ANNEX 1: ACTION RESEARCH PROPOSAL APPLICATION FORM AND

ENDORSEMENT OF IMMEDIATE SUPERVISOR

A. RESEARCH INFORMATION

RESEARCH TITLE: Improving the Reading Level of Pupils in Grades 3 to

6 Through Project MAMA (Mahal ko Anak Ko, Mahal ko Anak Mo
SHORT DESCRIPTION OF THE REASRCH:
This study seeks to determine if the innovation Project MAMA can
improve the reading level of identified non-readers of Asan Sur Elementary
School for the School Year 2019-2020.

RESEARCH CATEGORY (Check RESEARCH AGENDA CATEGORY

one only) (check only one main research
___National theme)
___Region _/_ Teaching and Learning
___Schools Division ___ Child Protection
___District ___ Human Resource Development
_/_School ___ Governance

(Check only one)

_/_ Action Research
___ Basic Research
(Check up to one cross-cutting
theme, if applicable)
___ DRRM
___ Gender and Development
___ Inclusive Education
___ Others (please specify):
_______________________

FUND SOURCE (e.g. BERF, SEF, AMOUNT

others)

Ink, Bond papers PhP 2,000.00

Folders
Purchase and Reproduction of PhP 20, 000.00
Reading Materials
Internet fee Php 1,000.00
USB/CD Php 1 000.00

TOTAL AMOUNT Php 25, 000.00

 B. PROPONENT INFORMATION

INDIVIDUAL PROPONENT

LAST NAME: FIRST NAME: MIDDLE NAME:

RUIZ MERCEDES MONTEFALCO

BIRTHDATE: SEX: POSITION/DESIGNATION:

(MM/DD/YYYY)
11/17/1969 Female Principal II
REGION/DIVISION/SCHOOL (whichever is applicable)
ASAN SUR ELEMENTARY SCHOOL
CONTACT NUMBER CONTACT NUMBER EMAIL ADDRESS:
1 2
09128667537 mercedes.ruiz@deped.gov.ph

EDUCATIONAL TITLE OF THESIS/RELATED RESEARCH PROJECT

ATTAINMENT
(DEGREE TITLE)
Enumerate from
bachelor’s degree up
to doctorate degree
MAED
BEED
SIGNATURE PROPONENT:

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.

ELIZA O. ROSINO, Ph. D.

Name and Signature of Immediate School Head
Position/Designation: District Supervisor
Date: August 23, 2019
ANNEX 3: DECLARATION OF ANTI-PLAGIARISM AND ABSENCE OF CONFLICT
OF INTEREST

DECLARATION OF ANTI-PLAGIARISM

1. I, MERCEDES M. RUIZ, 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.

PROPONENT: MERCEDES M. RUIZ

SIGNATURE: ________________

DATE: August 23, 2019

 DECLARATION OF ABSENCE OF CONFLICT OF INTEREST

1. I, MERCEDES M. RUIZ, 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 conflict of interest during the initial

is screening as per DepEd Order No. 16, s. 2017 Research Management Guidelines.

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.

PROPONENT: MERCEDES M. RUIZ

SIGNATURE: ________________

DATE: August 23, 2019

 TABLE OF CONTENTS

Title Page i
Table of Contents ii
Letter to the Schools Division Superintendent iii
Indorsement from the Public Schools District Supervisor iv
Division Permit to Conduct an Action Research v

I Context and Rationale 1

II Action Research Questions 4

III Proposed Innovation, Intervention and Strategy 5

IV Action Research Methods 6

a. Participants and/or Sources of Data 6
b. Data Gathering Methods 6
c. Data Analysis Plan 7

V Action Research Work Plan and Timelines 7

VI Cost Estimates 8
VII Plans for Disseminations and Utilization 8
VIII References 9
Appendix
Curriculum Vitae 10