Republic of the Philippines

Department of Education
Region V - Bicol
SCHOOLS DIVISION OFFICE OF LEGAZPI CITY

DOCUMENT REVIEW TEMPLATE FOR OFF-CAMPUS ACTIVITY

Comment Sheet Information (to be filled in by the Division Youth Formation Focal Person)
Title of the Activity (Base on the Activity
Proposal)
Proponent/s:
Activity Head:
Destination / Venue:
Inclusive Dates (of the activity):
Total nos. of participating learners and their
grade level
Individual learner contribution: PhP
REQUIREMENTS: (put a check and write comments per box)
Recommendation signed by the Division Youth Formation Coordinator,
COMMENT: Education Program Supervisor - SGOD, SGOD Chief and Schools Division
Superintendent (SDS)
Completely filled-up Activity Proposal (Annex A) with prescribed
attachments:
1. Certified True Copy of Accreditation Certificate by Department of Tourism
(DOT) (if Applicable)
2. Certified True Copy of Certification from the Land Transportation,
COMMENT: Franchising and Regulatory Board (LTFRB) on the validity and scope of
franchise of the tour operator's vehicle/s, if applicable;
3. Copy of Registration of Vehicles
4. Copy of Professional Driver's License and Updated Medical Record
5. Copy of Roadworthiness Certificate
6. Information and Cost of Travel Insurance
7. Indicative Program (including itinerary of activities)
8. Other expenses that may be incurred
9. Information on the place/s to visit
COMMENT: Filled-out Manifest (Annex B) (except for the last column)
COMMENT: Parents / Guardian's Consent Form (Annex C)
Intervention Plan for learners who will not join the Off-Campus Activity, if
COMMENT:
needed
COMMENT: Schedule for the Submission of the Activity Report
Date Received:
Over-all remarks: (for approval, for return,
others)

Signed by the Focal Persons: JOSE SHERWIN B. SAGUIRER SANTOS T. ARAÑA

Project Development Officer 1 Senior Education Program Specialist

Signed by: MARIA SOLIDAD P. NUYLES PORTIA P. ENCISA

OIC- Chief, SGOD Chief, CID
Date forwarded to OSDS (for Approval of
SDS)

Approved by:
CRESTITO M. MORCILLA CESO VI
Schools Division Superintendent
Date Returned: