SBFP Form 1

Department of Education
Region VI
Master List Beneficiaries for School-Based Feeding Program (SBFP)
Division/Province: AKLAN Name of Principal: IDY R. PEDRITA
City/Municipality/Barangay: IBAJAY WEST Name of Feeding Focal Person: NIEVA G. GELITO
Name of School/School District: IBAJAY CENTRAL SCHOOL
1 Calizo, Jenevive L. F 12/17/2008 06/06/2014 65 12 Severely Underweight
2 Ayong, Jhon Lorenz R. M 02/11/2009 06/06/2014 63 12 Severely Underweight
3 Sevilla, Mark Sylvan M. M 07/25/2009 06/06/2014 58 12 Severely Underweight
4 Melo, Danrobel R. M 09/07/2009 06/06/2014 56 12 Severely Underweight
5
6
7
8
9
10
11
12
13
14
15
Prepared by: Noted by:
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
School Principal / Officer-In-Charge Feeding Focal Person
IDY R. PEDRITA NIEVA G. GELITO
Weight
(Kg)
Height
(cm)
BMI for
6 y.o.
and
above
Nutritional
Status (NS)
Ethnicity No. Name Sex
Date of Birth
(MM/DD/YYYY)
Date of
Weighing/
Measuring
MM/DD/YYYY
Age in
Years/
Months
Disability
4Ps ID
Number
SBFP Form 1
Department of Education
Region VI
Master List Beneficiaries for School-Based Feeding Program (SBFP)
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
Name of Parents
Beneficiary of SBFP
in Previous Years
(yes or no)
School Principal / Officer-In-Charge
IDY R. PEDRITA
SBFP Form 1
Department of Education
Region VI
Master List Beneficiaries for School-Based Feeding Program (SBFP)
Division/Province: AKLAN Name of Principal: IDY R. PEDRITA
City/Municipality/Barangay: IBAJAY WEST Name of Feeding Focal Person: NIEVA G. GELITO
Name of School/School District: IBAJAY CENTRAL SCHOOL
1 Gindap, Gerald M 11/10/2008 06/06/2014 66 14 Underweight
2 Ibea, Rica Nicole S. F 03/08/2009 06/06/2014 62 14 Underweight
3 Sescar, Angel Anne S. F 09/16/2009 06/06/2014 56 13 Underweight
4 Tuazon, Trisha Dhel R. F 04/04/2009 06/06/2014 62 13 Underweight
5 Castillo, Revenier S. F 11/16/2008 06/06/2014 66 14 Underweight
6 Fernandez, Jessica T. F 01/06/2009 06/06/2014 65 14 Underweight
7 Oczon, Heriana-Del R. F 02/16/2009 06/06/2014 63 13 Underweight
8 Asunta, Rico Jone D. M 01/02/2009 06/06/2014 65 14 Underweight
9 Gregorio, James Bryan D. M 05/21/2009 06/06/2014 60 13.5 Underweight
10 Pagayunan, John D. M 02/18/2009 06/06/2014 63 14.2 Underweight
11 Alvarez, Dave Ashly S. M 08/15/2009 06/06/2014 57 13 Underweight
12 Castro, Christian C. M 03/22/2009 06/06/2014 62 14 Underweight
13 Ruiz,John Lyndon P. M 07/14/2009 06/06/2014 58 13 Underweight
14 Sexiona, Colm Kian P. M 04/14/2009 06/06/2014 61 13 Underweight
15 Gregorio, Princess Angel P. F 03/22/2009 06/06/2014 62 14 Underweight
Prepared by: Noted by:
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
Feeding Focal Person School Principal / Officer-In-Charge
Weight
(Kg)
Height
(cm)
BMI for
6 y.o.
and
above
Nutritional
Status (NS)
Ethnicity Disability No. Name Sex
Date of Birth
(MM/DD/YYYY)
Date of
Weighing/
Measuring
MM/DD/YYYY
Age in
Years/
Months
4Ps ID
Number
IDY R. PEDRITA
SBFP Form 1
Department of Education
Region VI
Master List Beneficiaries for School-Based Feeding Program (SBFP)
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
School Principal / Officer-In-Charge
Name of Parents
Beneficiary of SBFP
in Previous Years
(yes or no)
IDY R. PEDRITA
SBFP Form 1
Department of Education
Region VI
Master List Beneficiaries for School-Based Feeding Program (SBFP)
Division/Province: AKLAN Name of Principal: IDY R. PEDRITA
City/Municipality/Barangay: IBAJAY WEST Name of Feeding Focal Person: NIEVA G. GELITO
Name of School/School District: IBAJAY CENTRAL SCHOOL
16 Pablo, Kimberly N. 10/18/2009 06/06/2014 55 13 Underweight
17 Soguilon, Charmain Mae T. 07/28/2009 06/06/2014 58 13 Underweight
18 Cabales, Jay Lou C. 10/06/2009 06/06/2014 56 13 Underweight
19 Lalisan, John Lloyd M. 09/10/2009 06/06/2014 56 13 Underweight
Prepared by: Noted by:
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
Feeding Focal Person School Principal / Officer-In-Charge
Weight
(Kg)
Height
(cm)
BMI for
6 y.o.
