ANNEX 1: Research Proposal Application Form and Endorsement of Immediate

Supervisor (Please fill-out completely)

A. RESEARCH INFORMATION

RESEARCH TITLE
(Done/Already conducted study is not allowed for funding under BERF)
Aha! BRAIN BREAK EXERCISE: IT’S BEHAVIORAL IMPACT ON THE NATIONAL
LEARNING CAMP (NLC) LEARNER-PARTICIPANTS

SHORT DESCRIPTION OF THE RESEARCH/STUDY

A qualitative research study in nature on the teaching-learning process

involving behavioral and social support. The Aha! Brain break exercise is an
interactive and engaging activity which aims to enhance the learners skills
and abilities, re-focusing and working out positive learning behaviors by
developing their physical, mental, social and emotional well-being to
produce individuals that can be considered as globally competent lifelong
learners.

SCHOOL/DISTRICT/DIVISION WHERE THE STUDY TO BE CONDUCTED

Santa Barbara National Comprehensive High School/District of Santa Barbara/
Schools Division of Iloilo

Address: Duran Street, Iloilo City, 5000

Telephone Nos: (033)509-7653; (033)336-2816
Email Address: region6@deped.gov.ph
Website: region6.deped.gov.ph
 RESEARCH CATEGORY SOURCE (S) OF RESEARCH TOPIC
(check the source (s))
(check only one)
___National Agenda (DO 39, s. 2016)
o ___National ___Regional Agenda (RM 329, s. 2023)

o ___Region

o ___Schools Division RESEARCH AGENDA CATEGORY/THEME

o ___District (check only one main research theme)

o ___School/Office ___Teaching and Learning

___Child Protection
___Human Resource Development

(check only one) ___Governance

(check up to one cross-cutting theme, if
applicable)
o ___Action Research
___DRRM
o ___Basic Research
___Inclusive Education
___Gender and Development
___Others (please specify): ____________

RESEARCH TOPIC National Topic:

(Specify the topic under the HUMAN RESOURCE DEVELOPMENT:
identified theme, as indicated in Employee Welfare – Employee Wellness
the chosen research agenda (s).) (physical, emotional, spiritual, and mental)
e.g. CLASS SPACE under teaching
Regional Topic:
and learning theme in the national
agenda
e.g. CURRICULUM DELIVERY-

Address: Duran Street, Iloilo City, 5000

Telephone Nos: (033)509-7653; (033)336-2816
Email Address: region6@deped.gov.ph
Website: region6.deped.gov.ph
NUMERACY AND LITERACY
under teaching and learning in
the regional agenda (must include
the sub topic if applicable)

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

others)*
(Note: Action Research-Maximum of 30,000.00
Pesos regardless of level)

BERF ₱ 3,691.00

TOTAL AMOUNT ₱ 3, 691.00

*indicate also if proponent will use personal funds

*amount requested should be proportionate to the study being conducted, subject to
liquidation process as per government accounting rules and regulations.

B. PROPONENT/S INFORMATION
(Maximum of 3 Proponents per Study and 1 Study Only per Year should be
submitted)
Note: Previous researcher/s with unfinished study/research will not be accepted/
recommended for further evaluation by the RRC and TWC

LEAD PROPONENT / INDIVIDUAL PROPONENT

LAST NAME: FIRST NAME: MIDDLE NAME:

BENDAYON JUVY SOGO-AN

BIRTHDATE SEX: POSITION / DESIGNATION:

(MM/DD/YYYY)
MALE MASTER TEACHER II
08/27/1980

REGION / DIVISION / SCHOOL (whichever is applicable)

ILOILO/ SANTA BARBARA NATIONAL COMPREHENSIVE HIGH SCHOOL

Address: Duran Street, Iloilo City, 5000

Telephone Nos: (033)509-7653; (033)336-2816
Email Address: region6@deped.gov.ph
Website: region6.deped.gov.ph
CONTACT NUMBER 1: CONTACT NUMBER 2: EMAIL ADDRESS:
09092652902 juvy.bendayon@deped.gov.ph

EDUCATIONAL TITLE OF THESIS / RELATED RESEARCH PROJECT

ATTAINMENT
(DEGREE TITLE)
(Enumerate from bachelor’s
degree up to doctorate
degree)

Bachelor of Science in
Industrial Education

A Policy Review of Santa Barbara Iloilo’s Regulation on the

Master of Public
Use and Sale of Plastic Bags as Bagging Materials Under
Administration
Ordinance Number 11 series of 2008.

Doctor of Education Regenerative Mentoring Program for Out-of-School Youths

SIGNATURE OF PROPONENT: (To be signed here)

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.

RALPH F. PEREZ
______________________________________
Name and Signature of Immediate Supervisor
Position / Designation: OIC – Office of the School Principal
___________________
August 1, 2023
Date: _________________

Address: Duran Street, Iloilo City, 5000

Telephone Nos: (033)509-7653; (033)336-2816
Email Address: region6@deped.gov.ph
Website: region6.deped.gov.ph
PROPONENT 2

LAST NAME: FIRST NAME: MIDDLE NAME:

BIRTHDATE SEX: POSITION / DESIGNATION:

(MM/DD/YYYY)

SCHOOL / OFFICE ADDRESS: DIVISION / REGION:

CONTACT NUMBER 1: CONTACT NUMBER 2: EMAIL ADDRESS:

EDUCATIONAL TITLE OF THESIS / RELATED RESEARCH PROJECT

ATTAINMENT (DEGREE
TITLE)
(enumerate from bachelor’s
degree up to doctorate degree)

SIGNATURE OF 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.

______________________________________

Address: Duran Street, Iloilo City, 5000

Telephone Nos: (033)509-7653; (033)336-2816
Email Address: region6@deped.gov.ph
Website: region6.deped.gov.ph
Name and Signature of Immediate Supervisor
Position / Designation : ___________________
Date: _________________

PROPONENT 3

LAST NAME: FIRST NAME: MIDDLE NAME:

BIRTHDATE SEX: POSITION / DESIGNATION:

(MM/DD/YYYY)

SCHOOL / OFFICE ADDRESS: DIVISION / REGION:

CONTACT NUMBER 1: CONTACT NUMBER 2: EMAIL ADDRESS:

EDUCATIONAL TITLE OF THESIS / RELATED RESEARCH

ATTAINMENT PROJECT
(DEGREE TITLE)
(enumerate from bachelor’s
degree up to doctorate
degree)

SIGNATURE OF 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.

Address: Duran Street, Iloilo City, 5000

Telephone Nos: (033)509-7653; (033)336-2816
Email Address: region6@deped.gov.ph
Website: region6.deped.gov.ph
______________________________________
Name and Signature of Immediate Supervisor
Position / Designation : ___________________
Date: _________________

Address: Duran Street, Iloilo City, 5000

Telephone Nos: (033)509-7653; (033)336-2816
Email Address: region6@deped.gov.ph
Website: region6.deped.gov.ph