ADDITIONAL DATA FOR READINESS REPORT UNDER PARTNERSHIP

GENERAL INSTRUCTION:
1. Data/information to be included are donations received supporting BE-LCP/DLCP/SOLCP
2. Reporting is on weekly basis
3. Kindly read the label per column to guide you in accomplishing this form
4. One row per kind of donation received
5. File Name Format: District_School Name_School ID_<date week donation received> (example: Bauang North_Paringao NHS_300128_September 13-17) FOLLOW THIS FILE NAME FORMAT STRICTLY
6. DO NOT ALTER/CHANGE/MODIFY THIS TEMPLATE.
7. You may upload pictures and scanned copy of forms of agreements, if any
a b c d e f g h i
TAGGED TAGGED
FINANCIAL
FINANCIAL
(Non-
PARTNERS/DONORS (Monetary in PhP Physical/Description Unit of Contribution
monetary/Peso Total Financial
SCHOOL NAME SCHOOL ID (Specify group/person chosen in Absolute Value) (Specify in-kind donation (i.e. set, box, ream, cash,
Group/Person (RESOURCES) Equivalent) (f + g)
Column C) *For cash donations received) bank transfer, piece, etc.)
*Money value of in-
received
kind donations

PUGO CENTRAL SCHOOL 101001 OTHER PROFESSIONALS MODULES (Production & PrinLEIZYL FANG n/a 2,500.00 2,500.00 BOND PAPER REAM

PENCIL BOX

BALLPEN BOX

OTHER PROFESSIONALS OTHERS JEFFREY BUSTAMANTE 310.00 310.00 BROOMSTICKS PIECE

DUST PAN PIECE

PLASTIC BROOM PIECE

FINANCIAL ASSISTANCE (Dona

OTHERS PARENTS 970.00 N/A 970.00 N/A N/A

FINANCIAL ASSISTANCE (Donation, etc.) ELSA B. FLORES 200.00 N/A 200.00 N/A N/A

FINANCIAL ASSISTANCE (Donation, etc.) JUNIOR B. ANGELEO 2,800.00 N/A 2,800.00 N/A N/A
HENRY B. BALBIN AND VIOLY L.
FINANCIAL ASSISTANCE (Donation, etc.) BALBIN 1,000.00 N/A 1,000.00 N/A N/A
MODULES (Production & Printing) AGUSTINA PIGAO N/A 180.00 180.00 BOND PAPER REAM
FINANCIAL ASSISTANCE (Donation, etc.) JESSICA ANGELES 200.00 N/A 200.00 N/A N/A
FINANCIAL ASSISTANCE (Donation, etc.) LYR GRACE BASALLO 150 N/A 150 N/A N/A

MODULES (Production & Printing) ROSALLY TAVAS N/A 100.00 100.00 BOND PAPER REAM

MINIMUM HEALTH STANDARD SUPPORT (PPE. Etc.) REX FERNANDEZ N/a 1000.00 1000.00 HOLLOW BLOCKS PIECE

MODULES (Production & Printing) ALJONN V. GARCIA N/a 1000.00 1000.00 BOND PAPER REAM
MINIMUM HEALTH STANDARD SUPPORT (PPE. Etc.) BRYAN T. BALLOGUING N/A 750.00 750.00 HOLLOW BLOCKS PIECE
MINIMUM HEALTH STANDARD SUPPORT (PPE. Etc.) JONNEL B. DACPANO N/A 750.00 750.00 HOLLOW BLOCKS PIECE
MINIMUM HEALTH STANDARD SUPPORT (PPE. Etc.) MICHELLE B. LALES N/A 1,050.00 1,050.00 IRON RODS PIECE
MARY JOYCE DOCTOLERO N/A 620.00 620.00 PAINT LITER

SANDRA F. WAGUEY N/A 620.00 620.00 PAINT LITER

MARLYN LOZANO N/A 1,800.00 1,800.00 PAINT LITER

CHERRYLYN OLLERO n/a 200.00 200.00 BOND PAPER REAM

140.00 140.00 UV INK BOTTLE(100ML)

EDWIN LAROYA n/a 1,000.00 1,000.00 BOND PAPER REAM

NORMA C. BOADO AND WINSTON
BOADO 1,000.00 N/A 1,000.00 N/A N/A

JOSIELYN CACANINDIN n/a 210.00 210.00 BOND PAPER REAM

IRENE CARINO n/a 400.00 400.00 BOND PAPER REAM

n/a 238.00 238.00 INK BOTTLE(100ML)

