E-MIS FORM 1 PUPIL/STUDENTS PROFILE OF PUBLIC AND PRIVATE ELEMENTARY AND SECONDARY SCHOOLS SY 2010 - 2011 NAME OF SCHOOL:

(Please indicate the old name of school inside the parenthesis) ADDRESS: (street, barangay, municipality, province/city) NAME OF SCHOOL HEAD: Tel. No. Division: District: Official Designation:

I. ENROLMENT A. Enrolment in the Elementary Level by Age (as of _______________________) Pre-School 1 2 3 4 5 6 TOTAL Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female

Age 5 & Below 6 7 8 9 10 11 12 13 & above TOTAL

B. Enrolment in the Secondary Level by Age (as of ______________________) Pre-School 1 2 3 4 5 TOTAL Male Female Male Female Male Female Male Female Male Female Male Female Male Female

Age 12 & Below 13 14 15 16 17 & above TOTAL

II. NUMBER OF CLASSES GRADE / YEAR LEVEL Comnination 6

LEVEL Elementary Secondary Day Night

1/I

2/II

3/III

4/IV

Multigrade

Total

Prepared by: __________________________ (Signature over Printed Name) __________________________ Date Submitted __________________________ (Official Designation)

EMIS FORM 2 (Dated May 22, 2001)

PUBLIC ELEMENTARY AND SECONDARY SCHOOLS TEACHING AND NON-TEACHING PERSONNEL PROFILE SY 2010-2011 NAME OF SCHOOL:
(Please indicate the old name of school inside the parenthesis)

ADDRESS: NAME OF SCHOOL HEAD:

(Street, barangay, municipality, province/ city)

Tel. No.: Division: Capiz District: Official Designation:

NAME OF SCHOOL HEAD:

NAME OF INCUMBENT Grade/ year Level and Section of Assignment Sex Highest Educational Date of Birth Attainment Subject/s Taught Composition of Latest Appointment Non Teaching Grade/ Year Date of Position Assignment Level of Status Appointment Title Assignment Source of Fund/ Salary

Highest Education Attanm,ent: 1. BSEED, BSE, BSIE 2. MA, MAEd.

3. Ed.D. Ph.D. 4. Other (specify)

Compsosition of Grade/Year 1. Monograde 3. Mobile 2. Multigrade 4. Double Shift

Non-Teaching Assignment 1. Guidance Councilor 2. School Librarian 3. Coordinator (NFE Scout etc.)

4. Canteen Teacher 5. Clinic Teacher 6. Clerk 7. Other (specify)

Source of Fund for Payment 1. National Government 2. Local Gov't/ Special Educ Fund 3. PTCA 4. Others (specify)

Instruction: 1. Arrange the teachers by Grade/ Year Level and Class/ Section Adviser from Grades I-VI or 1st-4th year 2. Special/ Relief Teachers should be listed after class/ section advisers followed by Non-Teaching Personnel. 3. DO NOT put the name of substitute teachers, only the name of incumbents holding position. 4. For the vacant position/s put the cause and date of vacancy after the person who vacated the positiona nd fill up the necessary data in every column. 5. In case of unfilled new item/ position/s put "New Item" in the 12st column and fill up the Position Title Column.

_________________________________ Signature over Printed Name (Date Submitted) ______________________________ (Official Designation)

E-MIS FORM 3 (Revised May 20, 2003) ACCOMODATION FACILITIES PROFILE OF GOVERNMENT ELEMENTARY AND SECONDARY SCHOOLS SY 2010 - 2011 NAME OF SCHOOL: (Please indicate the old name of school inside the parenthesis) ADDRESS: (street, barangay, municipality, province/city) NAME OF SCHOOL HEAD: 1. SITES AND STRUCTURES A. Site
Distance from the Municipal Hall: Topography: Area (in sq.m.) Ownership Status: Mode of Acquisition: Proof of Ownership:

Tel. No. Division: District: Official Designation:

Ownership Status: 1. Owned 2. Not Owned

Topography 1. Flat 3. Rolling 2. Hilly 4. Swampy

Modes of Acquisition: 1. Donation 2. Purchase 3. Presidential Proclamation

Proof of Ownership 1. Title 2. Donation Paper Others (specify)

B. Buildings Constructed Type of Bldg Floor Area Ownership Status Materials Usage of No. of Rooms Rooms No. of (Pls. Provide one row for Storey the no. of rooms according to their usage.

Year

Cost (P)

Funding

Flooring

Roofing

Wall

Condition

Type of Bldg.
1. Cabaldon 2. Army 3. Magsaysay 4. Marcos 5. Imelda 6. JICA 7. SEDP 8. Others (specify)

Materials
1. Steel 2. Concrete 3. Wood 4. Nipa

Usage
1. Academic clsrm. 2. Science Lab 3. Practical Arts 4. Home Economics 5. Workshop 6. Library 7. Others 8. Storeroom 9. CAT Room 10. Toiler 11. Resource Center 12. Canteen 13. Clinic 14. Others (specify)

Condition
1. Good 2. Needs repair 3. Incomplete 4. Condemnable 5. Under Construction 6. Temporary

Funding
1. DECS 2. LGU 3. NGO 4. PTCA 5. JICA 6. US-AID 7. Private Orgn. 8. Others (specify)

Ownership Status 1. Owned 2. Rented 3. Presidential Proclamation

C. Utilities and Other Structures Availability Water Lighting Fence Auditorium Gymnasium Stage Availability 1. Available 2. Not Available

Source

Assessment of Facilities

Source of Fund 1. Waterline 2. Spring

Electricity 1. Generator 2. Elec. Cooperative

Assessment of Facilities 1. Excellent 3. Poor 2. Good

Note: This Form is for Government Institutions only.