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NOTE: PLS. LOOK AT YOUR FILE LAST YEAR

ON YOUR GESP ENDING (AS OF MARCH, 2012) - THIS WILL SERVE AS Distr ict ID School ID

YOUR BASELINE DATA Republic of the Philippines

DEPARTMENT OF EDUCATIONOFFICE OF PLANNING SERVICE

Research and Statistics Division

GOVERNMENT ELEM ENTARY SCHOOL PROFI LE

(END OF THE SY DATA, AS OF MARCH 31)

SCHOOL INFORMATI ON

SY 2012-2013

Name of School : Region :

(Official name)Division :

School Distr ict :

(If renamed, please indicate old name.)Legislative District :

Address : Tel. No. : # Street/Sitio/Purok Barangay

Mobile No. :

Fax No. :

Municipal ity Province/City E-M ail Address :

I ntegrated School Annex/Extension School

(Please check appropriate box if the school is offering both elementary and secondary levels.) (Please check appropriate box if the school is an annex/extension school.)

Yes (Please indicate School ID of Secondary level) Yes (Please indicate School ID of the Mother School)Secondary SchoolID: Mother SchoolID:

No No

Certi f ied True and Correct by : Checked by Distr ict Off ice : Ver i f ied by the Division Office :

School Head : Head of the Off ice : Head of the Off ice :

(Signature Over Printed Name) (Signature Over Printed Name)

Position Title : Date : Position Title : Date : Position Title : Date :

(Signature Over Printed Name)

INSTRUCTIONS

This form shall be accomplished by the head of all government elementary schools. In the case of schools with annexes, extensions, etc., a separate school profile shall be accomplished by

every annex, extension, etc.

The head of the school shall sign the forms certifying to the correctness of the data, and shall be responsible and accountable for any inaccuracy or false data/information reported.He/She shall submit the accomplished forms to the respective Division Office on or before May 24, 2013.

Important: Read the defin itions/instructions found at the bottom of each table before fil ling up the form. No item should be left blank. I nstead, " zero ( 0 )" or " not applicable (n/a) "

shal l be written. Shaded boxes shall not be fil led.

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Table A. PUPIL DATA, SY 2012-2013 (As of March 31, 2013) - Regular & SPED

Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 TOTAL (Grades 1-6) Non-Graded SPED

Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female

Enrolment

Number of Completers/Promotees/Graduates

Number of Dropouts

Number of Transferees In

Number of Transferees Out

Number of Late EnrolleesNumber of Continuing Pupils

PUPIL DATA (Table A) - The data to be entered cover this school year as of March 31, 2013 and shall be distributed by grade level and by sex.

Enrolment- includes all pupils enrolled in the school, as of March 31.

Number of Compl eters/Promotees/Graduates- Data on completersrefer to Kindergarten pupils who have completed the requirements for this level. In grades 1 to 5, promoteesrefer to pupils who successfully completed the grade level.

In Grade 6, this refer to pupils who completed the elementary level or the graduatesof the level.

Number of Dr opouts- refers to pupils who left school before completing the prescribed grade level within the specified school year from August 01 to March 31 and should not be included in the total enrolment as of the same date.

Number of Transferees In- refers to pupils who entered the school from another school, either government or private from August 01 to March 31.

Number of T ransferees Out- refers to pupils who left school to enter another school as evidence by the request for permanent record (Form 137) from August 01 to March 31 and should not be included in the total enrolment as of the same date.

Number of L ate Enr ollees- refers to pupils who entered the school after the cut-off date of July 31, i.e., from August 01 onwards.

Number of Continuing Pupils- refers to pupils who were enrolled in Alternative Delivery Mode (ADM) as defined in the DepED Order 54, s. 2012 and who have not yet completed the requirements for the grade level.

Table B. CAUSES OF DROPOUTS

(DEACTIVATED)

Certi f ied True and Correct by : Checked by Distr ict Office : Ver i f ied by the Division Office :

School Head : Head of the Office : Head of the Office :

Position Title : Date : Position Title : Date : Posi tion Title : Date :

(Signature Over Printed Name) (Signature Over Printed Name) (Signature Over Printed Name)

Particulars

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Standard

Complete

Incomplete

Non-Standard/Makeshift rooms

Total

Complete

IncompleteTotal

PHYSICAL FACILITIES DATA (Tables C1 and C2)

EXISTING NUMBER OF INSTRUCTIONAL AND NON-INSTRUCTIONAL ROOMS (Condemned/condemnable instructional and non-instructional rooms are not to be included.)

