Title: Project Brief Description (3 sentences only) Project Timeframe Implemented: Category ( Please Check One Only) ‘Most Functional Social Media Award ‘Most Innovative Youth Formation PPAs Award Thereby certify upon my honor that all facts and information indicated herein are true and ‘correct to the best of my knowledge and abilities. | further declare that any information given that proves to be untrue may constitute a ground for disqualification in the search | and prosecution for perjury. Further, I subscribe and agree that. the Department of | Education Region Ill have the sole prerogative to select the winners, and that their decision is final and executory. In witness hereof, I am executing and signing this statement voluntarily and without compulsion. Signature over Printed Name ob Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando(P) sa ZA Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] Seas"Republic of the Whilippines Bepartment of Education REGION II-CENTRAL LUZON Application Form Attachment 1. What is your project title? Describe your project entry not less than 500 words but not more than 800 words. 2. How does your project address the pressing issues of the youth/school/ community? (Answer must not less than 500 words but not more than 800 words.) 3. Who and how many are the beneficiaries of the project? How did they benefit from the project? (Answer must not less than 300 words but not more than 500 words.) 4. What are the significant impacts of the projects to the stakeholders? (Answer must not less than 300 words but not more than 500 words.) 5. Who are involved and describe their role to the success of the project? How did they ensure the implementation of the project? (Answer not more than 300 words) 6. How does the project promote the idea of teamwork, solidarity and goal oriented among its stakeholders? (Answer must not less than 300 words but not more than 500 words.) 7. What innovation did the team introduce in implementing and achicving the purpose of the project? (Answer must not less than 500 words but not more than 800 words.) 8. How the team was able to fund the implementation of the project? (Answer not more than 300 words) 9. What are your plan of strategies, mechanisms and measures to sustain the implementation of the project? (Answer must not less than 500 words but not more than 800 words.) ‘Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (?) Telephone Number: (045) 598-8580 to 89; Email Address: [email protected]Republic of the Whilippines Department of Education REGION IIL CENTRAL LUZON Name of Nominee: Region/ Division: — Maximum ‘Nominee Criteria Movs ae erree 1. Excellence in Student/Pupil Governance- 30 points [a Implementation of *Approved — General ] Mandated /Recommended | Plan of Action (GPOA) PPAs: + Approved ¥ Implemented 1-3 _ | Resolutions/Project PPAs=11 points _ | Proposals ¥ Implemented 4-6 [+ Signed School - PPAs=13 points | SPG/SSG | ¥ Implemented 7-10 | Memorandum — (PPA PPAs=15points _| Implementations) * Activity Completion Report duly signed by the school head. |). Efficiency in the | SPG/SSG Reports submission of necessary | based on DO 47 s. reports: 2014) ¥ Submitted 1-8 | 1. Approved General reports= 11 points | Plan of Action (GPOA) ¥ Submitted 4-5 2.Approved reports= 13 points | Resolutions ¥ Submitted 7-10 | 3.Approved Minutes reports 15 points | of the Meeting | 4.Duly Signed Financial Reports '5.Activity Completion 5 /Bvaluation Reports 6.Filing of List of Recognized School Clubs/ Organizations ‘7.Approved Project Proposals &.School | ‘Memorandum duly signed by SH/SP 9. Accomplishment Report 10.Election Reports |2. Networking, Linkages and Collaboration-5 points a Initiated and | Duly approved project. Implemented community | proposal 3 outreach /extension coe (oh, Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando?) 1A. ZB. Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] Say‘Republic of the Philippines Department of Education REGION II-CENTRAL LUZON | youth: pictures |" v One (1) initiated | Attendance of the and implemented | participants program/activity = 3 points Db. Participation in | Certificate of outreach /extension participation (in the programs/activities for the | last 2 years) youth: Y Participated in 1 outreach/extension programs/ activities for the youth= 1 2 point Y Participated in 2 outreach /extension programs/ activities | for the youth= 2 points [B. Experience as a Student Leader- 5 points [The nominee has been | Appointment/Election SPG/SSG officer for: Report that the name Y 6 months but less | of the nominee was | than 10 months= 1 | reflected as duly point | appointed/elected. ¥ 10 months but less | Certification that the 5 than 15 months 3 | nominee is serving as points student leader ¥ 15 months or more | indicating his/her | = 5 points term of office. | 4, Embodiment of DepEd Core Values- 40 points: a Initiated ‘and | Approved project implemented Maka- | proposal/s Diyos(upholds/respects | School Memo on the belief and faith, Manifests | implementation of the moral standard, right | project | conduct, hhonesty, | Accomplishment Involvement in religious | report/s activities) PPAS: v1 PPA conducted = | 3 points | ¥ 2PPAs conducted = 6 points | |v 3 PPAs conducted = I 10 points 10 fa © GB} ads: watsine st 04, Goverment Canter, imps San Franco ae Telephone Number: (045) 598-8580 to 69; Emall Address: [email protected]Republic of the Philippines Department of Education REGION II-CENTRAL LUZON [ ESR Entiated ni nal [Approved prajoot | implemented Maka- | proposal/s | Tao(charity/kindness, | School Memo on the empathy and sympathy, | implementation of the compassion, human dignity | project and equality and multi- | Accomplishment culturalism) PPAs: report/s, 10 YL PPA conducted = 3 points Y 2 PPAs conducted = 6 points Y 3 PPAs conducted = 10 points © Initiated and | Approved project implemented proposal/s Makakalikasan (cleanliness | School Memo on the and orderliness, proper | implementation of the waste management, energy | project conservation, ‘Accomplishment environmental protection | report/s and preservation and wise use of natural resources) PPAs: ¥ 1 PPA conducted = 8 points ¥ 2 PPAs conducted = 6 points ¥ 3 PPAs conducted = 10 points Initiated and | Approved project implemented _Makabansa | proposal/s (takes pride for being a | School Memo on the