Basic Education department

Senior High School – North Campus

ACTIVITY PROPOSAL FORM

Activity Name
Proponents
Date Filed
Activity Date
Activity Duration

1. Objective (State the clear and specific objectives of your proposed activity.)

2. Background (Provide a brief background or context for the proposed activity. Explain why it is relevant
and beneficial for the school and students.)

3. Description of the (Provide a detailed description of the activity, including what will take place, when it will
Activity happen, and how it will be conducted. Be specific about the resources required.)

4. Target Audience (Indicate the grade levels or classes that will participate in this activity.)

Email: shs-principal@usc.edu.ph
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 Basic Education department
Senior High School – North Campus
5. Expected (Describe the expected outcomes or learning objectives of the activity. What do you
Outcomes intend for the students to gain or achieve?)

The expected outcomes of this activity are the following:

1.

2.

3.

6. Timeline (Provide a timeline for the activity, including important dates, preparation time, and the
actual execution of the activity.)

7. Resources (List all the resources required, such as materials, equipment, facilities, or external
Needed support. Mention if there are any associated costs.)

8. Safety Measures (Explain any safety precautions or measures that will be taken to ensure the well-being of
students and participants.)

9. Budget

Particulars Expenses Total

Email: shs-principal@usc.edu.ph
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 Basic Education department
Senior High School – North Campus
Total
Note: All expenses must be promptly liquidated 5 days after the completion of the activity. Prepare a
comprehensive expense report that includes a breakdown of all expenses, the purpose of each expense,
the date of expenditure, and the amount spent. Be prepared to assist with any further clarification or
reconciliation of expenses if requested by the council.

10. Approval (Outline the steps or process you will follow to seek approval for this activity. Specify if
Process: you need approval from the school administration or any relevant committees.)

11. Evaluation Tools (Explain the tools and methods you will use to assess the success and impact of the
activity. This may include surveys, quizzes, rubrics, observations, or any other
assessment techniques.)

12. Attachment (Attach the program flow document that outlines the schedule and sequence of activities
during the event.)

Prepared by:

[Organizer’s Name and Signature]

MM-DD-YYYY

Reviewed by:

Email: shs-principal@usc.edu.ph
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 Basic Education department
Senior High School – North Campus

USC SHS Council Secretary

MM-DD-YYYY

Approved by:

MELANIE G. BAREJA, MS.

Principal, USC SHS

Email: shs-principal@usc.edu.ph
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