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COMPLETED ACTION RESEARCH

TITLE
AUTHOR/S
YEAR COMPLETED

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 COMPLETED RESEARCH APPROVAL SHEET

The research approval attached hereto, entitled _____INSERT HERE RESEARCH

TITLE_____ prepared and submitted by INSERT HERE NAME OF RESEARCHER,

INSERT HERE NAME OF SCHOOL AND DISTRICT, INSERT HERE SCHOOL YEAR

IMPLEMENTED, is hereby accepted and approved by the division research committee.

IRENE C. CULASTE-QUIMBO, PhD ________________________

SEPS Planning & Research/Member Date Signed

_____________________________ ________________________
CID Learning Area Concerned or Date Signed
SGOD Program Holder Concerned/ Member

ARTEMIO REY S. ADAJAR, PhD ________________________

Chief, SGOD/ Co-Chair Date Signed

ELBERT R. FRANCISCO, PhD ________________________

Chief, CID/ Co-Chair Date Signed

LANILA M. PALAPAR, PhD ________________________

ASDS/ Chair Date Signed

AUDIE S. BORRES, PhD ________________________

ASDS/Chair Date Signed

RANDOLPH B. TORTOLA, PhD ________________________

SDS/Adviser Date Signed

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 DISTRICT COMPLETED RESEARCH APPROVAL SHEET

The research approval attached hereto, entitled _____INSERT HERE RESEARCH

TITLE_____ prepared and submitted by INSERT HERE NAME OF RESEARCHER,

INSERT HERE NAME OF SCHOOL AND DISTRICT, INSERT HERE SCHOOL YEAR

IMPLEMENTED, has been examined and recommended for acceptance and approval in the

Division Research Committee.

DISTRICT PANEL OF EXAMINERS

Approved by the District Research Committee on Oral Examination with a grade of

_(Average Grade)_ on (Date Approved).

____________________________ ____________________________
Member Member

____________________________ ____________________________
Member Member

____________________________
Chair

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SIGNED DISTRICT RESEARCH PROPOSAL APPROVAL SHEET

(scan copy here)

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 QUALITY CONTROL CHECKLIST FOR COMPLETED ACTION RESEARCH

Instructions: Write N/A in the fields of information is Not Applicable. Ensure that the information indicated in
this checklist is properly filled out.

Research Title:

Funding Year:

Region:

Schools Division Office:

School and/or Functional

Division Conducted:

Authors:

[Lead Proponent]
Name: ____________________________________________
Position: _________________________________________
Contact Details: __________________________________

[Author 2]
Name: ____________________________________________
Position: _________________________________________
Contact Details: __________________________________

[Author 3]
Name: ____________________________________________
Position: _________________________________________
Contact details: __________________________________

SCORE SHEET

Instructions: Fill out the fields below based on the results of the evaluation of the research report. For research
for acceptance, check the “Accept” box only if the completed research has received ALL Fully Evident “FE”
marks; check the “Return to Proponent” box otherwise.

For research for archiving, check the “General public disclosure” box only if the completed research has
received ALL “FE” marks and does not fall under the category of research for limited public disclosure; check
the “Limited Public Disclosure” box otherwise.

Date of No. of Times Evaluated 1st 3rd

Evaluation: (including this one): 2nd Other:

DECISION:
(a) For Acceptance: ACCEPT RETURN TO
PROPONENT
(b) For Archiving: GENERAL PUBLIC LIMITED PUBLIC
DISCLOSURE DISCLOSURE

Full Score NE PE FE

5
 (Not Evident) (Partially Evident) (Fully Evident)
Credible 6

Contributory 3

Communicable 2

Conforming 3

TOTAL 14

COMMENTS:

Prepared by: Approved by:

(Name/Position/Office) (Name/Position/Office)

CHECKLIST
Completed Action Research

Directions: Put a check (🗹) mark in the box under the appropriate column (NE = “not evident”; PE = “partially
evident”; and FE = “fully evident”) if the conditions indicated in each criterion below were satisfied by the
completed action research. Consult the Instruction Guide for Evaluators for additional guidance in evaluating
each criterion. (IMPORTANT: The completed action research must receive all FE marks to be eligible for
acceptance.)

