1.

General Program Information:

Program Title: Must include the type of activity and the target participants

Program Description: Briefly state the details of the program

Prerequisite Programs: Include all needed programs the participants need to take prior to
the program

Duration: Indicate the number of days/ hours the program shall be conducted

Management Level of Indicate the management level whether school, district, division or
Program region

Delivery Mode Specify the learning delivery modality (virtual or in person)

Target Personnel: Specify the type of personnel and the job group or target personnel

Budget Requirements: Itemize the budget needed for the conduct of the program

Rationale:

● Discuss a short background of the program.

● Briefly discuss the competency/ies of the target participants needed to be addressed
by the learning intervention of the program.
● Include laws, issuances, and conducted studies to back up the need to conduct the
program.

Objective:
Must include the following elements:
● Audience
● Behavior
● Criteria/ Condition
 ● Degree

End of Program Outputs:

List all needed outputs of every session.

Expected Final Outcomes/Success Indicators:

List all outcomes or success indicators participants shall achieve at the end of the program.

2. The Program Delivery

A. The Program Content and Expected Outputs:

(Please refer to the session guides for the needed data)

N Session Specific Objectives Duration Expected Resource Materials

o. Title (KSAs) hrs/mins Output of the
activity/ session
1.

2.

3.

4.
5.

6.
 Schedule of Sessions
Time/Day Day 1 Day2 Day3
7:45-8:00 Opening Program MOL MOL

9:00-12:00

LUNCH
1:00-1:30
1:30-4:30

4:30-5:00

3. Program Supplies/Equipment/Materials

(Please refer to the session guides for the needed supplies/equipment/materials)

Prepared by:

(List all group members)