(Enclosure No. 1A to DepEd Memorandum No.59, s.

2015)
(To be submitted to the Division Office a week after the start of each school year)

CONFIDENTIAL

School-Based Report on Incidents of Bullying

School Year 2023 - 2024

School: MANALO ELEMENTARY SCHOOL Classification: (Private/Public) Public School ID: 102415

Address: Manalo,Amulung, Cagayan Level: (Kindergarten/Elementary/Secondary) Elementary

Nature of Bullying Victims Perpetrator Status

Date/ Place of
Gender- Cyber Sex Sex Action Taken Recommendation (Resolved/ Pending/ Referred
Incident Physical Social Retaliation Name Age Name Age
based Bullying (M/F) (M/F) to other agency)

N/A NONE

Number of Resolved Cases N/A

Cases for Monitoring N/A
Number of Cases referred to other Government Agencies N/A
Number of Cases referred to other Non-Government Agencies N/A

Note: Bullying is perpetrated by a student against another student which may be:
Physical - unwanted physical contact (punching, shoving, pushing, kicking, slapping, tickling, headlocks, etc)
Social - refers to any deliberate, repetitive and aggressive social behavior intended to hurt or belittle an individual (name-calling, curisng, labelling, etc.)
Gender-Based - refers to any act that humiliates or excludes a person on the basis of perceived or actual sexual orientation and gender identity
Cyber Bullying - any bullying done through the use of technology or any electronic means (texting, email, chatting, online games, etc.)

Revised and Conformed by: MINERVA S. PAGULAYAN Prepared by: SUSAN C. LAGEN
Teacher in-charge School Guidance Counselor

Date: July 12, 2024 Date: July 12, 2024