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BE Form 01
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&chool 'ear (01)-(01*
BRIGADA ESKWELA
PHYSICAL FACILITIES AND MAINTENANCE NEEDS ASSESSMENT FORM
Instruction+ onduct an ocular inspection of the school ph,sical listed belo. /hen proide the needed information to facilitate theimproement to be done on these identied facilities. 2If needed ,ou ma, use separate forms for each classroom or school facilit,3.
FACILITIES
CONDITION(Check One)
Rem!k"N#$!e %&
'm!%emen#Nee*e*
(e+,+ !e'!-!e'n#'n,-
!e.cemen#-e#c)
M#e!'.Re"%$!ce"
Nee*e* (In*'c#ek'n* n* /$.'#0)
Mn%1e!Nee*e*(In*'c#e
/$n#'#0 n*n#$!e %& .2%!
"e!'ce" nee*e*
S#'"&c#%!0
Un"#'"&c#%!0
I& Un"#'"&c#%!0-
*e"c!'2e #he!%2.em
• Roofs45utters
• eilings
• 6alls
•
Blac7boards• hairs4des7s4tables
• 6ater facilities4Drainage &,stem
• &ignages
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• &chool garden
FAI!I/IE&
#$DI/I#$ 2hec7 #ne3
Remar7s $ature ofImproement
$eeded2e.g. repair%repainting%
replacement3
8aterial Resources$eeded 2Indicate7ind and 9ualit,3
8anpoer $eeded2Indicate 9uantit,
and nature of laboserices needed3
&atisfactor,
:nsatisfactor,
If :nsatisfactor,%describe the
problem
• !ighting
• 6indos
•
Doors• omfort Rooms
• &chool 5rounds
• &chool anteen4linic
• &chool Fence4 all
• Electricit,
• Alternatie gate
• Reference 8aterials
• !aborator, e9uipment
Prepared b,+ $oted+
MARDY SON PUN3ALAN ;;;;;;;;;;;;;;;;; BENITO C+ HERNANDE3
&chool Ph,sical Facilities oordinator Date of Inspection &chool
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BE Form 0(
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&chool 'ear (01)-(01*
BRIGADA ESKWELASCHOOL WORK PLAN
Instruction+ !ist don all the specic actiities that ,ou ill be underta7ing in relation to the conduct of Brigada Es7ela in ,our schooland ll in the re9uired information. Add another sheet if needed. #nce completed% submit a cop, to the adopt-A-&chool Program coordinator orBrigada Es7ela coordinator of ,our diision on or before ;;;;;;;;;.
KRA Ac#''#'e" T'me.'ne Pe!"%n4"
Re"%n"'2.e
M#e!'."
Nee*e*
B$*,e#
1.Adocac, and8ar7eting
(.Resource8obili=ation
>. Implementation
?. 8onitoring andEaluation
@. Reporting
Prepared b,+ $oted b,+
AMIE B+ BUCO ;;;;;;;;;;;;;;;;;;;;;;;;; ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
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&ignature oer Printed name Date Prepared A&P Diision oordinator4 BE coordinator
BE Form 0>
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&chool 'ear (01)-(01*
BRIGADA ESKWELARESOURCE MOBILI3ATION FORM
Instruction+ :sing the completed BE Form 01+ Ph,sical Facilities $eeds Assessment as basis% summari=e the resources 2materials andmanpoer3 needed and list don the potential source or partners to be tapped. Add additional sheet if needed. /he &tatus and Remar7scolumns should be updated regularl, to determine progress in ac9uiring resources needed.
M#e!'." Nee*e* 5$n#'#0
Ke0Pe!"%n"6O!,n'7#'%n
#%2e Te*
S#!#e,'e"6P.n%&
Ac#'%nPe!"%n Re"%n"'2.e S##$" Rem!k"
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L2%!Sk'.."6V%.$n#ee!"
Nee*e*5$n#'#0
Ke0Pe!"%n"6O!,n'7#'%n
#%2e Te*
S#!#e,'e"6P.n%&
Ac#'%nPe!"%n Re"%n"'2.e S##$" Rem!k"
Prepared b,+ $oted+
;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; BENITO C+ HERNANDE3
Resource 8obili=ation ommittee hairperson Principal IV
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BE Form 0?
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&chool 'ear (01)-(01*
BRIGADA ESKWELADAILY ATTENDANCE OF VOLUNTEERS
Date+ ;;;;;;;;;;;;;;;;;;;;
Instruction+ Volunteers themseles should personall, ll in the details re9uired b, this form under the superision of an, of thecommittee members. For the last column% indicate if masonr,% carpentr,% plumbing% painting% electrical% gardening4landscaping% ordinar,labours or others.
