(Enclosure No. 2 to DepEd Memorandum No. , s.

2020)

Republic of the Philippines

Department of Education

National Educators Academy of the Philippines

FORM 2020R.1 Professional Development Program/Course Recognition Application Form

INSTRUCTIONS: Input the necessary details. Indicate N/A if not applicable. DO NOT ABBREVIATE. LEARNING

SERVICE PROVIDER PROFILE

Learning Service Provider Type the complete name.

Complete Office Address Type the complete office address.

Contact Person Type the complete name. Mobile No. Type the mobile no.

Telephone No. Type the office telephone no. Email Address Type Email address.

NEAP Authorization Number For Authorized Learning Service Provider only.

Version as of March 10, 2020 Page

1
PROGRAM PROFILE
You will need to complete the following components to describe the program you would like to be recognized.

Title Division Orientation on the Operationalization of the School Learning Continuity Plan

(Outline the reasons for offering this program. You should consider the need this program addresses for teachers
Rationale and include an overview of how relevant and reliable research relates to the content and/or delivery of the
program. Include citations in your overview. Also, provide references to the sources outlined.)

(Provide a brief description of the program. State the terminal and enabling objectives of the program by
Program Description referring to what teachers/school leaders will gain in terms of their professional knowledge, professional
practice and/or professional engagement.)

Professional Development (State the NEAP Professional Development Priorities this program covered.)
Priorities

(Please specify your participants based on their career stage, subject PRC Program (For Non-DepEd
Target Participant area, grade level, etc.) Accreditation LSPs)
No.

Delivery Platform Identify delivery platform here. Indicative Date of Implementation From Start Date to End Date

COURSE LIST
Learning Service Providers can attach one or more courses in a program for recognition. You are required to list courses you are applying for
recognition in the table below and then provide a detailed description of each course on the COURSE DESIGN page.
Course Title Professional Standards Covered Schedule Modality
1 Type here. (PPST, PPSSH, PPSS with specific domain/s and From Start Date to Choose an item.
strand/s) End Date
2 Type here. (PPST, PPSSH, PPSS with specific domain/s and From Start Date to Choose an item.
strand/s) End Date
3 Type here. (PPST, PPSSH, PPSS with specific domain/s and From Start Date to Choose an item.
strand/s) End Date
4 Type here. (PPST, PPSSH, PPSS with specific domain/s and From Start Date to Choose an item.
strand/s) End Date
5 Type here. (PPST, PPSSH, PPSS with specific domain/s and From Start Date to Choose an item.
strand/s) End Date
Add more row to add courses.

Professional Development Programs/Courses Recognition Application Page

Form 2
COURSE DESIGN
Provide a detailed description of each of the course by breaking it into discrete sessions. You may create a copy of this page if you have two or
more courses.
Course Title

Course Description

Intended Resource Person/

Assessment
Duration Topic Learning Methodology Outputs Learning
Strategies
Outcomes Facilitator
1 State its Describe its Describe its Explain, in detail, the professional Explain how Describe what Identify the
duration, topic (focus, intended development activities including the learning teachers/scho Resource Person/
e.g. 90 content and learning the learning resources that outcomes will ol leaders’ Learning
minutes key learning outcomes. teachers/school leaders will be assessed; outputs to Facilitator
points or what engage in, clearly describing how if possible achieve responsible for
teachers will be the presenter will facilitate each attach an learning this session.
learning session and how the participants assessment outcomes. Attach
about). will engage with the content and tool. CV/Resume.
meet the domain/s, strand/s and
indicator/s in the selected
Professional Standards.
Type here.
2 Type here. Type here. Type here. Type here. Type here. Type here.

Type here.
3 Type here. Type here. Type here. Type here. Type here. Type here.

4 Type here. Type here. Type here. Type here. Type here. Type here. Type here.

5 Type here. Type here. Type here. Type here. Type here. Type here. Type here.

Add more row to add sessions.

Professional Development Programs/Courses Recognition Application Page 3

Form
PROGRAM/COURSE IMPLEMENTATION PLAN
How the program will be Provide details on how the funds will be allocated. If registration, how
Funding Source Budget Requirements
funded? much will be collected in each course?

Monitoring and Evaluation Plan

Levels of M and Methods and Schedule of M User of M and E

Indicators Data Sources Person/s Responsible Resources
E Tools and E Data

Level 4. Results What will be What Who and/or When will M Who will be accountable What resources Who will use the
measured? methods/tools what documents and E activities for ensuring that M and are needed to data gathered?
will be used to will provide data be undertaken? E activities are done? implement M and
collect data? or evidence on E activities?
the indicators?

Level 3. Behavior Type here. Type here. Type here. Type here. Type here. Type here. Type here.

Level 2. Learning Type here. Type here. Type here. Type here. Type here. Type here. Type here.

Level 1. Reaction Type here. Type here. Type here. Type here. Type here. Type here. Type here.

Declaration:

I hereby declare the information provided in this application is true and correct and there have been no misleading statements,
omission of any relevant facts nor any misinterpretation made.

Sign off by the Program/Course Manager or its equivalent

Program Manager Type here
Signature
Date Click here to enter a date.

Professional Development Programs/Courses Recognition Application Page

Form 4