Enclosure No. 1 to Regional Memorandum No. _________________, s.

2023

Rural Farm School Program Processing Checklist

School: _______________________________
School Address: ________________________
Name of School Head: ___________________
Designation: ___________________________
School Year: ___________________________
Division: ____________________________
Contact Number: _____________________
Major: ______________________________
Email Address: _______________________

Checklist Checkmark Observations

I. Letter of Intent

II. Concept Note on the Implementation

 General Information
 Development Issues
 Rationale
 Related Issues
 Development Intervention
 Activity Concept
 Assessment
 Indicative Implementation
Arrangements
 Teacher’s Profile with Specialization on
AFA
 Number of Years in Teaching
 Number of TESDA Certificate Holders
(NC II/TM)
III. Facilities and Equipment
 The school must have at least one half
(1/2 or 5000 sq. m. of laboratory farm.
 Owned by the school
 With MOA

 Must have list of basic tools in AFA

specialization (sample: Agri-Crop
Production)
 IV. Learning Support Materials on AFA
 List of available SLMs and other
learning support materials
V. List of Partnership with MOA
(line government agencies/DA, TESDA,
ATI,DOLE, DOST,NEDA, LGU: Agricultural
business sector, Animal business sector, Poultry
Farm, Piggery Farm, Fishpond/Aquaculture
VI. Findings
Submitted documents are complete upon actual inspection and verification of the school. The
school is suitable for the establishment of Rural Farm School with enough land area that will be
utilized for the actual operation of the courses offered like: Agri crop Production, Local Tour
Guiding Services, Furniture Making, Aqua Culture

VII. Recommendations
For Issuance of Permit – A. Genita

Evaluators:

WILLIAM C. AGOMANA ARNEL T. GENITA

Regional TLE/ TVL Focal Person Regional RFS / iPEd Focal Person

Recommending Approval:

MALA EPRA B. MAGNAONG ROGELIO C. EVANGELISTA

CLMD Chief QAD Chief

APPROVED:

DR. ARTURO B. BAYOCOT, CESO III

Regional Director