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7/26/2019 Annex 1A School-Community Data Template 151030
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ANNEX 1A School-Com
I. SCHOOL PROILE!DATA
IDENTI"IN# INOR$ATION
School ID% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Name o' School% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
A(()e**% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& +a)an,ay% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Di*t)ict% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& $unicipality% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Dii*ion% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Re,ion% &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
A. #EO#RAPH"
A. Relatie Di*tance o' the SchoolDi*tance in /m
a. From the poblacion
b. From the nearest public elementary school
c. From the nearest private elementary school
d. From the nearest public secondary school
e. From the nearest private secondary school
f. From the District Oce
g. From the Division Oce
A.0 Inci(ence o' c)ime* an( othe) human-in(uce( haa)(*
A 0 1 Chec/ i' the)e hae 2een inci(ence* o' the 'ollo3in, in the la*t 0 yea)*
Instruction: Please input required data/information in unshaded cells. Fill-in only the grade levels that are applicThis template aims to organize eisting school and community data from di!erent sources. If you "nd it useful ttemplates and transfer it here# you may do so. $ther%ise# you can &ust attach the other data templates to this fo
A.1 Location o' the School. Check the appropriate description.
!long the high"ay
#ear the coastline
#ear a river or "ater"ay
$y the hillside
On top of a mountain
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ANNEX 1A School-Com
A.7. 4hat a)e the 0 mo*t ')e5uent natu)al haa)(*6
1st most frequent: _________________________________2nd most frequent: _________________________________
rd most frequent: _________________________________
A.8 Re*ult o' (i*a*te) inci(ent*
+. LEARNIN# EN9IRON$ENT
+.1 Cla**)oom* an( *eat*
LeelNo. o' Cla**)oom*
In #oo( Con(ition Total
8indergarten
9rade 1
9rade 2
9rade
9rade
9rade ;
9rade
+.1.1 Cla**)oom 5uantity =SRC.18.>
Total En)ollment:Cu))ent S" o) Repai)!
Reha2ilitation
Lea)ne)%cla**1
3chool used as an evacuation center in the last years
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ANNEX 1A School-Com$ale emale $ale emale
Num2e) Num2e) Num2e) Num2e)
LeelSubject: ___________ Subject: ___________ Subject: ___________ Subject: ___________
Num2e) Ratio Num2e) Ratio Num2e) Ratio Num2e) Ratio
8indergarten
9rade 1
9rade 29rade
9rade
9rade ;
9rade
9rade ?
9rade 1@
9rade 119rade 12
TOTAL
+.7 Li2)a)y%
#o. of boos: _________
#o. of tables: _________
#o. of chairs: _________
Ratio 0 Ratio 0 Ratio Ratio
5earner:toilet ratio A 0otal enrollment divided by number of toilets 5earner:toilet bo"l ratio A 0otal enrollment divided by number of toilet bo"ls
+.0 Tet2oo/*. In(icate num2e) o' tet2oo/* pe) ,)a(e leel an( *u2ect =SRC.0.>
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ANNEX 1A School-Com+.?. Doe* the *chool *u2*c)i2e to any o' the Inte)net *e)ice p)oi(e)!* li*te( a2oe6
+.?.0 A)e the)e Inte)net ca'!*hop*!4ii-ena2le( *tation* in the a)ea64ls. specify: __________________________________________
C. TEACHERS
C.1.1 Num2e) o' nationally-'un(e( teache)* ;cu))ent S" 3chool 4ro,ect 0eams are encouraged to conduct intervie"s or focus group discussions "ith parents+guardians+communityon reasons cited
7. DROPOMT =SRC.?.>
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ANNEX 1A School-Com
#)a(e 0
#)a(e 7
#)a(e 8
#)a(e @
#)a(e ?
#)a(e
#)a(e
#)a(e 1J
#)a(e 11
#)a(e 1
O9ERALL
7.0 Num2e) o' ()opout* 2y cau*e ;in*e)t ne3 column* i' nece**a)y
8. P)omotion!,)a(uation )ate* 'o) the la*t th)ee S"*
ANNEX 1A School-Community D
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y
#)a(e @
#)a(e ?
#)a(e
#)a(e
#)a(e 1J
#)a(e 11
#)a(e 1
O9ERALL
@.1 $ean Pe)centa,e Sco)e* o' NAT #)a(e 0 an( @ ;o) #)a(e an( #)a(e 1J 'o) the Secon(a)y Leel9rade 1@
LeelCu))ent S"% &&&&
En,li*h ilipino $ath Science HEKASI
9rade
9rade
9rade 1@
?4romotion rate: no. of promoted learners divided by the total enrollment - 1@@I9raduation rate: no. of graduates divided by the total enrollment - 1@@
@. $EAN PERCENTA#E SCORES ;2a*e( on National Achieement Te*t*< =SRC..>
ANNEX 1A School-Community D
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@. P)oect*!inte)ention* implemente( to imp)oe 2a*ic competencie* o' lea)ne)* ;in*e)t ne3 )o3* i' nece**a)y
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