Enter the number of rooms currently being used and not currently being used forinstructional and non- instru ctional pur poses, regardl ess of funding source, in the appropriate boxes.

The columns for Totals shall include those currently being used and not currently being used.

I nstructional rooms- refer to rooms use for instructions with the following dimensions regardless of the number of doors (either 1 door or 2 doors) and regardless of funding source and year constructed:

6m x 8m (Bagong Lipunan type) 7m x 18m (multi-purpose, workshop, science lab., computer lab.)

7.5m x 6m

Standard -refer to rooms which are safe and usable, (whether complete or partially incomplete classroom construction) and having the standard dimensions as defined in the instructional rooms.Completeclassrooms construction - refer toschool building projects which were completed within the contract duration period and have the following features:

cemented floor; smooth finished walls; painted walls, ceiling and roofing; full cathedral type ceiling; complete set of windows; entrances with doors; complete electrical wires and fixtures

(for areas with electricty); roofing or weather protection; blackboard and toilet (optional).

Incompleteclassrooms construction - refer to school building projects which were not completed within the contract duration period but follow the correct dimensions and materials.

Non-Standard/Makeshi ft rooms -refer to safe and usable rooms which areconsidered temporary structures as a means of easing up classrooms shortage and/or temporary shelter during emergencies.

These also refer to rooms which do not meet the prescribed standard dimensions and may basically made of bamboo, nipa, cogon, lumber and other light materials.

Condemnable rooms- refer to rooms deemed to be dangerous to the extent that life, health, property or safety of the public or its occupants are endangered, based on joint evaluation of PFSED, Municipal Engineer & COA official.

Condemned rooms- refer to rooms deemed to be dangerous to the extent that life, health, property or safety of the public or its occupants are endangered, with approval of PFSED, Municipal Engineer and COA for condemnation.

Note: Non-i nstructional rooms used for two or more purposes such as libr ary, offi ce or cli nic, shall be counted separately.Tables C1 and C2 must be greater than or equal to th e totals of i nstructional and non-i nstructional rooms needing r epair of Table C5.

Certi f ied True and Correct by : Checked by Distr ict Office : Ver i fied by the Division Office :

School Head : ___________________________________ H ead of the Office : ___________________________________ H ead of the Office : ___________________________________

Position Title : _______________ Date : _______________ Position Title : _______________ Date : _______________ Position Title : _______________ Date : _______________

7m x 9m 7m x 7m

7m x 8m 7m x 6m

(Signatur e Over Prin ted Name)

Used as libraries Used as clinic

Total Non-

instructional

Rooms

Not currently

used

SY 2012-2013 (As of March 31, 2013)

Non-Instructional Rooms

Status

(Signature Over Pr inted Name) (Signature Over Pr inted Name)

Table C1. EXISTING NUMBER OF INSTRUCTIONAL ROOMS IN THE SCHOOL BY STATUS,

SY 2012-2013 (As of March 31, 2013)

Category

Instructional Rooms

Used as academic

classrooms

Used as Science

Laboratories

Used as H.E.

rooms

Used as I.A./

Workshops

Used as computer

rooms

Used for

Kindergartenclasses

Used for SPED

classes

Not currently

used

Table C2. EXISTING NUMBER OF NON- INSTRUCTIONAL ROOMS IN THE SCHOOL BY STATUS,

Used as canteen Used as offices Other uses

Total

InstructionalRooms

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Table C3. EXISTING NUMBER OF ROOMS IN THE SCHOOL BY FUNDING SOURCE, SY 2012-2013 (As of March 31, 2013)

NUMBER OF INSTRUCTIONAL ROOMS ACCORDING TO FUNDING SOURCE (Table C3)

Based on the total instructional and non-instructional rooms in Tables C1 and C2, indicate the number of the rooms according to the following funding sources:

DepEd budget- includes classrooms and other instructional rooms funded from the Regular School Building Program implemented by the Department of Public Works and Highways (DPWH) and DepEd (for Red and Black Schools)

DepEd with counterpart f unds rooms constructed using DepED funds with counterpart of at least 10% from other sources.

LGU/SEF - classrooms and other instructional rooms funded from the Special Education Fund (SEF) and the budgets of Local Government Units (LGU): provincial, municipal or barangay units.

PTA-funded - includes classrooms and other instructional rooms funded by the Parents-Teachers Association (PTA).

Congress- includes classrooms and other instructional rooms funded from the Congressional Initiatives, Priority Development Assistance Fund (PDAF), Countrywide Development Fund (CDF), more commonly known as "pork barrel".

For eign funds/donors- includes classrooms and other instructional rooms funded from foreign-assisted projects and bilateral agreements with donor countries.

Pr ivate sector- includes classrooms and other instructional rooms funded through donations of private individuals, corporations, alumni associations, non-government organizations and philanthropic organizations.

Others- these are rooms which are funded by other sources not listed above.

Note: Totals in th is table shall tall y with th e totals in Tables C1 and C2, respectively.

Table C4. NUMBER OF ON-GOING CONSTRUCTION BY FUNDING SOURCE, SY 2012-2013 (As of March 31, 2013)

NUMBER OF ROOMS IN THE SCHOOL WITH ON-GOING CONSTRUCTION BY FUNDING SOURCE (Table C4)

On-going construction- are school building projects in the process of implementation or projects with actual works being undertaken in the project site and considered not yet completed.

Cer ti fied True and Correct by : Checked by Distr ict Off ice : Ver ified by the Division Office :

School Head : _____________________________________ Head of the Off ice : _____________________________________ Head of the Office : _____________________________________

Position Title : _______________ Date : _______________ Position Ti tle : _______________ Date : _______________ Position Title : _______________ Date : _______________

Private sector OthersType of Room

Instructional Rooms (refer to Table C1)

(Signatur e Over Prin ted Name)

TotalDepEd budget

DepEd with

counterpart

funds

LGU/SEF PTA-funded CongressForeign funds/

donors

LGU/SEF PTA-funded Congress

(Signature Over Printed Name) (Signature Over Pr inted Name)

Non-Instructional Rooms (refer to Table C2)

TOTAL

TOTAL

Foreign funds/

donorsPrivate sector Others Total

Instructional Rooms

Non-Instructional Rooms

Type of Room DepEd budget

DepEd with

counterpart

funds

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NUMBER OF INSTRUCTIONAL AND NON-INSTRUCTIONAL ROOMS NEEDING REPAIR (Table C5)Indicate the number of instructional rooms by type of repair needed.

Major Repair- repair or replacement of schoolbuilding components which are subjected to critical structural loads and stresses and which

are estimated to cost ten percent (10%) or more of the cost of a standard building unit such as roof frames, posts and exterior walls.

Minor Repair- repair or replacement of schoolbuilding components which are not subjected to critical structural loads and stresses and

which are estimated to cost less than ten percent (10%) of the cost of a standard building unit such as repair of windows, doors, partitions

and the like.

Note: Tables C1 and C2 must be greater th an or equal to the totals of i nstructional and non-instru ctional r ooms

needing r epair of this table.

Table C6. BUILDABLE SPACE FOR ADDITIONAL 7x9 CLASSROOMS, Table C7. EXISTING NUMBER OF CONDEMNED AND CONDEMNABLE CLASSROOMS,

SY 2012-2013 (As of March 31, 2013) SY 2012-2013 (As of March 31, 2013)

Does the school have available buildable space for additional 7x9 classrooms on

a vacant lot?

Yes No

EXISTING NUMBER OF CONDEMNED AND CONDEMNABLE CLASSROOMS (Table C7)

If Yes, how many additional 7x9 classrooms can be constructed? ________ Indicate the number of condemned and condemnable classrooms.

For the definitions, please refer to Physical Facilities Data (Tables C1 and C2).

BUILDABLE SPACE FOR ADDITIONAL 7x9 CLASSROOMS (Table C6)

Indicate the number of 7x9 classrooms that can be constructed in the available space in the school site.

Note: I n case, the school head does not have adequate inf ormation on the item above,

the assistance of the Di vision Physical Faci li ties Coordinator /

Di vision Project Engin eer can be asked.

EXISTING CLASSROOM FURNITURE (Table C8)

Count serviceable classroom furniture regardless of funding source

Number of Desks - refers to the total number of serviceable two-seater desks in the school.

Kindergarten Number of Chairs/Armchairs- refers to the total number of serviceable chairs/armchairs in the school.

Elementary In case of sets of tables and chairs, count the number of chairs.

Certif ied True and Correct by : Checked by Distr ict Off ice : Verified by the Division Office :

School Head : __________________________________ Head of the Office : __________________________________ Head of the Office : __________________________________

Position Title : _______________ Date : _____________ Position Title : _______________ Date : _____________ Position Title : _______________ Date : _____________

Condemned Condemnable

Table C5. NUMBER OF INSTRUCTIONAL AND NON-INSTRUCTIONAL

ROOMS NEEDING REPAIR, SY 2012-2013 (As of March 31, 2013)

Instructional Rooms

Non-Instructional Rooms

TOTAL

Type of RoomTypes of Repair

Major Minor Total

(Signature Over Pr inted Name)

Table C8. EXISTING CLASSROOM FURNITURE,

SY 2012-2013 (As of March 31, 2013)

(Signature Over Printed Name) (Signature Over Printed Name)

Desks Chairs/ ArmchairsLevel of Education

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used by pupils used by pupils

used by personnel used by personnel

Note: Toi let bowls located inside and outside the classroom shall be incl uded in the count whil e EXISTING NUMBER OF URINALS (Table C10)

those that are being used by both pupils & personnel shall be counted in " used by pupils" . Individual Urinal - a single urinal is designed for one male pupil standing upright.Trough or Multiple- a urinal which can accommodate 3 more pupils at the same time. Only the physical

structure shall be counted and not the number of pupils that can be accomodated.

A trough shall be counted by row (vertical or horizontal).

Note: Ur inals located inside and outside the classroom shall be incl uded in the count whi le

those that are being used by both pupil s & personnel shall be counted in " used by pupils" .

Table D1. AVAILABILITY OF WATER SUPPLY, SY 2012-2013 (As of March 31, 2013) Table D2. AVAILABILITY OF ELECTRICAL SUPPLY, SY 2012-2013 (As of March 31, 2013)

Local Piped Water Natural Source Grid Supply No source of electricity

Water Well/Deep Well Without Available Water Supply Generator

Rainwater Catchments Solar Power

IfLocal Piped Water, check the appropriate water supply provider: IfGrid Supply, check the appropriate electrical supply provider:

Maynilad Local water district Others, please specify _____________ MERALCO Others, please specify _____________

Manila Water Local water cooperative Local Electric Cooperative

Average Cost of Monthly Bills/Maintenance: (Please indicate the amount) ______________ Average Cost of Monthly Bills/Maintenance: (Please indicate the amount) _________________

Who Pays the Cost of Monthly Bills/Maintenance: (Check as appropriate): Who Pays the Cost of Monthly Bills/Maintenance: (Check as appropriate):

School MOOE School Canteen Fund PDAF/pork barrel School MOOE School Canteen Fund PDAF/pork barrel

LGU Private Individual/Sector LGU Private Individual/Sector

PTA Others, please specify _____________ PTA Others, please specify _____________

AVAILABILITY OF WATER SUPPLY (Table D1) AVAILABILITY OF ELECTRICAL SUPPLY (Table D2)

Local piped water- water source coming from local water service providers. Grid Supply- electricity coming from major or local power distributors (e.g, electric cooperatives, Meralco, etc.).

Water well- an excavation structure in the ground by digging, driving, boring or drilling to access water in Generator- machine operated by diesel or gasoline to produce electricity.

underground aquifiers. Solar Power - solar power is the conversion of sunlight into electricity thru different devices such as solar panels.

Rainwater catchment - water sourced from rainwater and collected thru a rainwater collector. No source of electr icit y - schools without existing electrical supply at all.

Natural source- water sourced from a spring or stream.

Without availabl e water supply- schools without existing water supply at all.

Certif ied True and Correct by : Checked by District Off ice : Veri fied by the Division Office :

School Head : _______________________________________ Head of the Off ice: _______________________________________ Head of the Off ice: _______________________________________

Position Titl e : _______________ Date : ______________ Position Title : _______________ Date : ______________ Position Title : _______________ Date : ______________

Table C9. EXISTING NUMBER OF TOILET BOWLS, Table C10. EXISTING NUMBER OF URINALS,

(Male & Female)

Urinals

Usage

Total Total

Toilet Bowls

SY 2012-2013 (As of March 31, 2013) SY 2012-2013 (As of March 31, 2013)

TroughCommon

Female IndividualTotalMaleUsage

(Signature Over Printed Name)(Signature Over Printed Name)

Water Supply Sources:

(Check as appropriate)

(Signature Over Printed Name)

Electrical Supply Sources:

(Check as appropriate)

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Table E. PERSONNEL DATA (Locally-funded and DepED Subsidized Teachers Working in the School), SY 2012-2013 (As of March 31, 2013)

Kindergarten

Elementary

ALS

ALIVE

PERSONNEL DATA (LOCALLY-FUNDED AND DEPED SUBSIDIZED TEACHERS WORKING IN THE SCHOOL) (Table E) - The data to be entered shall be as of March 31, 2013.

