SBFP Form 1 (2020)
Department of Education
Region ___
Master List Beneficiaries for School-Based Feeding Program (SBFP) (SY________)
Division/Province: ______________________________________ Name of Principal : ____________________________________
City/ Municipality/Barangay : ____________________________ Name of Feeding Focal Person : _________________________
Name of School / School District : _________________________
School ID Number: _________________________
Nutritional Parent's
BMI for Beneficiary of
Grade/ Date of Weighing / Age in Weight Height 6 y.o. Status (NS) Dewormed? consent for Participation
SBFP in
Date of Birth
No. Name Sex Measuring Years / milk? in 4Ps
Section (MM/DD/YYYY)
(MM/DD/YYYY) Months (Kg) (cm) and
(yes or no) (yes or (yes or no)
Previous Years
above (yes or no)
no)
BMI-A HFA
Prepared by: Approved by:
__________________________________ School Head
Feeding Focal Person
Note: This form shall be prepared by the school before the start of feeding to be compiled by the SDO.