Republic of the Philippines

Department of Education
REGION I
SCHOOLS DIVISION OFFICE I PANGASINAN

Enclosure B to DM-2020-235

School Report on the Provision of Mental Health and Psychosocial Support Services (MHPSS) to Learners and their Parents

SCHOOL SCHOOL SCHOOL

DISTRICT ID NAME

MHPSS Materials Distributed (ie. Printed/Reproduced/Received):

Grade No. of MHPSS Material (A) (B) (C) (D) (E) Total number Remarks
Level Learners Printed Reproduced Received Received Accepted of copies (donated by,
/ Parents (Photocopied from from Donations (A+B+C+D+E) distributed by,
) Division Regional from received by,
Office Office (thru Partners etc.)
the
Division
Office/DSO)

Narrative:
Timeline Photos (Please limit number of Report Description Remarks
photos to five and adjust size to
1.57 x 2.42 vice-versa)

Document Code: SDO1P-FR001

Address: Alvear St. Lingayen, Pangasinan
Revision No.: 01
Telephone No.: (075)-522-2202
Page No.: Page 5 of 6
Email: pangasinan1@deped.gov.ph
Effectivity Date: 12-09-2019
 Republic of the Philippines
Department of Education
REGION I
SCHOOLS DIVISION OFFICE I PANGASINAN

Prepared by: Approved for transmission: RECEIVED:

________________________ NAME OF SCHOOL HEAD

Position Position

Document Code: SDO1P-FR001

Address: Alvear St. Lingayen, Pangasinan
Revision No.: 01
Telephone No.: (075)-522-2202
Page No.: Page 6 of 6
Email: pangasinan1@deped.gov.ph
Effectivity Date: 12-09-2019