ANNEX A

ABOT ALAM: A NATIONAL PROGRAM FOR OUT-OF-SCHOOL YOUTH

OFFICIAL REGISTRATION FROM (Revised)
Ang abot alam ang pinakamalaking programa para maibalik ang mga Out-of-School Youth (OSY) sa pag-aaral,
mabigyan ng karampatang edukasyon, skills training/ pagsasanay at oportunidad sa trabaho o livelihood. Saklaw
ng programang ito ang mga kabataang hindi nakapag-aral, hindi nakapagtapos ng pag-aaral sa gulang na 15
hanggang 30 anyos.

Survereyor's Name:

Complete Address of Surveyor:

Position/ Office/ Affiliation ng Surveyor:

Barangay:

COMPLETE NAME
/Kumpletong Pangalan (i.e.
Last Name, Given Name,
Middle Name) (Extension
name if any ex. JR, SR, III)

BIRTHDATE / Kaarawan
(MM/DD/YY)

AGE / Edad

Sex (M/F)

CONTACT DETAILS /
COMPLETE ADDRESS /
Impormasyong pwedeng Tirahan (i.e. No., Street,
Tawagan (i.e. Email
Brgy., City or Municipality,
address, Cellphone &
Province)
Landline Number)

GABAY:LEGEND: REMARKS* | ALS** Alt
Accreditation & equivalency ProgramInformal Educaation |(PWD)***Persons
Impaired; PWD-PI- Physically Impaired

City/Municipality:

PARENTS/
GUARDIAN
(Magulang /
Tagapangalaga)
Complete Name

EDUCATION/Pinakamat
aas na Antas ng
Edukasyong Naabot
(i.e Elementary Grade,
Year in High School,
College)

(N/A if Not Applicable) etc. GSIS.With Special Need Email Address & Contact # of Surveyor: Province/ Lalawigan: PREFERRED TRACK/ Planong Gawin (i. mga numero. ALS-A & e SECOND. Entrepreurship/ Skills Training) (Puedeng Higit sa Isa ang lagyan ng Ekis) REMARKS * Isaad kung NUMBERS Indicate number Benepisyaryo ng of the ff if any/Isaad ang Programa ALS**. PWD-WSN. PYAP. at ALS-Infed aation |(PWD)***Persons With Disabilities/ May Kapansanan| ***Isulat ang PWD-Hi-Hearing Impaired. Philhealth. Kung May SSS. CRN. kung meron: 4Ps etc. Education. ALS Accreditation & equivalency Program Seonary.D: REMARKS* | ALS** Alternative Learning System|** Isulat ang ALS-BLP-ALS Basic Literacy Program. ALS-A&E elem ALS & equivalency Program-Elementary. PWD-VI-Visually -PI. Kapansanan/ (PWD)*** Pantawid Household.Physically Impaired.) Reason of becoming OSY . Employment.e.

.

41. SGC. s. 2015 Republic of the Philippines DEPARTMENT OF EDUCATION Region 02 Division of Nueva Vizcaya BRIGADA ESKEWELA 2015 NUMBER OF VOLUNTEERS Private Sector School_ID School_Name TOTAL Prepared by: NGO (PTA. Gawad Kalinga. etc. 2-A to DepED Memo No.) 0 Community Corporation 0 Parents 0 Private Individual/Co Alumni mmunity Member 0 0 Religious Organizations (Youth and Adult) Congressional Officials and Staff 0 0 Provincial Officials 0 .Enclosure No.

ASP Division Coordinator .

BE school Form 1 s N 2015 VOLUNTEERS Government Agencies/National & Local City/ Municipal Officials 0 Barangay Officials SK Officials 0 Approved by: 0 Provincial/ City/ Municipal Employees 0 Firement/P NP 0 AFP(PA.) Barangay Other Workers Volunteers 0 0 0 Total Number of Volunteers 0 . Marine. etc. Airforce.

SAMUEL R. OIC.D. SOLIVEN. Schools Division Superintendent . Ph.

s. 41. 0 Item Religious Amount (in Peso) Organizations (Youth and Adult) 0 Hardware Materials for Wash Fa Construction/Repair Item .Enclosure No. 2015 Republic of the Philippines DEPARTMENT OF EDUCATION Region 02 Division of Nueva Vizcaya BRIGADA ESKEWELA 2015 RESOURCES GENERATED School_ID School_Name Hardware Materials for Classroom Repairs Qty. 2-A to DepED Memo No. TOTAL Prepared by: Item Hardware Materials for Toilet Newly Construction/ Repair Amount (in Peso) Qty.

Coordinator .

1 ppines UCATION izcaya ELA 2015 ERATED dware Materials for Wash Facilities Newly Construction/Repair Religious Amount (in Peso) Organizations (Youth and Adult) 0 Approved by: Other Donations Item Religious Amount (in Peso) Organizations (Youth and Adult) 0 Total No. of Volunteers 0 Total No. of Hours Rendered (Labor) 0 Volunteer Man hours (Amount in Peso) 0 Total Amount (in Peso) 0 .BE school form 1.

SAMUEL R.D. Ph. Schools Division Superintendent . OIC. SOLIVEN.

2-A to DepED Memo No. SGC.) 0 Community Corporation 0 Parents 0 Private Individual/Co Alumni mmunity Member 0 0 Religious Organizations (Youth and Adult) Congressional Officials and Staff 0 0 Provincial Officials 0 . Gawad Kalinga. etc. s.Enclosure No. 41. 2015 Republic of the Philippines DEPARTMENT OF EDUCATION Region 02 Division of Nueva Vizcaya BRIGADA ESKEWELA 2015 DIVISION CONSOLIDATED REPORT NUMBER OF VOLUNTEERS Private Sector School_ID School_Name TOTAL NGO (PTA.

Prepared by: ASP Division Coordinator .

Marine. Airforce. etc.) Barangay Other Workers Volunteers 0 0 0 Total Number of Volunteers 0 .BE school Form 1 s N 2015 REPORT VOLUNTEERS Government Agencies/National & Local City/ Municipal Officials 0 Barangay Officials 0 SK Officials 0 Provincial/ City/ Municipal Employees 0 Firement/P NP 0 AFP(PA.

SOLIVEN. OIC. Ph. Schools Division Superintendent .D.Approved by: SAMUEL R.

0 Item Religious Amount (in Peso) Organizations (Youth and Adult) 0 Hardware Materials for Wash Fa Construction/Repair Item . 2015 Republic of the Philippines DEPARTMENT OF EDUCATION Region 02 Division of Nueva Vizcaya BRIGADA ESKEWELA 2015 DIVISION CONSOLIDATED REPORT RESOURCES GENERATED School_ID School_Name Hardware Materials for Classroom Repairs Qty. 2-A to DepED Memo No. 41. TOTAL Item Hardware Materials for Toilet Newly Construction/ Repair Amount (in Peso) Qty. s.Enclosure No.

Prepared by: ASP Coordinator .

of Volunteers 0 Total No. of Hours Rendered (Labor) 0 Volunteer Man hours (Amount in Peso) 0 Total Amount (in Peso) 0 .1 ppines UCATION izcaya ELA 2015 LIDATED REPORT ERATED dware Materials for Wash Facilities Newly Construction/Repair Religious Amount (in Peso) Organizations (Youth and Adult) 0 Other Donations Item Religious Amount (in Peso) Organizations (Youth and Adult) 0 0 Total No.BE school form 1.

SOLIVEN. Schools Division Superintendent . Ph. OIC.D.Approved by: SAMUEL R.