Local ly-f unded and DepED Subsidized teachers worki ng in the schoolare those teachers not having plantilla positions and whose compensation is not paid out of the national budget.

These are classified according to the following:

Special Education Fund (SEF) Teachers whose salaries are being paid by the Local School Board Fund (Provincial/City or Municipal) where the school is located.

Local Government Unit (LGU) funded Those teachers paid out of the general fund (not the SEF) of the LGU.

PTA-funded Teachers who receive their salaries through the Parents-Teachers Association (PTA).

Others These are teachers who are being funded by neither one of the above.

DepEd subsidized These are teachers who are paid by DepEd through honorarium.

Table F1. TEACHING RELATED AND NON-TEACHING PERSONNEL DATA (Nationally-funded), SY 2012-2013 (As of March 31, 2013)

Principal IV

Principal III

Principal IIPrincipal I

Head Teacher V

Head Teacher IV

Head Teacher III

Head Teacher II

Head Teacher I

Guidance Coordinator/Counselor

Security Guard

Utility Worker

TEACHING RELATED AND NON-TEACHING PERSONNEL DATA (NATIONALLY-FUNDED) (Table F1) - The data to be entered shall be as of March 31, 2013.

Note: F or the defi niti ons, please refer to Teaching Personnel Data (Table F2).

Totals in column 12 must tally with entr ies in column 2.

Certif ied True and Correct by : Checked by Distr ict Office : Verif ied by the Division Office :

School Head : Head of the Off ice : Head of the Off ice :

Position Title : Date : Position Title : Date : Position Title : Date :

TOTAL Nationally-funded personnworking in the school

Number actually working in the

school

On leave

Female TOTAL

Col. 1 Col. 2 Col. 3 Col. 4 Col. 5

Position Title

NATIONALLY-FUNDED PERSONNEL

Number of

positions

assigned in

the school

per latest

PSI-POP

Female Total

Funding Source

Special Educ. Fund (SEF)

POSITIONS ASSIGNED IN THE SCHOOL

Personnel detailed from otherschool(s)/ DepEd office(s)

(Col.16+Co

Col. 17Col. 6 Col. 7

Position(s)

vacant

Personnel detailed to

(Col.3+Col.13) (Col.4+Col.14)

(Signature Over Printed Name) (Signature Over Pr inted Name) (Signature Over Pr inted Name)

Provincial/City

Male Female TotalMale

TOTAL

DepEd

office(s)

within the

division

DepEd

office(s)/

school(s)

outside the

division

Secondary

school(s)

within the

division

TOTALMale

Col. 16Col. 8 Col. 9 Col. 10 Col. 11 Col. 18

Municipal

Local Gov't Unit

(LGU) fundedPTA-funded Others

TOTAL

Locally-funded

DepEd Subsidized

TOTAL(Col.5+Col.6+

Col.7+Col.11 )

Col. 12 Col. 13

Class

Col. 14 Col. 15

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Table F2. TEACHING PERSONNEL DATA (Nationally-funded), SY 2012-2013 (As of March 31, 2013)

a. Teaching Posit ions

Master Teacher III

Master Teacher IIMaster Teacher I

Teacher III

Teacher II

Teacher I

SPED Teacher (I-V)

b. Assignment (Number of teachers actuall y worki ng in the school) :

Handling Grades 1-6

Handling SPED classes

Handling Kindergarten classes

Handling ALS classes (Mobile Teacher)

ALS Coordinator

Handling Full Time Ancilliary Services

TEACHING PERSONNEL DATA (NATIONALLY-FUNDED) (Table F2) - The data to be entered shall be as of March 31, 2013.

Nati onall y-fu nded personnel- are those teaching, teaching-related and non-teaching personnel having plantilla positions, including those with provisional appointments.

Number of positi ons assigned in the school per l atest PSI-POP- refers to the number of plantilla items assigned to the school.

Number actually work ing i n the school- are those teaching, teaching-related and non-teaching personnel with plantilla positions who are actually performing their specific assignments in the school, as of March 31, 2013.

On l eave personnel- refers to those who are on sick, vacation, study and/or maternity leave as of March 31, 2013.

Posit ion (s) vacant- refers to the plantilla positions that are unfilled as of March 31, 2013.

Personnel detailed to DepEd offi ce(s) withi n the division- are those assigned/designated to the district office or to the division office.

Personnel detail ed to DepEd off ice(s)/school(s) outside the division- are those assigned/designated to the regional office, to the central office or to other schools whether elementary or secondary schools outside the division.