Filipino, resiliency in times | implementation of the of need crisis, obedience to | project existing rules and | Accomplishment, regulations, — community | report/s service involvement and promotes and patronizes 10 local products, services and practices) PPAS: v1 PPA conducted = 3 points Y 2PPAs conducted = 6 points 3 PPAs conducted = 10 points 5. Leadership Advocacy, Governance and Development-20 points The nominee has been | Certificate of 5 Linvited asa _ resource | Recognition indicated 10 ob ‘dross: Matalino St. D.M. Government Center, Maimpis, Cty of San Femando() AJA. AB Telephone Number: (045) 598-8580 to 89; Email Address: region3 @deped.gov.phRepublic of the Dhitippines Department of Education REGION IIl-CENTRAL LUZON the name of no | finfluence other youth | as Resource Speaker through his/her advocacy: | Invitation letter v School _Level=1 | Activity report point indicated the salient Y District Level= 2 | points of his/her points discussion. ¥ Division Level= 3 | points |v Regional Level= 4 points ¥ National Level 5 | points [The nominee has been | Certificate of participated in leadership | Participation | | workshops, seminars and | indicated the name of | webinars: nominee. (in the last | School —_Level=1 | 2 years) | point Activity report ¥ District Level= 2 | indicated the | points highlights of the 5 ¥ Division Level= 3 | seminar. points Plan of action how Y Regional Level- 4 | she/he will cascade points what she/he has ¥ National Level= 5 | learned from the points seminar The flag ship PPA/s of the | Approved project Nominee has been adopted | proposal and implemented in the: | Memorandum stating a School _Level1 | the implementation of point the PPAs ¥ District Level= 2 | Accomplishment points Report. 5 ¥ Division Level= 3 | points | Regional Level= 4 points ¥ National Level= 5 |__ points | a Awards and Recognition, | Certificate or Plaque Outstanding of Recognition ‘Accomplishment Received | indicated the name of = | by the Nominee: the nominee. (in the | % School Level=1 | last 2 years) point fo e as) ‘Address: Matalino St. D.M. Government Center, Maimpis, Cty of San Fernando (®) ta 4B ew Telephone Number: (045) 598-8580 to 89; Email Address: [email protected]Republic of the Philippines Department of Education AEGION Il-CENTRAL LUZON [¥ District Lev | points Y Division Level= 3 | points |” Regional Level= 4 points Y National Levels 5 points ‘Total Score Signature over Designation and Date ) | t QS i} ‘Address: Matalino St. D.M. Government Center, Maimpis, Cy of San Femando() AJA 4B aw Telephone Number: (045) 598-8560 to 89; Email Address: region3@deped govph 2s‘Republic of the Philippines Department of Education REGION II-CENTRAL LUZON Name of the Nominee: Region/Division: Category: (please check one) () Elementary () Secondary —__Make-Diyos ‘Maka Tao Makakalikasan —Makabansa Criteria | 1. Impact of the Project - 30% ‘a Addresses the | The SPG/SSG was able to | The SPG/SSG was |The SPG/SSG was |The SPG/SSG was problem/issues of | identify and address a able to identify and| able to identify a| able to identify a the specific problem of the | address a specific | specific problem of | specific problem of school/community | school by providing | problem of the | the school and | the school and just (Maximum of 15) solution such as | school by providing | provide solution | plan to address the points) sustainable and long-term | a solution such as | that is relevant but | problem- 9 points program/project - 18 | information did not hit the MOVs: points dissemination, problem of the cominar, school. - 11points Approved proposal orientation, ‘Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) Telephone Number: (045) 598-8580 to 89; Emall Address: [email protected]Republic of the Philippines Department of Education AEGION Il-CENTRAL LUZON Workable Action Plan Proofs/evidences that the problem was address wainings, etc. — 13 points . Frequency of the Project Implementation (Maximum of 10 points) MOvs: Approved project proposal ‘School Memo on the implementation Complete Number of Accomplishment Report Needed Thrice per sch. quarter= 10 points ‘Once per month -8 points Twice per sch, quarter= 4 points Once per sch. quarter = 2 points c Scope of Implementation (Maximum of 5 Points) MOVs: Approved project proposal Region wide- 5 points Division wide. 4 points District wide 3 points ‘School wide -1 point Address: Matalino St. 0.M, Government Center, Maimpis, City of San Fernando (P) AJ a Telephone Number: (45) 59-8580 to 89; Emall Address: [email protected] SUC Cetcane SAI?Republic of the Ihilippines Department of Education REGION I-CENTRAL LUZON Memorandum on the implementation of the project Workable Implementation Plan Accomplishment | Report _ 2, Team Work on th .¢ Implementation of the ct 35% Engaged Stakeholders (Maximum of 25 points) MOVs: Signed Pledge of Commitment Attendance in the Activity Implementation Notarized MOA with cso The SPG/SSG was able to engage 100% Barangay Officials, 100% PTA Officers and parents and five (5) relevant Civic Society Organizations were involved in the project, implementation- 25 points ‘The SPG/SSG was able to engage 80% Barangay Officials, 80% PTA Officers and parents and three (3) relevant Civic Society Organizations were involved in the project implementation- 20 points Tae SPG/SSC was able to engage 60% Barangay Officials, 60% PTA Officers and parents and two Q) relevant Civic Society Organizations were involved in the project implementation- 15 points The SPG/SSG was able to engage 59% & below of Barangay Officials, 59% | & below PTA Officers ‘and parents and one (1) relevant Civic Society Organizations were involved in the project implementation- 10 points Involvement of the The School Head, 100% of teachers and _ personnel, The School Head, 80% of teachers and The School Hiead, 60% of teachers and ‘The School Head, 59 % & below of (Maximum of 10/ 100% SPG/SSG officers | personnel, 100% | personnel, 100% | teachers and points) were involved and engaged | SPG/SSG officers | SPG/SSG'_ officers | personnel, csuiicoese in planning and | were involved _and | were involved _and | 100%SPC/SSG oe ‘Address: Matalino St. D.M. Government Center, Malmpis, ity of San Fernando (P) AJA. JAB Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] SSE Cocco AAT?Republic of the Philippines Department of Education REGION II-CENTRAL LUZON [ Move: implementation of the | engaged in planning | engaged in planning | officers were asi eres aeyenrst0 paises Sao Sela earanos | ana eels | raed picture in planning of the project- 8| of the project- 6| engaged in planning and implementation points points ‘and implementation of tia pre oa eeiunmersect ira) points 3: Creativity and Innovation of the Project: 25% Uniqueness of the |The approved project was | The ‘approved | The ‘approved | The approved approved project | new, unique and beyond | project ‘wens || project ‘was | project was totally (Menisoum of 18 the mandated PPAs ef the | patterned ut| patterned but |edopted fromthe points) SPG/SSG-15 points modified on the | modified from the | other SPG/SSG mandated PPAs of | other, SPG/SSG | organizations and or Movs: the 'SPG/SSG-13 | organizations. -9 | mandated PAS. of | Approved project points | potnes SPO/SSG-7 points Rea ay stated the background of the rao ka ta rationale. "The project provides | The approved project solved | The ‘approved | The ‘approved | The ‘approved innovative the problem beyond its | project nearly solved | project nearly solved | project nearly solved solutions. expectations, introduced|the problem, its|the problem, its|the problem, its (Maximum of 10) highly innovative solution, | promote the | promote the | promote the points} it promotes the. intended | Intended core values | Intended core values | Intended core values core values and 100% ofthe | and 80% of the|and 60% of the | and 59% or below of Mover aaeece ML SrapE Aca | ene MNT a | aceon || asim merce Tos ‘Accomplishment | participated in the project- | aware/participated | aware/participated | aware/participated Report how the | 10 points a ss oe Address: Matalino St. 0.M. Government Center, Maimpis, City of San Fernando (®) AJA 4B aa Telephone Number: (045) $98-8580 to 89; Email Address: region3@deped gov.ch CeedeNe MAIERRepublic of the Dhilippines Department of Education REGION Il-CENTRAL LUZON identified problem im the project - 8] in the project - 6]in the project - 4 was solved. points points points Attendance of the learners participated in the project. Narrative of the impact of the projects to the learners. 4, Effective Use of Resources: 10% ‘Accountability and | The SPG/SSG|The __SPG/SSG]|The __SPG/SSG|The _ SPG/SSG Transparency provided/submitted/posted | provided/submitted | provided/submitted | provided/submitted (Maximum of 5 | the signed disbursement | the signed | the signed | the signed points) and liguidation report: | disbursement and | disbursement and_| disbursement and (financial report / in-kind | liquidation report: | liquidation report: | liquidation report: Movs: donation) to SPG/SSG| (financial report / | (financial report / | (financial report / Signed Officers, Teacher-Adviser | in-kind donation) to | in-kind donation) to | in-kind donation) to Disbursement/ and the School Head and | SPG/SSG Officers, | SPG/SSG Officers | Teacher-Adviser Liquidation report | posted in _ Bulletin | Teacher-Adviser | and Teacher- | only -2 points Receiving copy of | Boards/Official FB page of | and the School | Adviser-3 points the report, the organization-5 points | Hicad-4 points other Collaboration with school clubs/organization for support in the implementation The SPG/SSG was able to partner and engage the 100% of listed clubs or organizations in school in The SPG/SSG was able to partner and engage the 70% of listed clubs or organizations in The SPG/SSG was able to partner and engage the 50 % of listed clubs or organizations in | ‘The SPG/SSG was able to partner and engage the 49% & below of listed clubs or organizations in fe: So? Gob ‘Address: Matalin St. D.M, Government Center, Maimpis, Cty of San Fernando (P) AJA ZAR Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] SSeSRepublic of the Philippines Bepartment of Education REGION II-CENTRAL LUZON (Maximum of 5 the implementation of the| school in the|school in the |school in the points) project- 5 points implementation of | implementation of | implementation of, MOVs: the project- 4 the project- 3 | the —project- 2 Signed Pledge of points points points Commitment of other Clubs and organization in the school. List of all clubs/organizations in the school Total Score Signature Over Printed Name of the Evaluator Designation and Date of Evaluation oe ‘Address: Watalino St.0.M. Government Center, Maimpis, ity of San Ferrando) AJA \ AB Telephone Number: (045) 598-8580 to 83; Email Address: [email protected] SessaRepublic of the Philippines Department of Education REGION lIl-CENTRAL LUZON Name of Nominee: Region / Division: ‘Score Sheet for Outstanding 'YES-O Student Leads Maximum | Actual | Criteria Movs pate hoses | Organizational Leaderahip-35 points Timplementation of all_mandated Programs, | Projects, and Activities (PPAs) : nveeied | “+ Implemented 1-3 PPAs- 5 points proposal | © Implemented 4-6 PPAs- 10 points Implementation | + implemented 7-9 PPAs- 15 points Plan 20 * Implemented 10 PPAs- 20 points Activit Completion Report Governance 1. Calendar of Annual Proposed Activities (CAPA) | 2. Certificate of Registration 3. Registration Form 4. Membership Form 5. Biannual Accomplishment Report (BAR) S¥ 2021-2022 and 2022-2023 6. Activity Completion Report 7. Monitoring and Evaluation form by MOVs listed in Division YES-O Program Coordinator ‘ouvenanns 1s 8. Five Year Targets from 2022-2027 9. Financial Reports + 1-2 accomplished documents: 5 points | + 3-4 accomplished documents- 7 points | # 5-6accomplished documents- 9 points | & 7-8 accomplished documents-13 points + 9 accomplished documents. 