Republic of the Philippines

Department of Education
SCHOOLS DIVISION OF BATANGAS

GAWAD BALISONG
BEST YOUTH FORMATION PROGRAM IMPLEMENTER
CRITERIA AND SCORE SHEET

SCHOOL: _____________________________ SCHOOL HEAD: ____________________

DISTRICT: _____________________________ POSITION: ____________________

DIRECTIONS: Please score the data below based on the given indicators. Be cautious on
the accumulated and non-accumulated remarks on each criterion.
CRITERIA POINTS EARNED
1. Leadership Development Program (20pts)
⚫ Student Government Officers - 10pts (accumulated)
➢ Has organized SG officers in school - 1pt
➢ school officer/s was/were member in the District Level
- 2pts
➢ school officer/s was/were member in the Division
Federated Officers - 3pts
➢ school officer/s was/were member in the National
Level - 4pts
➢ with action plan - 2pts
➢ with implemented action plan 3pts
➢ the result of the action plan has contributed to the
Youth Formation Program of the school -5pts
2. Knowledge Development Program (20pts)
⚫ Has engaged in Social Media 10pts(accumulated)
➢ has created healthy social media account - DepEd
Tayo Youth Formation School Facebook Page - 2pts
➢ has actively posted Youth Formation related activities
in their DepEd Tayo Youth Formation School FB Page
- 3pts
➢ has records of pupils/students who participated in
Youth Formation activities in the different level - 5pts
⚫ Has school initiated Youth Formation related activities -
5pts (not accumulated)
➢ 1 to 3 activities - 1pt
➢ 4 to 7 activities - 3pts
➢ 8 and above - 5pts
⚫ Has participated in training conducted by external
providers 5pts (not accumulated)
➢ attended 1 to 3 training - 1pt
➢ attended 4 to 7 training - 3pts
➢ attended 8 and above - 5pts
3. National Greening Program (20pts)
⚫ Youth for Environment in Schools Organization (YES - O)
5pts (accumulated)
➢ with organized YES - O in school - 1pt
➢ the organization has an action plan - 1pt

Address: Provincial Sports Complex, Bolbok, 4200 Batangas City

(043)722-1840 / 722-1796 / 722-1437 / 722-2675 / 722-1662
deped.batangas@deped.gov.ph
www.depedbatangas.org
 Republic of the Philippines
Department of Education
SCHOOLS DIVISION OF BATANGAS

➢ he action plan was implemented and evaluated -3pts

⚫ School-inside-a-Garden (SIGA) 5pts (not accumulated)
➢ has established School In A Garden - 1pt
➢ SIGA contributes with impact to the physical
appearance of the school - 3pts
➢ SIGA has contributed and serves as curriculum
laboratory for learners - 5pts
⚫ Gulayan sa Paaralan Program (GPP) 5pts (not
accumulated)
➢ has established Gulayan sa Paaralan in school - 1pt
➢ has contributed in the development of students health
through school feeding - 3pts
➢ Has contributed and extended its serviceability in the
community - 5pts
⚫ Youth for DRR 5pts (not accumulated)
➢ has contingency plan - 1pt
➢ the plan was based from Student - Led School
Watching and Hazard Mapping - 3pts
➢ The implementation of the plan was evident - 5pts
4. Inclusive Youth Formation Program (20pts)
⚫ Child Protection Policy 10pts (accumulated)
➢ with established child protection committee - 2pt
➢ with compilation of intake sheets - 4pts
➢ with reports on action/s taken in every case - 4pts
⚫ Child Friendly School System 10pts (not accumulated)
➢ Yearly scored CFSS Checklist
✓ 25 - 30 - 1pt
✓ 31 - 35 - 3pts
✓ 36 and above - 5pts
➢ CFSS Checklist
✓ checklist was analyzed 1pt
✓ result of analysis was given appropriate action /
intervention 3pts
✓ interventions were applied and evaluated 5pts
5. Partnership and Linkages (10pts) (accumulated)
⚫ with list of prospective partners - 1pt
⚫ with proposal to possible partners on Youth Formation
Activities - 3pts
➢ 1 to 2 proposals - 1pt
➢ 3 to 4 proposals - 2pts
➢ 5 above - 3pts
⚫ with MOA / MOU - 2pts
⚫ the partnership was implemented - 4pts
6. Youth Formation Awards Program (10pts)
⚫ received recognition award in relation to Youth Formation
from different level (7pts) not accumulated
➢ District - 1pt
➢ Division - 3pts

Address: Provincial Sports Complex, Bolbok, 4200 Batangas City

(043)722-1840 / 722-1796 / 722-1437 / 722-2675 / 722-1662
deped.batangas@deped.gov.ph
www.depedbatangas.org
 Republic of the Philippines
Department of Education
SCHOOLS DIVISION OF BATANGAS

➢ Region - 5pts
➢ National - 7pts
⚫ received recognition from external partners/organizations
due to commendable school activities in relation to Youth
Formation - 3pts
TOTAL

_________________________________________________
SIGNATURE OVER PRINTED NAME OF THE EVALUATOR

________________________________
DESIGNATION AND DATE

Address: Provincial Sports Complex, Bolbok, 4200 Batangas City

(043)722-1840 / 722-1796 / 722-1437 / 722-2675 / 722-1662
deped.batangas@deped.gov.ph
www.depedbatangas.org