A. Credible
The completed action research…

No Criterion Relevant Sections NE PE FE Remarks

1 Uses personal
reflection to
Check entire paper
but especially the
☐ ☐ ☐
make a Context and
compelling case Rationale,
for Innovation,
investigation Intervention, and
and Strategy, and Action
intervention. Research Questions
2 Utilizes a
research design
Action Research
Methods
☐ ☐ ☐
that is correct
and appropriate
for
investigating
the chosen area
of focus,
problem, or
issue.
3 Describes the
chosen research
Action Research
Methods
☐ ☐ ☐
design and
resulting
research
processes in a
manner that is
understandable

6
 to other
teachers
planning similar
interventions
and researchers
conducting
similar work.
4 Shows that the
researcher/s
Whole paper ☐ ☐ ☐
have followed
the Reflect-
Plan-Act-
Observe
approach in
their research.
5 Uses
quantitative
Action Research
Methods
☐ ☐ ☐
(statistical)
and/or
qualitative
(thematic/conte
nt analysis,
process tracing)
tools that are
appropriate to
the
problem/issue
and research
design to
analyze data.
6 Reflects on its
own findings in
Discussion of Results
and Reflection
☐ ☐ ☐
a manner that is
accurate and
consistent with
the results of
the
researcher/s’
data analysis
and engages
with the
researcher/s’
understanding
of the area of
focus.

B. Contributory
The completed action research…

No Criterion Relevant Sections NE PE FE Remarks

7 Addresses
“real” and
Context and
Rationale,
☐ ☐ ☐
“existing” Innovation,
issues and Intervention, and
challenges Strategy, and Action
identified by its Research Questions
stakeholders.
8 Reports new
results,
Discussion of Results
and Reflections but
☐ ☐ ☐
knowledge, also watch for

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 and/or findings cited in the
conclusions that Abstract, and Context
are falsifiable. and Rationale
9 Reports results
that contribute
Discussion of Results
and Reflections but
☐ ☐ ☐
to the also watch for
professional findings cited in the
development of Abstract, Context and
its Rationale, and
proponents/rese Conclusion
archers or their
peers; decision-
makers; or the
welfare of
stakeholders.

C. Communicable
The completed action research…

No Criterion Sections to Consider NE PE FE Remarks

10 Documents the
research
Whole paper ☐ ☐ ☐
process and
results in
accordance with
the prescribed
rules.
11 Utilizes
language that is
Whole paper ☐ ☐ ☐
appropriate and
understandable
to the group
being studied.

D. Conforming
The completed action research…

No Criterion Relevant Sections NE PE FE Remarks

12 Cites and
acknowledges
Whole paper ☐ ☐ ☐
sources per the
guidelines of
ONLY one
style guide,
whether
required by
another
authority or
chosen by the
researcher,
throughout the
research paper.
13 Secures the
free, prior, and
Action Research
Methods; Consent
☐ ☐ ☐
informed forms in supporting
assent/consent documents
of research
participants

8
 (and their
parents/legal
guardians if the
participants are
children).
14 Includes a clear
and feasible
Action Plan ☐ ☐ ☐
action plan
(only for
BERF-funded
research), and
points to
opportunities
for future
interventions
and studies.

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 COMPLETED RESEARCH APPLICATION FORM
AND ENDORSEMENT OF IMMEDIATE SUPERVISOR

A. RESEARCH INFORMATION
RESEARCH TITLE:

SHORT DESCRIPTION OF THE RESEARCH:

RESEARCH CATEGORY (check RESEARCH AGENDA CATEGORY

only one) (check only one main research theme)
o National Kindly check (/)
o Region A. Theme 1-Teaching and Learning (by
o Schools Division subject area)
o District o A. 1. English
o School o A. 2. Mathematics
o A. 3. Science
(check only one) o A. 4. Filipino
o A. 5. Araling Panlipunan
o Action Research o A. 6. Edukasyon sa Pagpapakatao
o Basic Research o A. 7. MAPEH
o A. 8. Mother Tongue