15 points 2, Networking, Linkages and Collaboration 40 points Involvement and Participation in Certificate of community civie/ organizations/ associations and | Membership | its activities Certificate | of | * 1-2 participations/involvement-6 points | Participation (in| 10 + 3-4 participations/involvement- 8 points | {he last 2 years) #5 participations/involvement- 10 points _| Row teydne con | Sah Adarest: Matalino St. D.M, Government Center, Malls, Cy of San Fernando) 3A. AB ‘Telephone Number: (085) 598-8580 to 89; Emall Address: [email protected] =awe, Republic of the Bbilippines Department of Education REGION II-CENTRAL LUZON hare hiayher Iearnings on the activity [Tnitiated and implemented outreach programs/ activities in the community. + 1.2 initiated and implemented outreach program/activity- 5 points + 3 initiated and implemented outreach program/activity- 10 points ‘+ 4 initiated and implemented outreach program/activity- 15 points © 5 initiated and implemented outreach program/activity- 20 points ‘Approved outreach program/activity Accomplishment Report-Explicitly explain how the community benefited from the activity. Attendance of the participants 20 | Outstanding Accomplishments as Makekcalikasan Advocate v Award + School Level- 2 points + District/Municipal Level - 4 points + Division/Provincial Level- 8 points If the award is given by National or International giving body, it shall correspond to highest points. Certificate or Plaque of Recognition (in the last 2 years) Serve as Resource Speaker in any trainings, webinars and workshops offered by DepEd and private sectors related to Environment Protection and Awareness ‘* Schoo! Level- 2 points + District /Municipal Level - 4 points + Division/ Provincial Level- 5 points If the trainings, webinars and workshops were organized by the National or International Entity, it shall correspond to highest points. Certificate of Recognition (in the last 2 years) Highlights of the Talk Invitation letter Promoting and Practicing SRs (Refuse, Reduce, Reuse, Repurpose, Recycle) at school, home and | im the community ['B. Embodiment of the Core Value Makakalikasan- 25 points Video advocacy or IBC material Picto Narrative © Qindicators- 3 points + 3indicators- 5 points ‘+ Lindicator- Lpoint 5 + 2indicators- 3 points + 3 indicators- 5 points Promoting and Practicing Vegetable Gardening at | Video advocacy school, home and in the community or IEC material «© Lindicator- Ipoint Picto Narrative 5 ‘Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] (ab; AJA JAB Cotteate to KANTRepublic of the Philippines Department of Education REGION II-CENTRAL LUZON po seen eee mene aes Promoting and advocating the practice of not Video advocacy using single-used plastic at school, home and in | or IEC material the community Picto Narrative 6 + 1indicator- Ipoint + 2indicators- 3 points +3 indicators- 5 points Promoting and Practicing energy, water and Video advocacy electric supply conservation at school, home and | or IEC material in the community Picto Narrative es ‘+L indicator- Ipoint + 2indicators- 3 points + 3 indicators- 5 points | Lead the environment protection and preservation | Video advocacy | at school, home and in the community or IEC material |" + Tindicator- 1point Picto Narrative . + 2indicators- 3 points + 3 indicators- 5 points Total Score ‘Signature over Printed Name of the Evaluator Designation and Date of Evaluation ‘Address: Matalino St. 0.M. Government Center, Maimpis, ity of San Fernando (P) Telephone Number: (045) 598-8580 to 89; Emall Address: [email protected]Republic of the Philippines: Department of Education REGION Il-CENTRAL LUZON Name of Nominee: Region/Division: Category: () Elementary () Secondary Score Sheet for YES-O Best ‘School Implementer Criteria MOVs Maximum points ‘Actual Score | points Implementation of School Inside a Garden (SIGA) “Clean and Greon Campaign”. 25 Seed bank and Nursery Establishment 25 or more variety of seeds and seedlings- 5 points 20 variety of seeds and seedlings- 4 points 15 variety of seeds and scedlings- 3 points 10 variety of seeds and seedlings- 2 points Svariety of seeds and seedlings- 1 point Establishment of Flowering Garden 25 or more variety of flowering plants- 20: points 10 points ty of flowering plants- 8 15 variety of flowering plants- 6 points 10 variety of flowering plants- 4 points 5 variety of flowering plants- 2 point Picture of Seed Cabinet and Nursery with proper label | Picto-Narrative signed bby the School Head 10 Native Endemic and Indigenous Trees Planted /Tree Seedlings For tree seedlings: |v. 150 pes or more with 5 variety | of Endemic and Indigenous tree seedlings- 5 points 149-130 pes with 5 variety of Endemic and Indigenous tree seedlings- 4 points Picto-Narrative signed bby the School Head ‘Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] 1Bgee, BW Sg Republic of the Philippines: Department of Education REGION II-CENTRAL LUZON Y 129-110 pes with 5 variety of Endemic and Indigenous tree seedlings- 3 points ¥ 109-90 pes with 5 variety of Endemic and Indigenous tree seedlings- 2 points | ¥ 89 pes and below with 5 variety | of Endemic and Indigenous tree seedlings- 1 point For planted trees: Y 5 Endemic or Indigenous tree planted in school- 5 points ¥ 4 Endemic or Indigenous tree planted in school- 4 points ¥ 3 Endemic or Indigenous tree planted in school- 3 points ¥ 2 Endemic or Indigenous tree planted in school- 2 points v1 Endemic or Indigenous tree planted in school- 1 point Whichever is applicable to school. ~ Initiated and conducted Arbor | Activity Day and Earth Day Celebration | program/matrix Signed ¥ 100% of Schoo! Population Accomplishment Attended- 5 points Report Y 99%-80% of School Population | Attendance of the Attended- 4 points participants Y 79%-60% of School Population Attended- 8 points o) ¥ 59%-40%% of School Poptilation Attended- 2 points Y 39% & below of School Population Attended- 1 point | [Bi awareness and Outreach Programs 25 points + Environmental Educations, | Video Advocacy or EIC Awareness Campaigns and material Symposia on Environmental | Approved Project Issues and Call to actions Proposal Indicators: i Matix o) List Winners Photo documentation Activity Report Video Advocacy or EIC material ¥ Seminar-Workshop, Trainings, Webinars Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) Telephone Number: (045) 598-8580 to 89; Email Address: [email protected]Republic of the Philippines Department of Cducation REGION lIl-CENTRAL LUZON Y Enviro-related contest, | One tumbler for every learner campaign Y Build Material Recovery Facility (MRF) All indicators shall be provided to ‘obtain the highest points, absence of the given indicators correspond to deduction of point/s. * Environmental Youth Camp | Approved Project Proposal Y Conducted one (1) Program Matrix | Environmental Youth Camp in | attendance of the | collaboration with existing participants 5 clubs/ organization in the Activity Completion school. report with proper photo documentation © Watershed Protection and ‘Activity request Conservation Photo documentation | Attendance of the Initiated and conducted one (1) | participants Mangrove planting. Minimum | Certificate of Number of 500 mangrove seedlings Bt Manareee Gesdlees f planted Planted ¥ Manila Bay Conservation Program/Activity * Clean-up drives (coastal or | Activity Request, T community clean-up drives) __ | Photo documentation Certification of ¥ 350 kis, or more collected solid | Collected Solid Waste | waste- 5 points 5 from the Concerned ¥ 201-250 Kis. collected solid | Barangay Official j waste- 4 points | ¥ 151-200 kis. collected solid 6 waste- 3 points ¥ 101-150 kis. collected solid waste- 2 points ¥ 100 kis & below collected solid waste- 1 point © Adopta ‘Memorandum of river /community/forest Agreement 5 Implementation Plan Ve) ‘Address: Matalino St. D.M. Government Center, Maimpis, Cty of San Fernando (P) ja, Telephone Number: (045) 596-8580 to 89; Email Address: [email protected] Suma"Republi ic of the Philippines Department of Cducation REGION Il-CENTRAL LUZON ‘ogress Indicators Activity Report 3. Solid Waste Management, Butrepreneursiip and Eacagy Conservation: 20 points + Promoting and Practicing 5Rs Repurpose, Recycle) in School Video advocacy or EIC material posted in conspicuous vicinity of the school. 5 Narratives from the students the importance of SRs | (Refuse, Reduce, Reuse, [+ Functional Material Recovery | Facility (MRF) Y 10 months photo documentation and Sale i Report- 5 points iF ¥ 8-9 months photo documentation and Sale Report- 4 points ¥ 6-7 months photo documentation and Sale Report- 3 points ¥ 4-5 months photo | documentation and Sale | Report-2 points |v 1-3 months photo ] documentation and Sale Report- 1 point [Monthly photo |documentation of MRF jand 5 ale Report signed by ke School Head + Environmental Entrepreneurship Indicators: ¥ Conduct environmental entrepreneurial skill development. ¥. Recycled Product Corner ¥- Sale Report of Recycled Product All indicators shall be provided to obtain the highest points, absence of the given indicators correspond to deduction of point/s. \ctivity Request [Photo documentation of [Recycled Product Corner fale report of recycled [product signed by the Pisbool Hou. Y Promoting and Practicing No to Single Use Plastic Indicator: Y One tumbler for every learner and school personnel © 100% of School Population has l atumbler- 5 points Approved Project Proposal School Memorandum. Photo documentation (Certification that all the| learners and — school| Telephone Number: (045) 598-8: ‘Address: Matalino St. D.M. Government Center, Maimpis, ity of San Fernando (P) 3580 to 89; Email Address: [email protected]Republic of the Philippines Department of Education REGION II-CENTRAL LUZON [© 99%-80% of School Population [personnel have af has a tumbler- 4 points tumbler. © 79%-60% of School Population | has a tumbler- 3 points | © 59%.40%% of School | Population has a tumbler- 2 points © 39% & below of School Population has a tumbler- 1 point + Energy, Water and Power Video advocacy or BIC 2 Supply Conservation material posted in conspicuous vicinity of the school. Narratives from the students the importance of Energy, Water and Power Supply Conservation | Collaboration to Gulayan sa Paaralan Program (GPP)- 20 points ‘* Crop integration (fruit, leafy | Narrative report with vegetables, root vegetables, _| Proper photo 5 indigenous plants) documentation * Use of organic fertilizer and/or | Narrative report with pest control Proper photo 3 ie ni ___| documentation ‘+ Properiy maintained compost | Narrative report with pit and heap Proper photo 2 | documentation * Utilization of Garden Space | Narrative report with Proper photo 5 documentation “Utilization of Garden Produce | Narrative report with (School Feeding) Proper photo 5 documentation Fauerdiip md Lange 10 ponte Forged and engaged the MOA/ MOU/Letter of ‘community and local Understanding government unit (LGU) in clean | Program and green program of the Implementation as | school. stated in the 5 x Moa/MOU/LOU [ateraae: Accomplish Activity ¥ Forged partnership with Report with proper Community (Barangay) and__| Photo decumentation. ‘Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) Asa, Telephone Number: (045) 598-8580 to 89; Emall Address: [email protected]Republic of the Philippines: Department of Cducation REGION ll-CENTRAL LUZON LGU (MAO, CENRO, MENRO, PENRO)- 5 points Absence of one indicator- 2 points © Established partnership with Non-Government Organization/s and or/ Civic | MOA/ MOU/Letter of Society Organization/s ‘Understanding Program | Indicators: Implementation as aortas eran i tite stated in the 5 | NGOs oF CSOs. § points Moa/MOU/LOU ¥ Forged partnership with 2 Accomplish Activity NGOs or CSOs- 3 points Report with proper ¥ Forged partnership with 1 NGO | Photo documentation or CSO- 1 point Total Seore Signature over Printed Name of the Evaluator Designation and Date of Evaluation ‘Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) ‘Telephone Number: (045) 598-8580 to 89; Email Address: [email protected]Republic of the Philippines Department of Education REGION Ill-CENTRAL LUZON Name of Nominee: Region / Division: "| Maximum | Actual Criteria Movs Paral pen i, Exemplary Student Leadership. 40 points i + Organized and Implemented BKD of Programs, Projects, and Activities (PPAs) | Approved project on Drug Prevention Fsropcael Implementation ¥ Implemented 1-3 BKD relevant PPAs- 10 | Plan points Activity ay ¥ Implemented 4-6 BKD relevant PPAs- 15 | Completion points Report with ¥ Implemented 7-9 BKD relevant PPAs- 25] proper _photo points documentation ¥ Implemented 10 BKD relevant PPAs- 30 | points ia * Governance ¥ General Annual BKD Action Plan of PPAS ¥ Contextualized BKD School Charter approved by the School Head | 4 Lstof BKD Officers ¥ List of Members ¥- Registration Form Membership Form 7 Minutes of the Meeting ¥ BKD Resolutions Y Communication/Request/ Support MOVs listed in| 49 Letters Governance ¥ Biannual BKD Accomplishment Report (BAR) SY 2021-2022 and 2022-2023 + 13 accomplished documents- 2 points + 45 accomplished documents- 4 points + 6-7 accomplished documents- 6 points | © 8-9 accomplished documents-8 points + 10 documents provided/submitted- 10 points i |B. Networking, Linkages and Collaboration on Drug Abuse Prevention. 