and
above
Nutritional
Status (NS)
Ethnicity Disability No. Name Sex
Date of Birth
(MM/DD/YYYY)
Date of
Weighing/
Measuring
MM/DD/YYYY
Age in
Years/
Months
4Ps ID
Number
IDY R. PEDRITA
SBFP Form 1
Department of Education
Region VI
Master List Beneficiaries for School-Based Feeding Program (SBFP)
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
School Principal / Officer-In-Charge
Name of Parents
Beneficiary of SBFP
in Previous Years
(yes or no)
IDY R. PEDRITA
SBFP Form 1
Department of Education
Region VI
Master List Beneficiaries for School-Based Feeding Program (SBFP)
Division/Province: AKLAN Name of Principal: IDY R. PEDRITA
City/Municipality/Barangay: IBAJAY WEST Name of Feeding Focal Person: NIEVA G. GELITO
Name of School/School District: IBAJAY CENTRAL SCHOOL
1 SIMERA, KYVEE JAMES D. F 12/17/2008 06/06/2014 70 15 1.05 Wasted/U
2 Abada, Nico Jess S. M 09/26/2008 06/06/2014 68 15 1.19 Wasted/U
3 Aquino, Nino Donard T. M 08/02/2008 06/06/2014 70 15 1.19 Wasted/U
4 Calizo, Jhan Justine S. M 01/02/2008 06/06/2014 77 17 1.18 12.2 Wasted/U
5 Macahilig, Richard S. M 12/30/2007 06/06/2014 77 14 1.07 12.2 Wasted/U
6 Masangcay, James B. M 12/30/2007 06/06/2014 78 14 1.04 12.9 Wasted/U
7 Sastre, Reymundo M. M 08/15/2008 06/06/2014 69 15 1.16 Wasted/U
8 Zaulda, Reymar T. M 02/21/2008 06/06/2014 75 15 1.1 12.3 Wasted/U
9 Camacho, Clariz Yna C. F 10/25/2008 06/06/2014 67 14 1.11 Wasted/U
10 Fernandez, Charlotte F 06/24/2008 06/06/2014 71 15 1.2 Wasted/U
11 Salazar, Janine Cairyl F 02/01/2008 06/06/2014 76 17 11.8 11.8 Wasted/U
12 Canja, Mark Angelo I. M 10/02/2008 06/06/2014 68 15 1.12 Wasted/U
13 Gelito, Aron C. M 04/17/2008 06/06/2014 73 15 1.11 12.1 Wasted/U
14 Briones, Nicca May A. F 05/14/2008 06/06/2014
15 06/06/2014
Prepared by: Noted by:
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
Feeding Focal Person School Principal / Officer-In-Charge
Weight
(Kg)
Height
(cm)
BMI for
6 y.o.
and
above
Nutritional
Status (NS)
Ethnicity Disability No. Name Sex
Date of Birth
(MM/DD/YYYY)
Date of
Weighing/
Measuring
MM/DD/YYYY
Age in
Years/
Months
4Ps ID
Number
NIEVA G. GELITO IDY R. PEDRITA
SBFP Form 1
Department of Education
Region VI
Master List Beneficiaries for School-Based Feeding Program (SBFP)
6
12
72
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
School Principal / Officer-In-Charge
Name of Parents
Beneficiary of SBFP
in Previous Years
(yes or no)
IDY R. PEDRITA
SBFP Form 2
Department of Education
Region VI
SCHOOL-BASED FEEDING PROGRAM (SBFP)
Division/Province: AKLAN
City/Municipality/Barangay: IBAJAY WEST
Name of School/School District: IBAJAY CENTRAL SCHOOL
1. Kinder
2. Grade I
3. Grade II
4. Grade III
5. Grade IV
6. Grade V
7. Grade VI
Prepared by: Noted by:
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
SBFP DepEd Focal
NIEVA G. GELITO
Unit Chief
IDY R. PEDRITA
Total
Number of Undernourished School
Children by Grade Level
Nutritional Status at Start of Feeding
No. of
Severely
Wasted
No. of 4 Ps Ben.
No. of Pupils who
are beneficiaries in
previous years
Ethnicity 4 Ps Beneficiaries in previous years
No. of
Wasted
Total
Beneficiaries
No. of Ethnic Ben.
SBFP Form 2
Department of Education
Region VI
SCHOOL-BASED FEEDING PROGRAM (SBFP)
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
Unit Chief
IDY R. PEDRITA
Remarks
Ethnicity 4 Ps Beneficiaries in previous years
SBFP Form 2
Department of Education
Region VI
SCHOOL-BASED FEEDING PROGRAM (SBFP)
Division/Province: AKLAN
City/Municipality/Barangay: IBAJAY WEST
Name of School/School District: IBAJAY CENTRAL SCHOOL
1. Kinder
2. Grade I
3. Grade II
4. Grade III
5. Grade IV
6. Grade V
7. Grade VI
0 0 0 0 0 0
Prepared by: Noted by:
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
Total
NIEVA G. GELITO IDY R. PEDRITA
SBFP DepEd Focal Unit Chief
Number of Undernourished School
Children by Grade Level
Nutritional Status at Start of Feeding Ethnicity 4 Ps Beneficiaries in previous years
No. of
Severely
Wasted
No. of
Wasted
Total
Beneficiaries
No. of Ethnic Ben. No. of 4 Ps Ben.
No. of Pupils who
are beneficiaries in
previous years
SBFP Form 2
Department of Education
Region VI
SCHOOL-BASED FEEDING PROGRAM (SBFP)
Note: This form shall be prepared by the school, to be compiled by the DO, and for final compilation by the RO, for submission to DSWD-FO, copy furnished DepEd-HNC.
IDY R. PEDRITA
Unit Chief
Ethnicity 4 Ps Beneficiaries in previous years
Remarks