Data information form MCDPU

Series of 2022 CMO.MCDPP.F.009 REV.00 28 JUL 2022

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Madrasah form No:

CITY GOVERNMENT OF DAVAO MADR-C ___________

City Mayor’s Office Time Processed:
Madrasah Comprehensive  From:____________ to: _______________
Development and Promotion Unit
(MCDPU)
Registration Updating/Amendment

DAVAO CITY MADRASAH CENTER REGISTRATION FORM AND EVALUATION SHEET

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A. BASIC INFORMATION
Name of Madrasah:
Street Subdivision/Village Barangay City
Complete Address:
Date Established: Estimated Building Area:
(mm/dd/yyyy)

Building □ Concrete Others: (Specify) No. of Floor(s): No. of CR:

Structure:
□ Wood No. of Room(s): No. of Faculty Office:
First name Middle name Surname Contact No.:
Name of Operator/Administrator:

□ TAHDERIYAH (Kindergarten) □ IBTIDAIYAH (Grade School)

Basic Madrasah Education
Program/Level: □ MUTAWASSIT (Preparatory) □ THANAWI (High School)
Others: (Specify) :
No. of Enrolled
School Year:
Pupils/Students: Male _____ Female ______ Total _______ _____ - _____
First name Middle name Surname Contact No.:
Name of Principal:
Length of
Name of Faculty Member(s) Teaching
Status
(First name Middle name Surname)
(Years) (Licensed ⅼ City Paid ⅼ Volunteer)

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(Continue on separate sheet if necessary)
B. FACILITIES AND EQUIPMENTS
□ Flagpole □ School Signage □ Chairs Qty. _____
□ Tables Qty. _____ □ Electric Fan Qty. _____ □ Air conditioner Qty. _____
□ Lights Qty. _____ □ Sound System Qty. _____ □ Television Qty. _____
□ Bulletin Board Qty. _____ □ Computer Qty. _____ □ Projector Qty. _____
□ Lavatory Qty. _____ □ Bell/Buzzer Qty. _____ □ Boards Qty. _____
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C. CHECKLIST OF REQUIREMENTS
Description of Document/Requirement Remarks
1. Securities and Exchange Commission (SEC) Registration Certificate
2. Barangay Clearance (for new registration)
3. Letter of Intent (for new registration)
4. List of enrolled pupils/students
5. List of PTCA set of officers
6. Sketch location
7. Pertinent documents of the faculty members (Biodata, certificates, diploma etc.)
8. School photos (front, rear, back, inside)
Note: All above-cited requirements must be placed in 1 brown color expanded long envelop.
D. SUMMARY OF FINDINGS

E. RECOMMENDATION

Evaluated by:

_____________________________ _____________________________
Evaluator/Monitor Evaluator/Monitor

Date: ________________________ Date: ________________________

Conformed:

_____________________________
School Representative

Date: ________________________

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