ROGER LABAYO 1,000.00 N/A 1,000.00 N/A N/A

MARK SAOYAO 1,000.00 N/A 1,000.00 N/A N/A

MARIANNE BOADILLA 1,000.00 N/A 1,000.00 N/A N/A

ANTHONY DOCTOLERO n/a 1500.00 1500.00 STUDY TABLE WITH CHAIR SET

n/a 400.00 400.00 CASTLE TENT PIECE

2 IN 1 REVERSIBLE WHITE
n/a 400.00 400.00 BOARD AND BLACKBOARD PIECE

n/a 760.00 760.00 PLAY MAT PIECE

COGELYN CONTIG AND JESSIE

BALLATONG 1,000.00 N/A 1,000.00 N/A N/A
EADINESS REPORT UNDER PARTNERSHIP

j k l m n o p

Remarks
Beneficiaries Form of Agreement,if any (Number of modules
Other Remarks
Quantity of Materials (Learners, Teaching (MOA, MOU, Deed of produced from the
Location of Beneficiaries Date of Acceptance (relevant information related to the
*For in-kind donations Personnel, Non Teaching Donation, No signed donations received, if
donation, project received)
Personnel, ALL) agreement) used for reproduction of
LMs)

5 ALL various barangays in Pugo OCTOBER 22,2021 Deed of donation Used for reproduction of modules

5 ALL various barangays in Pugo OCTOBER 22,2022 Deed of donation Used for school pantry

5 ALL various barangays in Pugo OCTOBER 22,2021 Deed of donation Used for school pantry

USED FOR THE MAINTAINANCE FOR

2 ALL PUGO CENTRAL SCHOOL OCTOBER 22,2022 Deed of donation THE CLEANLINES OF THE CLASSROOM

USED FOR THE MAINTAINANCE FOR

1 ALL PUGO CENTRAL SCHOOL OCTOBER 22,2023 Deed of donation THE CLEANLINES OF THE CLASSROOM

USED FOR THE MAINTAINANCE FOR

1 ALL PUGO CENTRAL SCHOOL OCTOBER 22,2021 Deed of donation THE CLEANLINES OF THE CLASSROOM
USED FOR THE BEAUTIFICATION OF
N/A ALL PUGO CENTRAL SCHOOL OCTOBER 22,2021 Deed of donation N/A SCHOOL ZONES
USED FOR THE BEAUTIFICATION OF
N/A ALL PUGO CENTRAL SCHOOL OCTOBER 21,2021 Deed of donation N/A SCHOOL ZONES

N/A ALL PUGO CENTRAL SCHOOL OCTOBER 20,2021 Deed of donation N/A USED FOR SCHOOL IMPROVEMENT
USED FOR CLASSROOM
N/A ALL PUGO CENTRAL SCHOOL OCTOBER 21,2021 Deed of donation N/A IMPROVEMENT
1 ALL PUGO CENTRAL SCHOOL OCTOBER 20,2021 Deed of donation USED FOR REPRODUCTION OF LMs
N/A ALL PUGO CENTRAL SCHOOL OCTOBER 19,2021 Deed of donation USED FOR THE REPAINT AND REPAIR OF THE TABLES AND CHAIRS
N/A ALL PUGO CENTRAL SCHOOL OCTOBER 19,2021 Deed of donation N/A USED FOR THE REPAINT AND REPAIR OF THE TABLES AND CHAIRS
USED FOR PRINTING READING
1/2 ALL PUGO CENTRAL SCHOOL OCTOBER 19,2021 Deed of donation MATERIALS

USED FOR THE CONSTRUCTION OF

100 ALL PUGO CENTRAL SCHOOL OCTOBER 18,2021 Deed of donation N/A THE WASH AREA AND FOOD PARK

5 ALL PUGO CENTRAL SCHOOL OCTOBER 19,2021 Deed of donation N/A USED FOR REPRODUCTION OF LMs
50 ALL PUGO CENTRAL SCHOOL OCTOBER 18,2021 Deed of donation N/A USED FOR THE CONSTRUCTION OF THE WASH AREA AND FOOD PARK
50 ALL PUGO CENTRAL SCHOOL OCTOBER 18,2021 Deed of donation N/A USED FOR THE CONSTRUCTION OF THE WASH AREA AND FOOD PARK
5 ALL PUGO CENTRAL SCHOOL OCTOBER 18,2022 Deed of donation N/A USED FOR THE CONSTRUCTION OF THE WASH AREA AND FOOD PARK
 USED FOR THE BEAUTIFICATION OF
4 ALL PUGO CENTRAL SCHOOL OCTOBER 18,2021 Deed of donation N/A SCHOOL ZONES
USED FOR CLASSROOM AND GARDEN
4 ALL PUGO CENTRAL SCHOOL OCTOBER 18,2021 Deed of donation N/A IMPROVEMENT
USED FOR THE BEAUTIFICATION OF
4 ALL PUGO CENTRAL SCHOOL OCTOBER 18,2021 Deed of donation N/A SCHOOL ZONES

