HARDSHIP POST FORM

School:_______________________
Barangay:
__________
District:
__________

Division:____________________
Region:
___ __
EDP Code:

1. DESCRIPTION OF TRAVEL FROM MUNICIPAL POBLACION TO SCHOOL

a. Total Distance from Poblacion to School
b. FIRST LEG
Distance:
From: Poblacion, Naawan
To:
______
Mode of Transport:
______
Frequency of trips per hour/day/week/month:
__________________
Travel Time (1-way in hours/minutes):
______
Average Fare 1-way:
______
c. SECOND LEG
Distance:
.
From: Mat-i, Naawan
To:
____________
Mode of Transport:
____________
Frequency of trips per hour/day/week/month:
__________________
Travel Time (1-way in hours/minutes):
____________
Average Fare 1-way:
d. THIRD LEG
Distance: _______________
From: ______________
To:
__________________
Mode of Transport:
__________________
Frequency of trips per hour/day/week/month:
__________________
Travel Time (1-way in hours/minutes):
Average Fare 1-way:
__________________
d. FOURTH LEG
Distance: _______________
From: ______________
To:
__________________
Mode of Transport:
__________________
Frequency of trips per hour/day/week/month:
__________________
Travel Time (1-way in hours/minutes):
_________________
Average Fare 1-way:
__________________

NAME OF TEACHER

POSITION

___________________

__________

GRADE
_______

_________________

CLASS SIZE
___________

Prepared by:
______________________
ALS Mobile Teacher

Verified by:
_________________
PS District Supervisor

Certified Correct:
____________________
__________________________________________
Municipal Mayor
Schools Division Superintendent