Personnel detail ed to Secondary school(s) withi n the divi sion- are those assigned/designated to secondary schools within the division.

Personnel detailed fr om other school(s)/ DepEd off ice(s) -are those who are actually working in the school but whose items belong from secondary school(s) or from another DepED office(s) like the district, the division, the regional,

the central office or from other school division(s).

Note: I n Table F2a, totals in column 12 must tally with entri es in column 2.

I n Table F2b, if a teacher i s handling two or more assignments, he/she shoul d be counted in h is/her assignment where he/she has the most number of loads.

I n Table F2b, total in column 18 (Handling Grades 1-6) must tally to Total (Grade 1-6) in Table I .

I n Tables F2a& F2b, totals in column 18 must tall y with entri es in Table G column 7.

Totals in Tables F2a& F2bmust tally.

Certif ied True and Correct by : Checked by Distr ict Off ice : Veri fied by the Division Off ice :

School Head : Head of the Off ice : Head of the Office :

Position Title : Date : Position Title : Date : Position Title : Date :

Secondary

school(s)

within the

division

Col. 6 Col. 12

TOTAL Nationally-funded personnworking in the school

Female Total

Col. 5Col. 4

Position(s)

vacant

Number actually working in the

school

Personnel detailed to

(Col.3+Col.13)

TOTAL(Col.5+Col.6+

Col.7+Col.11 )

On leave

Female TOTAL

Col. 14

Position Title

NATIONALLY-FUNDED PERSONNEL

Number of

positions

assigned in

the school

per latest

PSI-POP

POSITIONS ASSIGNED IN THE SCHOOL

Male

DepEd

office(s)

within the

division (Col.4+Col.14)

Personnel detailed from otherschool(s)/ DepEd office(s)

Male

DepEd

office(s)/

school(s)

outside the

divisionCol. 7 Col. 15

TotalFemaleTOTAL Male

TOTAL

Col. 1 Col. 2 Col. 3

(Signatur e Over Pri nted Name)

Col. 13

TOTAL

(Col.16+Col

(Signatur e Over Pri nted Name)

Col. 10 Col. 17 Col. 18Col. 16Col. 9 Col. 11

(Signatur e Over Prin ted Name)

Col. 8

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Table G. TEACHER ASSIGNMENTS (Nationally-funded teachers working in the school), SY 2012-2013 (As of March 31, 2013)

Master Teacher III

Master Teacher II

Master Teacher I

Teacher III

Teacher II

Teacher I

SPED Teacher (I-V)

TEACHER ASSIGNMENTS (NATIONALLY-FUNDED TEACHERS ACTUALLY WORKING IN THE SCHOOL) (Table G) - The data to be entered shall be as of March 31, 2013.

Ancil lary services- are those rendered as a guidance counselor, librarian, property custodian, office clerk, canteen manager, coordinator (ALS, PE, Boy/Girl Scout, etc.), teacher nurse. Class advisorship is not included.

Note: Totals in column 7 of thi s table must be equal to the totals in Tabl es F2a& F2b(column 18 - Total Nationall y-funded personnel working in the school).

Table H. NUMBER OF TEACHERS BY RESIDENCE Table J. NUMBER OF TEACHERS BY TEACHING ASSIGNMENT IN

(DEACTIVATED)SY 2012-2013 (As of March 31, 2013)

Table I. NUMBER OF TEACHERS BY GRADE LEVEL

(Nationally-funded teachers actually working in the school), English

SY 2012-2013 (As of March 31, 2013) Mathematics

Filipino

Science

MakabayanSIBIKA/HEKASI

Note: I f a teacher is teaching two or more grade levels, he/she should be counted in gr ade where his/her teaching load has H.E./E.P.P.

the most number of teaching loads. E.K.A.W.P.

I f a teacher has equal teaching loads lke a multi -grade teacher, he/she will be counted in the highest grade level taught. M.S.E.P.

Total in this table must tally with the total in Table F2b- Handli ng Grades 1-6 (column 18) Note: A teacher who is teaching more than one learni ng area or grade

Grade 5 and 6 of this table must be less than or equal to Grade 5 and 6 in Table J. level can be counted more than once.

