SBFP Form 1 (2024)
Department of Education
Master List Beneficiaries for School-Based Feeding Program (SBFP) ( SY 2024-2025 )
Division: Schools Division of Sorsocon City Name of Principal : Jeannie C. Del
City/ Municipality/Barangay : Sorsogon City, Brgy. Balete Bacon West District Name of Feeding Focal Person :
Name of School / School District : Bacon West Central School/ Bacon West Distri
School ID Number: 114534
Date of Parent's Beneficiary of
Date of Birth Nutritional Status (NS) Participation in
Grade/ Weighing / BMI for 6 y.o. consent for SBFP in
No. Name (MM/DD/YYY Age in Years / Months Weight (Kg) Height (cm) 4Ps
Section Measuring and above milk? Previous Years
Y) (yes or no)
(MM/DD/YYYY) (yes or no) (yes or no)
BMI-A HFA
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
SBFP Form 2 (2024)
Department of Education
SCHOOL-BASED FEEDING PROGRAM (SBFP) SUMMARY OF BENEFICIARIES & START OF FEEDING (SY: 2025-2
Schools Division Offi Schools Division of Sorsocon City
Sorsogon
City/ City, Brgy. Balete Bacon West District
Municipality/B
Name of School / School Distri Bacon West Central School/ Bacon West District
School ID Number: 114534
Date of Start of Feeding: __________________________
Last Mile School: ___Y ___N
Nutritional Status at Start/End of Feeding No. of Secondary Targets
Number of
Undernourished School Overweight
Children by Grade Sex Severely Severely No. of Pupils-at- No. of Stunted/
Wasted Normal + Stunted Normal Tall risk-of-dropping- Severely
Level Wasted Stunted out (PARDOs) Stunted
Obese
1. Kinder F
Total 0 0 0 0 0 0 0 0 0 0
2. Grade I F
Total 0 0 0 0 0 0 0 0 0 0
3. Grade II F
Total 0 0 0 0 0 0 0 0 0 0
M
4. Grade III F
Total 0 0 0 0 0 0 0 0 0 0
5. Grade IV F
Total 0 0 0 0 0 0 0 0 0 0
6. Grade V F
Total 0 0 0 0 0 0 0 0 0 0
7. Grade VI F
Total 0 0 0 0 0 0 0 0 0 0
Grand Total F
Total 0 0 0 0 0 0 0 0 0 0
Prepared by: Approved by:
SBFP DepEd Focal School Head
Note: This form shall be prepared by the school before the start of feeding and after feeding, to be compiled by the SDO, and for final compilation by the RO, for subm
& START OF FEEDING (SY: 2025-2026)
o. of Secondary Targets
No. of Pupils
No. of 4 who are Date Feeding
No. of 4 Ps
No. of
No. of Indigent Indigenous
Learners
Beneficiaries
beneficiaries in Started/Ende
Dewormed previous years d
Learners Peoples (IPs) (Repeaters)
0 0 0 0 0 07/14/2025
0 0 0 0 0 07/14/2025
0 0 0 0 0 07/14/2025
0 0 0 0 0 07/14/2025
0 0 0 0 0 07/14/2025
0 0 0 0 0 07/14/2025
0 0 0 0 0 07/14/2025
0 0 0 0 0 07/14/2025
l compilation by the RO, for submission to DepEd BLSS-SHD
SBFP Form 3 (2024)
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING
FOR THE MONTH OF _________________, SY _________________
Region:
SDO: School:
District: School ID Number:
Grade: __________ Section _____________________
NFP ACTUAL FEEDING
NAME OF PUPILS SEX 7/14 7/15 7/16 7/17 7/18 7/21 7/22 7/23 7/24 7/25 7/28 7/29 7/30 7/31 8/1 8/4 8/5 8/6 8/7 8/8
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Prepared by:
B. Deworming D. Actual Feeding
SBFP COORDINATOR
( x ) - not dewormed (H or N ) - Present, served with Hot meals or Nutritious Food Products
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/N +M ) - Present, served with Hot meals or Nutritious Food Products & Milk
( A ) - Absent, not served
School Head (H2/N2+M2 or H/N+M2) - Present, served twice
ACTUAL FEEDING
NAME OF PUPILS SEX
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Prepared by:
B. Deworming D. Actual Feeding
School Feeding Focal Person
( x ) - not dewormed (H ) - Present, served with Hot meals
Approved by: ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
( A ) - Absent, not served
School Head (H2/N2+M2 or H/N+M2) - Present, served twice
SBFP Form 5 (2020)
SBFP Form 4 (2024)
DEPARTMENT OF EDUCATION
REGION/SDO/DISTRICT:
NAME OF SCHOOL:
SCHOOL ID NO.:
SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT
LIST OF AUTHORIZED CONSIGNEES (SY: ____________________)
NAME & DESIGNATION TEL. NO. MOBILE NO. EMAIL ADD SPECIMEN
SIGNATURE
1
SCHOOL INSPECTION TEAM (SY: ________________)
NAME & DESIGNATION TEL. NO. MOBILE NO. EMAIL ADD SPECIMEN
SIGNATURE
1
Note: Only authorized consignees are allowed to receive the goods.
Use long hand signature.
SBFP Form 5 (2021)
SBFP Form 5 (2024)
DEPARTMENT OF EDUCATION
REGION/DIVISION/DISTRICT: ____________ Region V, Schools Division of Sorsogon City, Bacon West District
NAME OF SCHOOL: _______ Bacon West Central Scool
SCHOOL ID NO.: ____ 114534
SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT
LIST OF BENEFICIARIES (SY _________________)
Classification of Students in terms of Milk Tolerance (Please check on
Without milk intolerance With milk intolerance but
Name Sex Grade & Section
and will participate in milk willing to participate in milk
feeding feeding
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
SBFP Form 5 (2021)
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
Prepared by: APPROVED BY:
School Feeding Focal Person School Head
SBFP Form 5 (2021)
Milk Tolerance (Please check one)
Not allowed by parents to
participate in milk feeding
SBFP Form 5 (2021)
SBFP Form 6 (2021)
SBFP Form 6 (2024)
DEPARTMENT OF EDUCATION
REGION/DIVISION/DISTRICT: ___ SORSOGON CITY
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________
SCHOOL-BASED FEEDING PROGRAM
NFP DELIVERIES (SY 2024-2025)
Grade Level Sex Number of Beneficiaries Date Delivered No. of Packs Received No. of Packs for
Replacement/ Rejected
New Replacement Total (New +
Replacement)
Kinder
M
Total 0
Grade 1 M
Total 0
Grade 2 M
Total 0
Grade 3 M
Total 0
Grade 4 M
SBFP Form 6 (2021)
Total 0
Grade 5 M
Total 0
Grade 6 M
Total 0
GRAND TOTAL:
F
Total 0
PREPARED BY: APPROVED BY:
School Feeding Focal Person School Head
MILK DELIVERIES (SY ______________)
Grade Level Sex Number of Beneficiaries Date Delivered No. of Packs Received No. of Packs for
Replacement/ Rejected
New Replacement Total (New +
Replacement)
Kinder
M
SBFP Form 6 (2021)
Total 0
Grade 1 M
Total 0
Grade 2 M
Total 0
Grade 3 M
Total 0
Grade 4 M
Total 0
Grade 5 M
Total 0
Grade 6 M
Total 0
GRAND TOTAL:
SBFP Form 6 (2021)
GRAND TOTAL: F
Total 0
PREPARED BY: APPROVED BY:
School Feeding Focal Person School Head
SBFP Form 6 (2021)
Remarks
SBFP Form 6 (2021)
Remarks
SBFP Form 6 (2021)
SBFP Form 6 (2021)