NAME POSITION6DESIGNATION
ADDRESS6ORGANI3ATION6
AFFILIATION
CONTACTNUMBER
TIME SIGNATURE
TOTALNUMBERS
OFHOURSSERVED
8NATUREOF
VOLUNTEERSERVICESRENDERED
IN OUT
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$oted+BENITO C+ HERNANDE3 ;;;;;;;;;;;;;;;;;;;;;;
Principal IV Date
BE Form 0@
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&chool 'ear (01)-(01*
BRIGADA ESKWELARECORD OF DONATIONS RECEIVED
ITEMS6 MATERIALS 5UANTITY DATERECIEVED
NAME OF DONOR ASSUMED COST OF ITEMSPe! Un'# T%#.
TOTAL
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Prepared b,+ $oted b,+
;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; BENITO C+ HERNANDE3
ommittee on Documentation hair48ember Principal IV
BE Form 0)
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&chool 'ear (01)-(01*
BRIGADA ESKWELADAILY ACCOMPLISHMENT REPORT
DA' 1 ( > ? @)
DA/E+ ;;;;;;;;;;;;;;;;;
Instruction+ !ist don all the actiities that needs to be underta7en for each da, of the Brigada Es7ela ee7. At the end of each da,%please mar7 the appropriate column that corresponds to the status of each actiit,. ite reasons for non-completion.
Ac#''#'e"
STATUSREMARKS6RECOMMENDATIONS
C%m.e#e*S#!#e* 2$# n%#
0e#c%m.e#e*
N%# *%ne
D0 9D0 :D0 ;D0 <D0 =
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D0 >
Prepared b,+ $oted b,+
;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;; ;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;
Program Implementation ommittee hair48ember &chool
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SCHOOL HEAD? #$/A/ $#.+PTA PRESIDENT? #$/A/ $#.+
BE Form 0*
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&chool 'ear (01)-(01*
A+ SCOPE OR REPAIR AND MAINTENANCE WORK COMPLETED (P.e"e check !%!'#e c%.$mn)Wh# 1" *%ne
Re'!e* Re'n#e* Re.ce*O#he!"
(B!'e& De"c!'#'%n)9+R%%&":+Ce'.'n,";+W..
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BE Form 0*
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&chool 'ear (01)-(01*
B+ DONATIONS6MATERIALS RESOURCES GENERATED (U"e "e!#e "hee#"- '& nee*e*) /,pe of Donations S%$!ce" E"#'m#e* C%"#
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TOTAL
BE Form 0*
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&chool 'ear (01)-(01*
C+ VOLUNTEERS SERVICE
T0e %& V%.$n#ee!Nme %& 'n*''*$."6
%!,n'7#'%n
N$m2e! %& V%.$n#ee!"
D0 9 D0 : D0 ; D0 < D0 = D0 > TOTAL
TOTAL
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BE Form 0*Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
&.'. (01)-(01*
D+ ESTIMATED COST OF VOLUNTEER SERVICES RENDEREDT0e %& Se!'ce T%#. N$m2e! %& V%.$n#ee!" T%#. N$m2e! %& H%$!"
Ren*e!e*T%#. E"#'m#e* C%"#"
C!en#!0M"%n!0G!*en'n,6 Ln*"c'n,P'n#'n,We.*'n,E.ec#!'c.6 E.ec#!%n'c"P.$m2'n,O!*'n!0 L2%!
TOTAL
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BE Form 07
Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
E+ SIGNIFICANT EVENTS 6 EPERIENCES
Wh# hene* Wh% 1e!e 'n%.e* WhenWh# '"6!e 'm%!#n#c%n#!'2$#'%n #% #he %e!#'%n
#% #he "ch%%. %! #% e@'"#'n,nee*" %& #he "ch%%.
•
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BE Form 0*Republic of the PhilippinesDepartment of EducationRegion IV-A A!ABAR"#$
SCHOOLS DIVISION OF BATANGAS PROVINCE
LUCSUHIN NATIONAL HIGH SCHOOL!ucsuhin%alatagan%Batangas
F+ LESSONS LEARNED
G. SUGGESTIONS TO STRENGTHEN BRIGADA ESKWELA PROJECT
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P!e!e* 20?
BENITO C+ HERNANDE3P!'nc'. IV
D#e?