40 points [involvement or Participation in BKD Certificate of | community civie/organizations/associations _| Membership 10 | and its activities 2) Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) 9 j, Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] iBRepublic of the Philippines Bepartment of Education REGION II-CENTRAL LUZON J 1-2 participations/invalvement- 6 points | Certificate of 5 | ¢, 8-4 participations/involvement-8 points | Participation Gn . icipations/involvement- e last 2 years) 5 participations/involvement- 10 points | the last 2 years) how he/she can | share his/her | learnings on. the Drug Abuse Seer rs __| Prevention MMnitiated, Organized and implemented BKD ‘Approved | outreach programs/ activities in the community. | outreach | © 1-2 initiated and implemented BKD program/activity outreach program/activity- 10 points —_| Accomplishment * 3 initiated and implemented BKD Report-Explicitly outreach program/activity- 18 points | explain how the| 95 | + initiated and implemented BKD community | outreach program/activity- 20 points _| benefited from the | ©. Siinitiated and implemented BKD eee | outreach program/activity- 25 points | RACrcanee + Forged Partnership MOA/MOU/Letter ¥_ NGAs (PNP, PDEA, DDB) of Understanding ¥ LGUs Approved ¥ NGOs, Program or ¥ cso Activity ¥_ Religious Organizations Implementation A At least 5 indicators are provided to obtain the | as stated in the | highest points. | Moa/MOU/Letter of Understanding | Activity Report with proper photo documentation 8. Outstanding Accomplishments - 20 points ‘Outstanding Accomplishments as BKD Advocate | Certificate or v Award Plaque of ‘+ School Level- 6 points Recognition (in + District/Municipal Level -8 points | the last 2 years) 40 * _Division/Provincial Level- 10 points Ifthe award is given by National or International giving body, it shall correspond to highest points. Serve as Resource Speaker in BKD related | Invitation Letter trainings, webinars and workshops offered by | Certificate of DepEd and private sectors related to Environment | Recognition (in Protection and Awareness the last 2 years) 10 ‘© School Level- 4 points Highlights of the + District/ Municipal Level ~8 points | Tall . /Provincial Level- 10 points : eo ‘Address: Matalino St. DM, Government Center, Maimpis, Cty of San Fernando () ata 4B ‘Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] Sess"Republic of the Philippines Bepartment of Cyucation REGION III-CENTRAL LUZON if the trainings, webinars and workshops were organized by the National or International Entity, it shall correspond to highest points. [Total Score ‘Signature over Printed Name of the Evaluator Designation and Date of Evaluation oe ‘Address: Matalino St. DM, Government Center, Maimpis, City of San Fernando (P) AJA 74 ‘Telephone Number: (045) 598-8580 to £9; Email Address: [email protected] SES‘Republic of the Philippines Department of Education REGION IILCENTRAL LUZON ‘Soore Sheet for BKD Best ‘School Implementer Name of Nominee: Region / Division: | Maximum | Actual | cae wove Points ‘Score 1. Functionality of Barkada Kontra Droga (BKD) Program on Drug Abuse Prevention Lia Secondary Schoole. 20 points General Annual Action ‘Signed Approved Plan for BKD PPAs ‘Annual Action Plan for 5 Y Achievable and responsive | BKD PPAs BKD activities * Grand Launching of BKD | Approved Activity program in School Request “BD Kick-Off Activity School Memorandum. A Program Matrix | Registration list of the | participants + Organized and Functional | List of BKD Officers BKD School Chapter (clected or appointed) | ¥ Officers and Teacher- Designation of Teacher- 5 | Adviser Adviser as BKD | Coordinator + Contextualized BKD ‘Submit hard copy of School Charter BKD School Charter ¥ Rationale approved by the School ¥ Roles and Responsibilities | Head 5 of each Officers and teacher adviser and its members. ala 2. Scope and Coverage of Implementation. 20 points ‘School wide implementation ‘School Memorandum Advocacy video posted in the official BKD FB account of the School | and or Official FB A | | account of the School or | EIC materials posted in | the conspicuous vicinity of the school jae __| Photo documentation | Community involvement and ‘Memorandum of partnership Agreement with the | Barangay/s covering the ie school Pledge of commitment of L the Barangay Officials o& ‘Address: Matalin St. D.M. Government Center, Maimpis, Cty of San Femando() Asa \74B Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] Seuss 1"Republic of the bitippines Department of Education REGION II-CENTRAL LUZON j | Roles of Barangay in the | implementation of BKD | Program ‘Adopt a School on the BKD ‘Memorandum of Program, Agreement YS BKD related activities | Implementation plan of conducted -§ points the BKD PPAs Y 4BKD related activities | Activity Report — with conducted -4 points proper photo a Y 3.BKD related activities | documentation. conducted -3 points Y 2BKD related activities conducted- 2 points Y 1 BKD related activity | conducted -1 point [S_Wature of Extent of Drug Abuse Prevention Activities/ Projects | Initiated/Implemented and Organized- 40 points * Information or Advocacy | BKD videos Campaign Film Showing Indicators: BKD jingle ¥ BKD advocacy video Hugot lines related to ¥ Film showing BKD ¥_ BED jingle EIC material (posters) 10 Y_ Hugot lines related to BKD | Photo documentation Y_ EIC material (posters) | Each indicator is equivalent to 2 poate gPodt ma Mee eating: (Ts BKD Education ‘Approved Project | indicators: proposal/ Activity Y Integration of drug abuse | Request | prevention concepts and | School Memorandum BKD components in Activity Report with | classroom instruction proper photo Y Organizing Seminar- documentation workshops, Webinars on Drug Abuse Prevention ¥ Conduct BKD Student 10 Forum/Conference/ Summit Y Capacity Building for BKD Officers ¥ Integrate one session of KD (Drug Prevention) in Learning Action Cell (LAC) Each indicator is equivalent to 2 points. eee | ‘* School Intervention Process flow how to 5 Lndicators: conduct each service. ‘Address: Matalino St. D.M. Government Center, Maimpis, ity of San Fernando (P) Telephone Number: (045) 598-8580 to 89; Email Address: [email protected]Republic of the Philippines Department of Education REGION lll-CENTRAL LUZON Y Provision of guidance and | Report relative to illegal [ Pr | ‘counseling services to drugs if any and action ‘ cece vB Soaking | ¥ Referral Services | Y Ades fn Sten Surrenders if any ¥ Provision of guidance and | counseling services | Parents/ Guardians. Each indicator is equivalent to 1 point. LC + Alternative Intervention | Approved Activity Indicators: Request ¥ Friendly Sports/Athleties | Activity report with Competition proper photo ¥ Cultural Presentation documentation ¥ BKD Arte and crafts Registration of the re ¥ Religious Activities participants | Civic Engagement/Activity | If it is contest, list of ¥ Other Recreational winners duly signed by Activities: authorized person. | Bach indicator is equivalent to 1 point. ‘+ Establish and Functional _| Approved request on the BED Corner/Space establishing BKD Indicators: Corner ¥ Advocacy posters on BKD | Proper documentation ¥ Reading materials of BKD Corner Y Output of learners on BKD Pa activity ¥_BKD school news paper ~ BKD Accomplishment Report Other materials relevant for BKD Corner/Space | |& Extent of Involvement of the following in terms of providing Assistance, Leadership and Support (ALS) in the implementation of the BKD Program- 20 points 9 ‘Approved Project ] | Indicators: Proposal | “+> ‘Active participation in the | Program Matrix | Activity /ies. Registration list of the * Minimum of four (4) (at participants per activity. least 1 per quarter) BKD | Activity Report with 10 related activities proper photo: conducted documentation ¥ 90-10% of the target learners participated in the activity- 5 points Sead ‘Address: Matalino St. D.M. Government Center, Malmpis, City of San Fernando(P) AJA 74 ‘Telephone Number: (045) 598-8580 to 89; Emall Address: [email protected] EasyRepublic of the Philivpines: Department of Education REGION lII-CENTRAL LUZON 90% of the target learners participated in the activity- 4 points ¥ 60-70% of the target learners participated in the activity- 3 points ¥ 40-50% of the target learners participated in the activity- 2 points Y 39% & below of the target learners participated in the activity- 1 point * Parent Teacher Association (PTA) ALS, ‘Attendance in the Activity Involvement in planning Photo documentation Financial support if applicable Pledge of Coramitment ‘* School Head, Teaching and Non- Teaching ALS ‘Attendance in the Activity Involvement in planning Photo documentation Financial Support from the school budget or other source Provision of Technical assistance Pledge of Commitment ‘ALS involvement of NNGAs (PNP, PDEA, DDB) Lous NGOs, cso Religious Organizations At least 5 indicators are provided to obtain the highest points. < ASS S ‘MOA/MOU/Letter of Understanding Program Matrix indicating the active involvement. Activity Activity Report with proper photo documentation Total Score Signature over Printed Name of the Evaluator Designation and Date of Evaluation 2) Address: Motalino St. D.M. Government Center, Maimpis, ity of San Fernando(?) ALA. Za ‘Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] SayRepublic of the Philippines Department of Education REGION II-CENTRAL LUZON Name of Nominee: Region / Division: Category: () Blementary (}Secondary / Criteria MOVs Maximum | Actual Points Score Functionality of Child Protection in School- 40 points ‘Establish and Functional | List of the Composition of Child Protection School Child Protection Committee (per DepEd —_| Committee S Order No. 40 s. 2012} Minutes of the Meeting + Contextualize School Child | School Child Protection Protection Policy duly Policy A approved by the members of SCPC. + Establish School Referral _ | Process flow of the School and Monitory System Referral and Monitoring System A School Protocol on : Reporting and Referring | child abuse cases | + Annual Child Protection | Copy of Annual Child | Plan of Programs, Projects | Protection of Activities | and Activities Signed by the School = » Head a ‘© Conducted Child ‘Approved Project, Protection Activity/ies as _ | Proposal/ Activity Request stated in the Annual Child | Program Matrix | Protection Plan of PPAs Registration of the | ¥ 10 organized and attendees, | implemented CP PPAs- 20 | Activity Report with points proper photo |v Se organized and documentation | implemented CP PPAs- 16 | points ¥ 7-6 organized and ed implemented CP PPAs- 12 points Y 5-4 organized and implemented PPAs- 8 points ¥ 1-3 organized and implemented PPAs- 4 points eb, ‘Address: Matalino St. D.M. Government Center, Maimpis, Cy of San Fernando (?) AJA ZB Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] SasRepublic of the Philippines Department of Education REGION II-CENTRAL LUZON [: Capacity Building on Child Rights and Child Protection-0 points © Organize and implement | Approved Project Seminar-workshops, proposals webinars or _ integrate | Program Matrix during the Learning Action | Registration list of the Cell/ School ‘Gender | participants Sensitive Training Activity Report with Indicators: proper photo Y Training on awareness and | documentation understanding of child maltreatment. and its common contributing | factors and immediate and | long-term impacts. | ¥ Training on classroom | management and positive discipline, in order to | minimize’ the use of corporal punishment and student-teacher and peer balling, Y Training on how to recognize signs and symptoms of child abuse, neglect or exploitation and make appropriate reports and referrals in line with procedures established by Fie echool child protection policy. ¥ Training for school | personnel to be sensitive | foward and. mpportive of | students who have 30 experienced child maltreatment. Y Capacitate school | personnel to what actions | to take if they suspect a | child is being maltreated | within or outside of school settings. ¥ Re-orientation on Personal Safety Lessons (PSL) (DepEd Order No. 45 s. 2009) * 6 trainings conducted relative to child rights and protection- 20 points ‘Address: Matalino St. D.M. Government Center, Maimpis, Cty of San Fernando (P) ‘Telephone Number: (045) 598-8580 to 89; Emall Address: [email protected]Republic of the Bbilippines Department of Cducation REGION IIl-CENTRAL LUZON * 5 trainings conducted relative to child rights and protection- 25 points © 4 trainings conducted relative to child rights and | protection- 20 points | + 3 trainings conducted | relative to child rights and protection- 15 points ‘+ 2 trainings conducted | relative to child rights and protection- 10 points | +L training conducted relative to child rights and protection- 5 points 3. Networking, Collaboration and Partnership on Child Protection- 15 points * Collaboration ‘and | Notarized Coordination with other | MOA/MOU/Letter of | partner agencies such as | Understanding | NGAs, NGOs, — CSO, | Approved Project Religious Groups and | Proposal /Implementation | among others. as stated in | | Indicators: MOA/MOU/LOU ¥ Pool of external experts _| Program Matrix % Network ofvolunteers _| Registration list of the Youth observatory | participants Activity Report with ¥ Forged 5 partnerships | proper photo on school child | documentation protection PPAS implementation- 15 points ¥ Forged 4 partnerships ‘on school child | protection PPAs implementation- 18 points ¥ Forged 3 partnerships | on school child | protection PPAs implementation- 9 points ¥ Forged 2 partnerships ‘on school child protection PPAs | | implementation- 7 points ‘Address: Matalino St. D.M. Government Center, Maimpis, Cty of San Fernando (P) Telephone Number: (085) 598-8580 to 89; Email Address: [email protected][Eni Fewedl perinersip Republic of the Philippines Department of Education REGION II-CENTRAL LUZON on school child protection PPAs implementation- 5 points 4. Child Protection Advocacy- 10 points ‘+ Raise awareness of child | Copy of all the indicators protection issues and abuse in schools and communities Indicators: Y Communication campaigns Advocacy videos EIC material (poster) Newsletter Let's protect our friends from violence and abuse campaign. Positive Discipline booklet or pamphlet (How to | handle violence and problematic student behavior) Scope and Coverage of the Campaign: School wide and sans 10 < Community | All indicators must be submitted /presented to obtain the highest points. I 5. Record Keeping and Information Management. 5 points ‘* Mechanism of School on | Process Flow of the how the information on | Mechanism child protection concerns | Reported Cases and should be recorded and | action taken managed, as well as shared. with persons in positions of 3 authority while assuring vietim privacy and that such information is shared strictly on a need-to know | basis. I * Annual Accomplishment | Copy Annual 1 Report Accomplishment Report, * Plan of Action on Child | Plan of Action and CP 2 Protection Implementation | Best Practices for the following SY. ‘Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] (ob) AIA JABRepublic of the Philippines Department of Education REGION IILCENTRAL LUZON + Best Practices of Child Protection Implementation (otal Score 1 Signature over Printed Name of the Evaluator Designation and Date of Evaluation ear Gob) & Address: Matalino St. D.M. Government Center, Maimpis, City of San Fernando (P) Asa 748 Q=y Telephone Number: (045) 598-8580 to 89; Email Address: region3@deped gov.phRepublic of the Bhilippines Department of Education REGION Il-CENTRAL LUZON Score Sheet for Most Punetional Social Media ‘Award Division Only Name of Nominee: Region/Division: NAME OF NOMINEE: DIVISION: MAXIMUM | PARTICIPANT” ree abil pots | POINTS [Facebook Page Community. 40 points (I) Facebook Page Followers | Screenshot of the * 1,000 above followers = | Professional 20 points Dashboard: Insights | * 700-999 followers = 18 | Page Overview (Your points i | fo0=699Jotowers «10 | Pa Pane) 20 points | points |. 700"oo euower-s | Novof Page ftowers | pas as of June © Below 100 followers = 3 | points | | @) Facebook Page Likes ‘Screenshot of the © 1,000 above likes =20 | Professional points Dashboard: Insights - © 700-999 likes = 15 Page Overview (Your points Page Pane) © 400-699 likes = 10 20 points points aleree Peter No.of Page ikes as of Ra June 2023 © Below 100 likes = 8 points ‘Facebook Page Activeness and Impact - 60 points (1) Frequency of posting / | Screenshot of the | sharing of materials and_| Professional videos | Dashboard: (Posts | @ Tpost everyday =20 | Pane) | points + Hpostevery 2 eye 18. | timeline: naan oe eeinte ery 3 days =10 | Summary of Posts cot | t fpest every 3daus 10 | som September 2022 | © Tpost every 4 days =5 | - une 2023 | points © 1 post every 5 days = 8 points o eM fay & GD *) ‘Address: Matalin St. D.M. Government Center, Maimpis, City of San Fernando (P) ew Telephone Number: (045) 598-8580 to 89; Email Address: [email protected]Republic of the Dhilippines Department of Education REGION II-CENTRAL LUZON (@) Average reach of ‘Screenshot of the a posted/shared video Professional * More than 2,000 reached | Dashboard: (Posts | = 20 points Pane) © 1500 - 1999 reached = 48 points. ‘Timeline Covered: 20 points | * 1000-1499 reached= | aa 29 pints pew ae * 500-999 reached =§ | 0m September ae = June 2023 © 1-499 reached = 3 points | 1G) Average reach of ‘Screenshot of the posted/shared photo —_| Professional * More than 2,000 reached | Dashboard: (Posts = 20 points Pane) | * 1500, 1999 reached = Nie ames capesrebe) a= _ | Timeline Covered: 20 points SO ‘Summary of Posts © 500. 999 reached =5 _| from September 2022 aiaie ~ June 2023 © 1-499 reached =8 points TOTAL 100 points Signature over Printed Name of the Evaluator Designation and Date of Evaluation ‘Address: Matalino St. DM, Government Center, Maimpis, City of an Fernando (P) J, Telephone Number: (045) 596-8580 to 89; Emall Address: [email protected] Sass Crean naoRepublic of the Bhilippines Department of Cducation REGION lI-CENTRAL LUZON Name of Nominee: Region/| Criteria Movs a Actual Score i. Implementation ‘Approved Project 25 [v3 years or more Proposal 25 ¥ 2years but less than 3 | Implementation 20 _yers | plan _ YL year but less than Activity Report is years ee 7 6 months but less than 1 10 | 2. Adopted and implemented 25 | by the schools ¥_90-100% List of Schools |____25 ¥70-89.99% Implemented 20 ¥_50-69.99% Implementation 15 ¥_30-49.90% plan of the 10 [7 Below 29.9996 school 5 Activity Report of | the School |Bitssued policy, guidelines and | Division i | standards Memorandum on | the PGS of 25 project proposal implementation 4, Stakeholders’ Involvement | MOA/MOU Letter of ae: ¥ Sor more stakeholders | Understanding 25. ¥_4 stakeholders Activity report 20. 73 stakeholders on the. 15 72 stakeholders implementation [19 Y ‘stakeholder stated in the 5 MOA/MOU om Total Score Note: In order rank as the Most Innovative YF PPAs, it should meet the minimum cut off score which is 70 points. ‘Signature over Printed Name of the Evaluator Designation and Date eh Address: Metalino St. D.M. Government Center, Maimpis, City of San Fernando (?) Asa. 4B. we Telephone Number: (045) 598-8580 to 89; Email Address: [email protected] Sasa