Annex A- Midline Nutrition Assessment Form

Schools Division Office: MISAMIS OCCIDENTAL

Date of Start of Feeding:

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M 3 8 9 0 6 11
F 2 6 7 0 0 12
Total 5 14 16 0 6 23
Grade 1 M 0 4 5 0 4 18
F 4 2 2 0 2 16
Total 4 6 7 0 6 29
Grade 2 M 1 5 6 0 6 7
F 2 3 4 0 4 8
Total 3 8 10 0 10 15
Grade 3 M 0 2 6 0 2 6
F 2 5 2 0 4 6
Total 2 7 8 0 6 12
Grade 4 M 2 4 8 0 3 9
F 2 2 2 0 2 5
Total 4 6 10 0 5 14
Grade 5 M 1 1 2 0 2 6
F 1 2 3 0 1 6
Total 2 3 5 0 3 12
Grade 6 M 1 1 4 0 1 4
F 1 1 2 0 4 4
Total 2 2 6 0 5 8
Non-Grade M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total 0 0 0 0 0 0
Secondary
Beneficiaries
All Kinder M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total 0 0 0 0 0 0
Stunted/ Severely
M 0 0 0 0 0 0
Stunded
F 0 0 0 0 0 0
Total 0 0 0 0 0 0
PARDOs M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total 0 0 0 0 0 0
Indigent Learners M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total 0 0 0 0 0 0
Indigenous Learners M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total 0 0 0 0 0 0
Midline Period

of Feeding

Normal Tall
19 0
28 0
47 0
9 0
7 0
16 0
8 0
8 0
16 0
12 0
4 0
16 0
16 0
9 0
25 0
4 0
3 0
7 0
6 0
6 0
12 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office: Misamis Occidental
City/ Municipality/ Barangay: Baliangao/ Tugas
Name of School/ School District: Agapito Yap Sr. Memorial Elementary School
School ID Number: 127272
Date of Start of Feeding: ###
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
g Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M 3 7 8 0 6 11
F 2 6 7 0 0 12
Total 5 13 15 0 6 23
Grade 1 M 0 3 3 0 4 17
F 4 2 2 0 2 16
Total 4 5 5 0 6 28
Grade 2 M 1 5 5 0 6 7
F 2 3 3 0 4 8
Total 3 8 8 0 10 15
Grade 3 M 0 2 3 0 2 6
F 2 4 2 0 4 5
Total 2 6 5 0 6 11
Grade 4 M 2 4 4 0 3 8
F 2 2 2 0 2 5
Total 4 6 6 0 5 13
Grade 5 M 1 1 1 0 2 5
F 1 2 2 0 1 6
Total 2 3 3 0 3 11
Grade 6 M 1 1 1 0 1 3
F 1 1 1 0 4 3
Total 2 2 2 0 5 6
Non-Grade M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total 0 0 0 0 0 0
Secondary
Beneficiaries
All Kinder M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total
Stunted/ Severely
M 0 0 0 0 0 0
Stunded
F 0 0 0 0 0
Total
PARDOs M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total
Indigent Learners M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total
Indigenous Learners M 0 0 0 0 0 0
F 0 0 0 0 0 0
Total
g Midline Period

of Feeding

Normal Tall
17 0
28 0
45 0
7 0
7 0
14 0
7 0
7 0
14 0
9 0
4 0
13 0
13 0
9 0
22 0
4 0
2 0
6 0
4 0
6 0
10 0
0 0
0 0
0 0

0
0 0

0
0 0

0 0
0 0

0 0
0 0
0 0
0 0
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
g Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office: Division of Misamis Occidental
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
g Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
g Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office: MISAMIS OCCIDENTAL
City/ Municipality/ Barangay: SAPANG DALAGA
Name of School/ School District: SALVADOR ES
School ID Number: 127532
Date of Start of Feedin ###
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted Normal Tall
Wasted + Obese Stunted
Kinder M 1 1 2

F
Total 1 1 2
Grade 1 M 1 2 1 2
F
Total 1 2 1 2
Grade 2 M 1 1
F 1 1
Total 2 0 2
Grade 3 M 3 3
F 1 1
Total 1 3 1 3
Grade 4 M 4 1 3
F
Total 4 1 3
Grade 5 M 1 1
F 1 1
Total 2 1 1
Grade 6 M 3 1 2
F 1 1
Total 4 2 2
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
g Midline Period

of Feeding

Normal Tall
Annex A- Midline Nutrition Assessment Form
Schools Division Office:
City/ Municipality/ Barangay:
Name of School/ School District:
School ID Number:
Date of Start of Feeding:
Last Mile School: _____ Y _____N

Summary of SBFP Beneficiaries for SY 2024-2025 assessed during Midline Period

Number of Beneficiaries
according to Grade Level or Nutritional Status at Midline Period of Feeding
Classification
Severely Overweight Severely
Primary Beneficiaries Sex Wasted Normal Stunted
Wasted + Obese Stunted
Kinder M
F
Total
Grade 1 M
F
Total
Grade 2 M
F
Total
Grade 3 M
F
Total
Grade 4 M
F
Total
Grade 5 M
F
Total
Grade 6 M
F
Total
Non-Grade M
F
Total
Secondary
Beneficiaries
All Kinder M
F
Total
Stunted/ Severely
M
Stunded
F
Total
PARDOs M
F
Total
Indigent Learners M
F
Total
Indigenous Learners M
F
Total
g Midline Period

of Feeding

Normal Tall