Certif ied True and Correct by : Checked by Distr ict Off ice : Ver i f ied by the Division Office :

School Head : Head of the Office : Head of the Office :

Posi tion Ti tle : Date : Posi tion Ti tle : Date : Posi tion Ti tle : Date :

Assigned to ancillary services

as additional load

Col. 7

Class teaching 200 min. per

day or more

Col. 1

(Signature Over Printed Name) (Signature Over Printed Name)

Col. 3 Col. 4

TOTAL

(Col.2+Col.3+Col.4+Col.5+Col.6)

(360 min. or more) part-time to ancillary services

Not assigned to ancillary

services

Assigned full-time to

ancillary servicesPosition Title

Carries full-time class teaching load Assigned part-time to class teaching,

Col. 6

Class teaching less than 200

min. per day

Col. 5Col. 2

Grade 6

Male Female Male Female Male Female

Grade 1Total

(Grade 1-6)Grade 2 Grade 3 Grade 4 Grade 5 Grade 6

TOTAL

FemaleMale

Male

Teaching AssignmentGrade 5

GRADE 5 AND 6 (Nationally-funded teachers actually working in the school),

Male

Female Male Female

(Signatur e Over Prin ted Name)

Female Male Female Male Female

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Table K. NUMBER OF COMPUTERS IN THE SCHOOL BY FUNDING SOURCE, SY 2012-2013 (As of March 31, 2013)

LGU/SEF PTA-funded CongressForeign

funds/donors

Private

sector

a. Academic Use

Computers (Desktop/Notebook/Netbook/Tablet)

Desktop Virtual Terminal

b. Computers for Admi nistrative Use

Computers (Desktop/Notebook/Netbook/Tablet)

Desktop Virtual Terminal

c. Computers Needing Repair

Computers (Desktop/Notebook/Netbook/Tablet)

Desktop Virtual Terminal

NUMBER OF COMPUTERS IN THE SCHOOL BY FUNDING SOURCE (Table K)

Indicate the number of computers according to the following funding sources:

DepEd budget- includes computers procured through the DepEd Computerization Program and other similar programs.

LGU/SEF- computers procured from the Special Education Fund (SEF) and the budgets of Local Government Units (LGU): provincial, municipal or barangay units.

PTA-funded- computers funded from the Parents-Teachers Association (PTA).

Congress- computers funded from the Congressional Initiatives, Priority Development Assistance Fund (PDAF), Countrywide Development Fund (CDF), more commonly known as "pork barrel".Foreign funds/donors- computers procured through foreign-assisted projects and bilateral agreenents with donor countries.

Other Gov't Agencies- computers funded from other government agencies such as DTI, DOST, CICT, etc.

Pr ivate sector- computers donated by private individuals, corporations, alumni associations, non-government organizations, philanthropic organizations

Others- These are computers procured from other sources not listed above.

Computers for Academic Use- are utilized in the classroom/laboratory as an aid to instruction.

Computers for Admini strative Use- are for encoding administrative data of the school, e.g. enrolment, attendance, disbursements, financial statements, and other reports.

Computers Needing Repair- refers to damaged computers procured in the last 5 years that can still be repaired (not being used but not yet condemned).

Computers- refers to desktop, laptop, netbook, tablet (ipad/android/etc).

Desktop Virtual Terminal- computer terminal consisting of monitor, keyboard and mouse connected to a terminal device that connects to a computer host (do not count the computer host).

Certif ied True and Correct by: Checked by Distr ict Office: Ver if ied by the Division Office:

School Head : ___________________________________ Head of the Off ice : _____________________________________ Head of the Off ice : _____________________________________

(Signature over Printed Name) (Signature over Pr inted Name) (Signature over Printed Name)

Posi tion T i tle : _________________ Date : ____________ Posi tion T i tle : ________________ Date : _______________ Posi tion T i tle : ________________ Date : _______________

TOTAL (a, b & c)

NUMBER OF COMPUTERS BY FUNDING SOURCE

DepEd

budgetOthers Total

Other Gov't.

Agencies

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Table L. DATA ON INTERNET CONNECTIVITY, SY 2012-2013 (As of March 31, 2013)

Availability of internet connection in the school : Yes No

IfYes, check the appropriate internet provider:

SMART PLDT DIGITEL WIT Global (Satellite)

GLOBE BAYANTEL SUN Others, please specify ___________

Table L1. NUMBER OF COMPUTERS CONNECTED IN THE INTERNET

Computers ComputersDesktop Virtual

Terminal

Indicate the number of computers connected in the internet.

Table L2. MONTHLY SERVICE FEE (IN PESOS) ON INTERNET CONNECTION BY FUNDING SOURCE

DepEd budget PTA-funded CongressForeign

funds/donors

Other Gov't.

AgenciesPrivate sector

Indicate the monthly service fee on internet connection by funding source.

