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CP Form 4B.1: Breakdown of Affected Learners


NO. OF BREAKDOWN
LEARNER (FILL-UP ONLY WHEN APPROPRIATE)
AREA/ S IP LEARNERS MUSLIM ALS OTHERS
LEARNERS WITH LEARNERS LEARNERS
LOCATIO AFFECTE K- G3 G4-G6 G7-10 JHS SHS DISABILITY

N D
M F M F M F M F M F M F M F M F M F M F
School Name
2624 2729 2624 2729 79 82 26 27 131 136 85 76 2624 2729

TOTAL

Note: Input enrollment data


CP Form 4B.2: Breakdown of Affected Personnel

NO. OF NON-
NO. OF TEACHING
TEACHING
AREA/ LOCATION PERSONNEL
PERSONNEL
AFFECTED
AFFECTED
OTHERS
M F M F
Name of
Building
0 0 1 0
(example:
Principal’s
Office)
Building A 1 3 0 0

TOTAL

Note: Input number of school personnel


CP Form 7: Resource Inventory

TEAM/COMMITTEE RESOURCE QUANTITY REMARKS


*Early Warning Team 1 Functional
● Siren
4 Functional
● Alarm System
(Batingaw)
Communication Team 10 Functional
● Handheld
Radio
Search and Rescue Team 8 Functional
● Spine Board
60 Functional
● Triangular 11 Functional
16 Functional
Bandage
● Splints

● Safety Hats
with Flashlight
*Sample only, input actual
inventory of available
resources in your school*
Write a short narrative of the following:

School Background:

Location:

Demographics:

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