B. Theme 2-Child Protection

o B. 1. Bullying
o B. 2. Early Pregnancy
o B. 3. Premarital Sex

C. Theme 3-Human Resource

Development
o C. 1. Professional Development
o C. 2. Scholarship Grant
o C. 3. Awards and Recognition
o C. 4. Employees Welfare
o C. 5. Succession and Exit
o C. 6. Career Guidance

D. Theme 4-Governance
o D. 1. Disaster Risk Reduction and
Management (DRRM)
o D. 2. Gender and Development (GAD)
o D. 3. Inclusive Education
o D. 4. School Operation
o D. 5. School Management

E. Continuous Improvement

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 FUND SOURCE (if applicable)*:
YEAR THE RESEARCH WAS CONDUCTED:

B. RESEARCH INFORMATION

LEAD RESEARCHER/INDIVIDUAL RESEARCHER

LAST NAME: FIRST NAME: MIDDLE NAME:

BIRTHDATE SEX: POSITION/DESIGNATION:

(MM/DD/YYYY):

SCHOOL/
OFFICIAL ADDRESS:
CONTACT NUMBER 1: CONTACT EMAIL ADDRESS:
NUMBER 2:

EDUCATION
ATTAINMENT TITLE OF THESIS/RELATED RESEARCH
(DEGREE TITLE) PROJECT
(enumerate from
bachelor’s degree up to
doctorate degree)

SIGNATURE OF
RESEARCHER:

RESEARCHER 2
LAST NAME: FIRST NAME: MIDDLE NAME:

BIRTHDATE SEX: POSITION/DESIGNATION:

(MM/DD/YYYY):

SCHOOL/
OFFICIAL ADDRESS:
CONTACT NUMBER 1: CONTACT EMAIL ADDRESS:
NUMBER 2:

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EDUCATION
ATTAINMENT TITLE OF THESIS/RELATED RESEARCH
(DEGREE TITLE) PROJECT
(enumerate from
bachelor’s degree up to
doctorate degree)

SIGNATURE OF
RESEARCHER:

RESEARCHER 3
LAST NAME: FIRST NAME: MIDDLE NAME:

BIRTHDATE SEX: POSITION/DESIGNATION:

(MM/DD/YYYY):

SCHOOL/
OFFICIAL ADDRESS:
CONTACT NUMBER 1: CONTACT EMAIL ADDRESS:
NUMBER 2:

EDUCATION
ATTAINMENT TITLE OF THESIS/RELATED RESEARCH
(DEGREE TITLE) PROJECT
(enumerate from
bachelor’s degree up to
doctorate degree)

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 SIGNATURE OF
RESEARCHER:

IMMEDIATE SUPERVISOR’S CONFORME

I hereby endorse the attached research proposal. I certify that the proponent/s has/have the
capacity to implement a research study without compromising his/her office functions.

NAME OF SCHOOL HEAD WITH

SIGNATURE
Position
Date: _____________

NAME OF PSDS/DIC WITH SIGNATURE

Public Schools District Supervisor/District In-
Charge
Date: _____________

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 DECLARATION OF ANTI-PLAGIARISM

1. I, _______________________________, understand that plagiarism is the act of

taking and using another’s ideas and works and passing them off as one’s own.
This includes explicitly copying the whole work of another person and/or using
some parts of their work without proper acknowledgment and referencing.

2. I hereby attest to the originality of this research proposal and has cited properly all
the references used. I further commit that all deliverables and the final research
study emanating from this proposal shall be of original content. I shall use
appropriate citations in referencing other works from various sources.

3. I understand that violation from this declaration and commitment shall be subject
to consequences and shall be dealt with accordingly by the Department of
Education.

PRINTED NAME OF RESEARCHER WITH SIGNATURE

Proponent/Position
Date Signed

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 DECLARATION OF ABSENCE OF CONFLICT OF INTEREST

1. I, ________________________________, understand that conflict of interest

refers to situations in which financial or other personal considerations may
compromise my judgment in evaluating, conducting, or reporting research.

2. I hereby declare that I do not have any personal conflict of interest that may arise
from my application and submission of my research proposal. I understand that
my research proposal may be returned to me if found out that there is conflict of
interest during the initial screening.

3. Further, in case of any form of conflict of interest (possible or actual) which may
inadvertently emerge during the conduct of my research, I will duly report it to the
research committee for immediate action.

4. I understand that I may be held accountable by the Department of Education for

any conflict of interest which I have intentionally concealed.

PRINTED NAME OF RESEARCHER WITH SIGNATURE

Proponent/Position
Date Signed

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 ABSTRACT

The abstract comes at the beginning of the paper but should be written after the author has
drafted the full report. It is a single-paragraph summary of approximately 150 to 250
words without citations, abbreviations, or math formulas. The abstract should: begin with
the broad context of the study; followed by specific background for the study; describe
the purpose, methods and procedures, core findings and results, and conclusions of the
study; emphasize new or important aspects of the research; engage the broad readership
of education and be understandable to a diverse audience (avoid using jargon). It should
be written for people who may not read the entire paper, so it must stand on its own. The
impression it makes usually determines whether the reader will go on to read the article,
so the abstract must be engaging, clear, and concise. In addition, the abstract may be the
only part of the article that is indexed in databases, so it must accurately reflect the
content of the article. A well-written abstract is the most effective way to reach intended
readers, leading to a more robust search, retrieval, and usage of the article. Follow the
abstract with three to five keywords.

Keywords: Keyword1, Keyword2, Keyword3, Keyword4, Keyword5

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 ACKNOWLEDGMENT

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 TABLE OF CONTENTS

PAGE

Title Page i
Completed Research Approval Sheet ii
District Completed Research Approval Sheet iii
Signed District Research Proposal Approval Sheet Iv
Quality Control Checklist for Completed Action Research iv
Completed Research Application Form and Endorsement of vii
Immediate Supervisor
Declaration of Anti-plagiarism ix
Declaration of Absence of Conflict of Interest x
Abstract xvi
Acknowledgment xvii
Table of Contents xviii
Context and Rationale 1
Action Research Questions 2
Hypothesis 25
Innovation/Intervention/Strategy Used 25
Action Research Methods 26
Research Design 26
Participants of the Study 26
Data Collection Methods 27
Data Analysis Plan 27
Discussion of Results 28
Conclusion and Recommendation 31
Reflection 32
Action Plan 33
Financial Report 34
Dissemination and Advocacy Plan 35
References 36
Appendices 37

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 CONTEXT AND RATIONALE

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ACTION RESEARCH QUESTIONS

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Hypothesis (only if applicable)

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INNOVATION/INTERVENTION/STRATEGY USED

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ACTION RESEARCH METHODS

Research Design

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Participants of the Study

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 Data Collection Methods

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Data Analysis Plan

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DISCUSSION OF RESULTS

Subtitle 1

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Table 1. Title of Table 1

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Subtitle 2

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Table 2. Title of Table 2

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Subtitle 3

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Table 3. Title of Table 3

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CONCLUSION AND RECOMMENDATION

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REFLECTION

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here. Type your text here. Type your text here. Type your text here. Type your text here.

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ACTION PLAN

Objectives Activities/ Responsible Estimated Desired

Strategies Person Time Outcomes
Allotment/
Completion
Date

FINANCIAL REPORT

Item Unit Quantity Description Unit Cost Total

Supplies and Materials

Total Php 0, 000

DISSEMINATION AND ADVOCACY

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 REFERENCES

Please follow the APA 7th edition style for your references. The author shall follow APA

7th edition reference style both in inside text and reference.

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APPENDICES

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Appendix 1: Pre-test – Post-test Questionnaire

Type the pre-test – post-test questionnaire here.

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Appendix 2: Approved Validation Sheet of the Innovation/ Intervention Material to

Use

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Appendix 3: Innovation/Intervention Materials to Use

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