Where does the school personnel access internet outside the school to encode E-BEIS data? (Check as appropriate).

District Office Internet Cafe At Home

Division Office Other schools Others, please specify ___________

DATA ON INTERNET CONNECTIVITY (Table L)

Indicate the number of computers which are connected to the internet through any of the following types of connection:

Wired- internet connection using the phone lines from the service provider to client.

F ixed wir eless- internet connection through radio frequency bands with directional radio antenna on each end of the signal.

Satellite- internet connection using satellite dish supplied by internet provider.

USB Modem- internet connection using USB dongle.Bandwidth- refers to maximum speed of internet connection.

Committed In ternet Rate (CIR)- refers to the guaranteed average bandwidth of a virtual circuit in a relay network.

Monthly service feeis the amount needed to pay for the internet connection on a monthly basis.

Certi f ied True and Correct by: Checked by Distr ict Office: Ver i f ied by the Division Office:

School Head : ___________________________________ Head of the Off ice : _______________________________ Head of the Off ice : _______________________________

(Signature over Printed Name) (Signature over Printed Name)

Posit ion Title : _________________ Date : __________ Posit ion Title : _________________ Date : ___________ Posit ion Tit le : _________________ Date : ___________

Desktop Virtual

Terminal

USB Modem

Type of Connection

Wired

Type of Connection

(Signatur e over Pr int ed Name)

LGU/SEF

Funding Source

Others Total

Number of Computers Connected

USB Modem

Wired

Fixed Wireless

Satellite

Fixed Wireless

CIRBandwidthAcademic Administrative

Satellite

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Table M. AVAILABILITY OF CELLPHONE NETWORK IN THE SCHOOL

(WILL BE PART OF SCHOOL INF ORMATI ON)

Table N. CAUSES OF CLASS DISRUPTIONS, SY 2012-2013 (check as appropriate) Table O. NUMBER OF CLASS DAYS, SY 2012-2013

Natural Calamities Celebrations

Man-Made Calamities Others, please specify _________

Indicate actual number of class days in this school year.

Table P1. FEEDING PROGRAM, SY 2012-2013

Does the school have a feeding program? Table P2. ESTIMATED HARVEST/PRODUCE USED IN

Yes No THE SCHOOL'S FEEDING PROGRAM, SY 2012-2013

If Yes, who subsidizes the feeding program? (check as appropriate) School MOOE School's Vegetable Garden/Fish Pond/Livestock

School Canteen Fund Barangay Vegetable Garden

LGU Private Individual/Sector Fish Pond

PTA Others, please specify _________ Livestock

Table S. DISASTERS/CALAMITIES, SY 2012-2013

Physical Facilities No. of times the school has been affected by disaster/calamity:

District

Division

Regional Natural

Central Typhoon

MONITORING/VISITS (Table Q) Flood

Tsunami

Volcanic Eruption

Table R. SERVED AS EVACUATION CENTER, Man-made

SY 2012-2013 Armed Conflict

Fire

Others

DISASTERS/CALAMITIES (Table S)

Cer tif ied True and Correct by : Checked by Distr ict Office : Ver ified by the Division Office:

School Head :______________________________ Head of the Offi ce :______________________________ Head of the Offi ce : ______________________________

Position Title :_______________ Date : _________ Posi t ion Ti tle : _______________ Date : _________ Posi ti on T i tl e : _______________ Date : _________

ESTIMATED HARVEST/PRODUCE USED IN THE SCHOOL'S

NUMBER OF CLASS DAYS (Table O)

Actual Number of Class Days: ______________

No. of school visits by the following personnel from:

Causes of Class

Disruptions:

Table Q. MONITORING/VISITS, SY 2012-2013

Estimated Percent ofTotal Harvest/Produce

Sources

Physical Facilities personnel are those Engineers, PFCs or other personnel from

FEEDING PROGRAM (Table P2)

Indicate the estimated percent of total harvest/produce used to support

the feeding program of the school.

Disaster/Calamity

No. of school visits

No. of times the school

has been affected

Offices

(Signature Over Prin ted Name)

Affected means the disaster caused damages to school property,

loss of lives of teachers, pupils and school personnel and disruption of classes.

(Signature Over Prin ted Name)

District/Division/Regional/Central personnel are those from the said office

other than Physical Facilities personnel.

(Signature Over Prin ted Name)

Landslide

No. of times the school has been

used as an evacuation center

the said office whether they are from District, Division, Region or Central Offices.Earthquake

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