S - DORP Form 1- INDIVIDUAL STUDENT PROFILE

Republic of the Philippines

Department of Education
Region VII
DIVISION OF ____________________________

Instruction: To be filled up by the student or parent.

(Pls check) Remarks

NAME OF PUPIL./STUDENT:__________________________________Signature: New
Year level: Continuing
Repeater
Date of Birth: Sex: Transferee
Age: Working
Home Address: Balik-aral

Address where you are presently living/staying while schooling: If Balik-aral,:

last grade/ year level Grade

attended
Previous Address: Year

Number of brothers and sisters presently

enrolled Distance of home from school Means of Transportation:
Male Female Total less than a kilometer Remarks
Elementary 1 kilometer none
Secondary more than a kilometer PDCab
College more than 2 kilometers Habalhabal
Total more than 3 kilometers Jeepney/Bus
horse
Membership in organization: Others
Name of Organization Position
Officer Member Which of the following programs have
you availed of
Student Government
STEP/YECS/GO-Negosyo Remarks
BSP/GSP PEPT

Fraternity/Sorority A&E
Religious EASE

Sangguniang Kabataan OHSP

Others (Pls specify) OEP

Family Background

Living with parentsYes Are both parents living together

No Separated

if yes,
Occupation
Name of Father: Income : none 1001-8000

Highest Grade/Level attained 3,000 below 8000-10000

3,001-5000 10000 above
Occupation
Name of Mother: Income : none 1001-8000

Highest Grade/Level attained 3,000 below 8000-10000

Address of Parents 3,001-5000 10000 above

if no,
 Sister
Name of Guardian: Relationship
/Brother
Uncle/Aunt Employer
Grand
parents Cousin Others:
Pls specify:
1 1 2
2 2 3
Number of 3 Number of 3 Total number 4
of household
Brothers: 4 Sisters: 4 members 5
5 5 6
6 6 7

Are you the Eldest Youngest Midchild

NOTE: To be included in the individual student/pupil profile/portfolio.
Remarks Recommendations
S - DORP Form 2 - SARDO Watch List (To be accomplished by Advisers Republic of the Philippines MONTH OF:
every month.) Department of Education
Note: To be submitted to the School DORP Coordinator Region DISTRICT:
DIVISION OF NEGROS ORIENTAL
Name of School:
Grade/Year Level
Section:
Please put 1 instead of a check mark to indicate classification or choice. If "others" please specify.

Attendance Academic Behavior Health & Nutr

No. of days Reading Grade Level Learning Difficulties
No Name of Pupil/Student Fever& Stoma
(Ref. Form 1) (Ref. PHILIRI) (Ref. Form 137) P NI MisB Malnut Headac ch
hes ache
late Absent NR F Ins Ind Eng. Fil Sci Math AP TLE MAP EP
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Total
Please reflect the following symbols Legend: NR- Non-Reader P - Passive Others:
after the name of the pupil F - Frustration NI - Not Interested
if Transferee - Asterisk * Ins - Instructional MisB-Misbehaving Submitted by:
if Repeater - plus sign + Ind- Independent
if Balikaral - X sign Plantilla Position:
if Re-entered- R sign Instructions: 1. PHIL-IRRI will be applied monthly only to the NR and F levels.
2. A student/pupil incurring 3 absences is a SARDO.
S - DORP Form 2 - SARDO Watch List (To be accomplished by Advisers Republic of the Philippines MONTH OF:
every month.) Department of Education
Note: To be submitted to the School DORP Coordinator Region DISTRICT:
DIVISION OF NEGROS ORIENTAL
Name of School:
Grade/Year Level
Section:
Please put 1 instead of a check mark to indicate classification or choice. If "others" please specify.
Attendance Academic Behavior Health & Nutr
No. of days Reading Grade Level Learning Difficulties
No Name of Pupil/Student Fever& Stoma
P NI MisB Malnut Headac ch
hes ache
No Name of Pupil/Student Fever& Stoma
(Ref. Form 1) (Ref. PHILIRI) (Ref. Form 137) P NI MisB Malnut Headac ch
hes ache
late Absent NR F Ins Ind Eng. Fil Sci Math AP TLE MAP EP
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Total
Please reflect the following symbols Legend: NR- Non-Reader P - Passive Others:
after the name of the pupil F - Frustration NI - Not Interested
if Transferee - Asterisk * Ins - Instructional MisB-Misbehaving Submitted by:
if Repeater - plus sign + Ind- Independent
if Balikaral - X sign Plantilla Position:
if Re-entered- R sign Instructions: 1. PHIL-IRRI will be applied monthly only to the NR and F levels.
2. A student/pupil incurring 3 absences is a SARDO.
 SY: 2013 - 2014
SIATON WEST 1

Name of School: MALOH CENTRAL SCHOOL

Grade/Year Level:

e classification or choice. If "others" please specify.

