Republic of the Philippines

Department of Education
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Gamu District
103340 CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL
Upi, Gamu,Isabela cp no.09778099443 [email protected]
 www.deped-isabela.com.ph  (078) 323-0281/323-2015 [email protected]

Form 1

ADOPT – A - SCHOOL PROGRAM QUARTERLY REPORT

ELEMENTARY

School: CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL Address: Upi, Gamu , Isabela
School ID: 1033340 Contact Nos:09778099443 Email Address: [email protected]

LEARNING ENVIRONMENT
DONOR DATE
DONATIONS PARTICULARS QTY. AMOUNT PRIVATE SECTOR LGU COMPLETED/
TURN OVER
1. Classroom
 New Classroom none
 Rehabilitation/Repair
2. Furniture none
3. Toilet & Wash Facilities none
4. Maintenance none
Construction Materials
5. Real State Land none
6. Others (Pls. Specify) none
TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/Receipts (Xerox)
Prepared by: ANGELICA L. UY - PRINCIPAL 2 Noted: GLORIA D. RAMOS, Ed.D – PSDS
 Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Gamu District
103340 CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL
Upi, Gamu,Isabela cp no.09778099443 [email protected]
 www.deped-isabela.com.ph  (078) 323-0281/323-2015 [email protected]

Form 2

ADOPT – A - SCHOOL PROGRAM QUARTERLY REPORT

ELEMENTARY

School: CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL Address: UPI, GAMU , ISABELA
School ID: 103340 Contact Nos:09778099443 Email Address:[email protected]

LEARNING SUPPORT
DONOR DATE
DONATIONS PARTICULARS QTY. AMOUNT PRIVATE SECTOR LGU COMPLETED/
TURN OVER
1. Audio Visual none
Educational Materials
2. School Supplies none
3. Educational Film/ none
Libraries
4. Others (Pls. Specify) none
TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/Receipts (Xerox)

Prepared by: ANGELICA L. UY - PRINCIPAL 2 Noted: GLORIA D. RAMOS, Ed.D - PSDS

 Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Gamu District
103340 CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL
Upi, Gamu,Isabela cp no.09778099443 [email protected]
 www.deped-isabela.com.ph  (078) 323-0281/323-2015 [email protected]

Form 3
ADOPT – A - SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY

School: CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL Address: UPI, GAMU, ISABELA
School ID: 103340 Contact Nos:09778099443 Email Address:[email protected]

TECHNOLOGY SUPPORT

DONOR DATE
DONATIONS PARTICULARS QTY. AMOUNT PRIVATE SECTOR LGU COMPLETED/
TURN OVER
1. Computer none
2. Electronic Learning none
Materials
3. Internet Connectivity none
4. Others (Pls. Specify) none
TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/Receipts (Xerox)
Prepared by: ANGELICA L. UY- P-2 NOTED: GLORIA D. RAMOS, Ed.D- PSDS
 Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Gamu District
103340 CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL
Upi, Gamu,Isabela cp no.09778099443 [email protected]
 www.deped-isabela.com.ph  (078) 323-0281/323-2015 [email protected]

Form 4
ADOPT – A - SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY

School: CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL Address: UPI, GAMU, ISABELA
School ID: 103340 Contact Nos:09778099443 Email Address: [email protected]

HEALTH AND NUTRITION

DONOR DATE
PRIVATE SECTOR LGU COMPLETE
DONATIONS PARTICULARS QTY. AMOUNT
D/ TURN
OVER
1. Feeding Program
2. Medical/Dental
Mission/Check-ups
3. Deworming Intervention
4. Health Supplies
December
5. Others (Pls. Specify) 3 boxes 3000 Private/Individual /
12, 2019
TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/Receipts (Xerox)

Prepared by: ANGELICA L. UY- PRINCIPAL 2 NOTED: GLORIA D. RAMOS, Ed.D- PSDS
 Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Gamu District
103340 CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL
Upi, Gamu,Isabela cp no.09778099443 [email protected]
 www.deped-isabela.com.ph  (078) 323-0281/323-2015 [email protected]

Form 5

ADOPT – A - SCHOOL PROGRAM QUARTERLY REPORT

ELEMENTARY
School: CAMP MELCHOR F. DELA CRUZ ELEMENTARY UPI, GAMU , ISABELA
School ID: 103340 Contact Nos:09778099443 Email Address: [email protected]

READING PROGRAM

DONOR DATE
DONATIONS PARTICULARS QTY. AMOUNT PRIVATE LGU COMPLETED/
SECTOR TURN OVER

1. Books

2. Supplementary Reading
none
Materials
3. Others (Pls. Specify) Assorted kinder toys 20 2000 Private individual December 12, 2019
TOTAL
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/Receipts (Xerox)
Prepared by: ANGELICA L. UY - PRINCIPAL 2 NOTED: GLORIA D. RAMOS, Ed.D- PSDS
 Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Gamu District
103340 CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL
Upi, Gamu,Isabela cp no.09778099443 [email protected]
 www.deped-isabela.com.ph  (078) 323-0281/323-2015 [email protected]

Form 6
ADOPT – A - SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY

School: CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL Address: UPI, GAMU, ISABELA
School ID: 103340 Contact Nos:09778099443 Email Address: [email protected]
ASSISTIVE LEARNING DEVICES FOR PUPILS/STUDENT WITH SPECIAL NEEDS

DONOR DATE
DONATIONS PARTICULARS QTY. AMOUNT PRIVATE SECTOR LGU COMPLETED/
TURN OVER
1. Pencil Grips NONE
2. Special Chairs NONE
3. Spelling Check Devices NONE
4. Hearing Aides NONE
5. Talking Computers NONE
6. Specialized Keyboard NONE
7. Braille Books NONE
8. Computerized System NONE
9. Others (Pls. Specify)
Please attach the following documents:
1. Deed of Donation
2. Deed of Acceptance
3. Pictures/Receipts (Xerox)
Prepared by: NOTED:
ANGELICA L. UY- PRINCIPAL 2 GLORIA D. RAMOS, Ed.D- PSDS
 Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Gamu District
103340 CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL
Upi, Gamu,Isabela cp no.09778099443 [email protected]
 www.deped-isabela.com.ph  (078) 323-0281/323-2015 [email protected]

Form 7
ADOPT – A - SCHOOL PROGRAM QUARTERLY REPORT
ELEMENTARY

School: CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL Address: FURAO GAMU , ISABELA
School ID: 1033340 Contact Nos:09778099443 Email Address: [email protected]
DIRECT ASSISTANCE

DONOR DATE
DONATIONS PARTICULARS QTY. AMOUNT PRIVATE SECTOR LGU COMPLETED/
TURN OVER
1. Stipend none

2. Others (Pls.
Specify)
TOTAL
Please attach the following documents:

1. Deed of Donation
2. Deed of Acceptance
3. Pictures/Receipts (Xerox)
Prepared by: Noted:
ANGELICA L. UY GLORIA D. RAMOS, Ed.D
Principal 2 Schools District Supervisor

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Republic of the Philippines
Department of Education
Region 02 (Cagayan Valley)
SCHOOLS DIVISION OFFICE OF ISABELA
Gamu District
103340 CAMP MELCHOR F. DELA CRUZ ELEMENTARY SCHOOL
Upi, Gamu,Isabela cp no.09778099443 [email protected]
 www.deped-isabela.com.ph  (078) 323-0281/323-2015 [email protected]