SBFP Form 1 (2023) Ministry of Basic, Higher and Technical Education

Master List -Beneficiaries for School-Based Feeding Program (SBFP) (SY2023-2024)

Division: _____________________________________ Name of Principal:______________________________________

City/Municipality/Barangay:_______________________________________ Name of Feeding Focal Person:___________________________
Name of School/School District:___________________________________
School ID Number: ___________________

Date of Age in BMI for 6 Nutritional Status Dewormed? Parent's consent Participation
Date of Birth Weighing Years/ Weigth Height y.o and (NS) for milk? in 4Ps
No. Name Sex Grade/Section (MM/DD/YYYY) /Measuring (Kg) (cm) (yes or no)
MM/DD/YYYY Month Above (yes or no) (yes or no)
BMI-A HFA
1
2
3
4
5
6
7
8
9
10
11
12
13
SBFP Form 2 (2023) Ministry of Basic, Higher and Technical Education

Master List Beneficiaries for School-Based Feeding Program (SBFP) (SY2023-2024)

Division: ________________________
City/Municipality/Barangay:_______________________________________
Name of School/School District:___________________________________
School ID Number: ___________________
Date of Start of Feeding:_________________________
Last Mile: Y XN
Nutritional Status at Start/End of Feeding No. of Secondary Targets

No. of
Number of Undernourished School No. of No. of No. of 4Ps No. of Pupils Date of Feeding
No. of No. of Learners
Children by Grade Level Pupils-at- Stunted/S Beneficiaries who are Started/Ended
SW W N OW+O SS S N T rosk-of- Indigent Indigenous Dewormed beneficiaries
everely
dropping- Learners People (Ips) in previous
Stunted
out years
(PARDOs) (Repeaters
1. Kinder
2. Grade I
3. Grade II
4. Grade III
5. Grade IV
6. Grade V
7. Grade VI
Total

Prepared by: Approved by:

_________________________________ _____________________________________
SBFP Focal Head

Note: This form shall be prepared by the school before the start of feeding, to be compiled by the SDO, and for final compilation by the RO, for submission to DepEd BLSS-SHD
SBFP Form 3 (2023) SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING

FOR THE MONTH OF _____________________________________2023-2024

Region:_________________________ School:__________________________________
Division:___________________________________ Grade: KINDER-GRADE 6
District:____________________________________ School ID Number: _____________________

ACTUAL FEEDING
NAME OF PUPIL
1 2 3 4 5 6 7 8 9 10 11 12 13 15 16 17 18
1
2
3
4
5
6
7
8
9
10
11
12
13
 ACTUAL FEEDING ATTENDANCE
NAME OF PUPIL No. of No. of
Days Feeding Percentage
20 21 22 23 24 25 26 27 28 29 30 (A) (B) (A/B)*100
1
2
3
4
5
6
7
8
9
10
11
12
13
SBFP Form 6 (2023)

REGION/DIVISION/DISTRICT: _____________________________________
Name of School:___________________________________
School ID Number: ___________________
NFP DELIVERIES
No. of Packs Received
No. of Packs for
Grade Level Number of Benificiaries Date Deliverd
Replacement Rejected
IFR MUNGBEANS CEREALS &MILK

Kinder
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
TOTAL:

MILK DELIVERIES
No. of Packs Received
No. of Packs for
Grade Level Number of Benificiaries Date Deliverd
Total(New + Replacement Rejected
New Replacement
Replacement)
Kinder
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
TOTAL:

Prepared by: Approved by:

__________________________________________ ______________________________________
School Feeding Coordinator