2 ALL PUGO CENTRAL SCHOOL OCTOBER 16,2021 Deed of donation USED FOR REPRODUCTION OF LMs

2 ALL PUGO CENTRAL SCHOOL OCTOBER 16,2021 Deed of donation USED FOR REPRODUCTION OF LMs

5 ALL PUGO CENTRAL SCHOOL OCTOBER 16,2021 Deed of donation USED FOR REPRODUCTION OF LMs

N/A ALL PUGO CENTRAL SCHOOL OCTOBER 16,2021 Deed of donation USED FOR REPRODUCTION OF LMs

1 ALL PUGO CENTRAL SCHOOL OCTOBER 15,2021 Deed of donation USED FOR REPRODUCTION OF LMs

2 ALL PUGO CENTRAL SCHOOL OCTOBER 15,2021 Deed of donation USED FOR REPRODUCTION OF LMs

1 ALL PUGO CENTRAL SCHOOL OCTOBER 14,2021 Deed of donation USED FOR REPRODUCTION OF LMs
N/A ALL PUGO CENTRAL SCHOOL OCTOBER 14,2021 Deed of donation USED FOR THE CONSTRUCTION OF THE WASH AREA AND FOOD PARK

USED FOR THE REPAINT AND REPAIR

N/A ALL PUGO CENTRAL SCHOOL OCTOBER 14,2021 Deed of donation OF THE TABLES AND CHAIRS
USED FOR THE BEAUTIFICATION OF
N/A ALL PUGO CENTRAL SCHOOL OCTOBER 14,2021 Deed of donation SCHOOL ZONES AND

USED FOR THE SUPPORT OF PROJECT

PRIME(PARENT’S READING INITIATIVE
THROUGH MEANINGFUL
1 LEARNERS PUGO CENTRAL SCHOOL OCTOBER 11,2021 Deed of donation ENVIRONMENT)

USED FOR THE SUPPORT OF PROJECT

PRIME(PARENT’S READING INITIATIVE
THROUGH MEANINGFUL
1 LEARNERS PUGO CENTRAL SCHOOL OCTOBER 11,2021 Deed of donation ENVIRONMENT)

USED FOR THE SUPPORT OF PROJECT

PRIME(PARENT’S READING INITIATIVE
THROUGH MEANINGFUL
1 LEARNERS PUGO CENTRAL SCHOOL OCTOBER 11,2021 Deed of donation ENVIRONMENT)

USED FOR THE SUPPORT OF PROJECT

PRIME(PARENT’S READING INITIATIVE
THROUGH MEANINGFUL
1 LEARNERS PUGO CENTRAL SCHOOL OCTOBER 11,2021 Deed of donation ENVIRONMENT)
PUGO CENTRAL SCHOOL OCTOBER 11,2021 Deed of donation
USED FOR THE IMPROVEMENT OF
N/A ALL PUGO CENTRAL SCHOOL OCTOBER 09,2021 Deed of donation SCHOOL ZONES
TYPE
LGU AND OTHER POLITICAL LEADERS
BARANGAY/COMMUNITY LEADERS
OTHER GOVERNMENT AGENCIES
OTHER ORGANIZATION/COMPANIES
BROADCASTING/TELECOMMUNICATION NETWORK
OTHER PROFESSIONALS
ICT EQUIPMENT ALAMINOS CITY
RADIO/TV/ INTERNET BASED INSTRUCTION BATAC CITY
MINIMUM HEALTH STANDARD SUPPORT (PPE. Etc.) CANDON CITY
MODULES (Production & Printing) DAGUPAN CITY
PERSONNEL ASSISTANCE (Teacher volunteer, etc.) ILOCOS NORTE
FINANCIAL ASSISTANCE (Donation, etc.) ILOCOS SUR
OTHERS LAOAG CITY
LA UNION
PANGASINAN I
PANGASINAN II
SAN CARLOS CITY
SAN FERNANDO CITY
URDANETA CITY
VIGAN CITY