Barangay/Community Activity Minutes Form

Region: VIII
Province: LEYTE
Municipality: PALOMPON
Barangay/Community: SAN ISIDRO
Venue: BRGY. HALL
Date: OCTOBER 26, 2022
Total Brgy. Households Total Families in the Brgy.

1. Activity Profile
Phase/Cycle: Phase 1
Program/Project (e.g. NCDDP etc):
Activity Name:
Facilitator/s:
Documenter/Secretary:

2. Attendance
# marginalized representatives # of community group
Total Members at BDRRMC representatives ______
Households Represented # of Pantawid HH # of Pantawid Families ______
Male attendees
# of female-headed households
Female attendees
Male IP attendees # of IP HH # of IP Families
Female IP attendees
Male Attendees 60 years old and above
Female Attendees 60 years old and above
Purok/Sitios represented
Sectors represented
Agenda/Objectives

Highlights of the activity including details of facilitation process and quality of participation of men and women
during the activity. (Attach the LGU prescribed minutes)

PINCOs and Grievances

Who raised the Concern and
PINCOs and Grievances Resolution/Next Steps/Agreements
Profile of the Person
e.g. Juan, IP member

Prepared by: Approved by:

Signature over Printed Name Signature over Printed Name

Position Position

Attachments (not limited to the following depending on the activity):

Attendance Sheet, Resolutions, Results/Outputs of the Activity (Copy of Plans)

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