Health & Nutrition Economic

IDENTIFIED

not saved
Saved
SARDO
comes
no comes
Tootha w/o
Others sch.sup walking, Others
che eating
plies w/o fare
& baon

Others:

Name of Teacher

SY: 2013 - 2014

SIATON WEST 1

Name of School: MALOH CENTRAL SCHOOL

Grade/Year Level:

e classification or choice. If "others" please specify.

Health & Nutrition Economic
IDENTIFIED

not saved
Saved
SARDO

comes
no comes
Tootha w/o
Others sch.sup walking, Others
che eating w/o fare
plies
& baon
 IDENTIFIED

not saved
Saved
SARDO
comes
no comes
Tootha w/o
Others sch.sup walking, Others
che eating
plies w/o fare
& baon

Others:

Name of Teacher
 DORP Form 3 - FICSF ANALYSIS SHEET

DIRECTIONS: CHECK THE PROBLEMS INITIALLY ASSESSED BY YOU AS ADVISER AS WELL AS THE SUGGESTED SOLUTIONS
ONE OR MORE PROBLEMS AND SOLUTIONS CAN BE CHECKED DEPENDING ON ASSESSMENT

( )
FACTORS PROBLEMS INITIAL SOLUTIONS
1. Had to take care of siblings 1. Counsel
2. Early marriage/pregnancy 2. Recommend students for
3. Parents' attitude toward schooling employment either on the
4. Family problems households or establishments
5. Others 3. Give seminars on effective
parenting
4. Prioritize needs
5. Enhance Communication
with family members
FAMILY/DOMESTIC 6. Conduct home visitation/
conference with parents
7. Introduce/implement and
"Adopt-School-Program"
8. Explain the disadvantages
of early marriage
9. Conduct Homeroom and
General PTA meetings.
10. Others

1. Illness 1. monitoring and supervision

2. Overage 2. Refer students to take
3. Death placement examinations
4. Drug abuse 3. Give special consideration
5. Poor academic performance 4. Guidance and Counseling
6. Lack of interest/distractions 5. Give alternative remediation
7. Hunger/malnutrition 6. Create conducive learning
INDIVIDUAL 8. Others atmosphere
7. Feeding program in school
8. Close monitoring and
supervision
9. Regular Health Center visit
10. Proper work orientation.
11. Others

1. Distance between home and school 1. Report to military men

2. Armed conflict (incl. tribal wars & clan feuds) 2. Construct cottage near school
3. Calamities/Disasters 3. Coordinate with proper
4. Others authorities
4. Adopt-a-Child program
5. Motivate and involve stake-
COMMUNITY/ holders
GEOGRAPHICAL 6. Coordinate with local officials
7. Seek help from Local/Provin-
cial Government
8. Request from LGU/Benefactors
9. Coordinate with local officials
10. Others

1. Teacher factor 1. Principal shall conduct

 2. Physical condition of classroom regular class observation
3. Peer influence 2. Teachers attend seminar on
4. Others Child Friendly School
4. Impose proper discipline
5.Tap stakeholders to repair
dilapidated classrooms
SCHOOL 6. Adopt-a-school program
7. Monitor the medium of
instruction
8. Enhance teaching strategies
9. Close monitoring/counseling
10. Send to seminars/workshops
11. Encourage students to join
extra curricular activities
12. Others

1. Child labor, work 1. Include student in the

2. Others adopt-a-child program
2. Sariling sikap program
3. Conference with employers,
parents, guardians on the
FINANCIAL
schedule of the child.
4. Attend skills development
trainings, & entrepreneurship
5. Distance learning
6. Others
- FICSF ANALYSIS SHEET

( )
DORP Form 4-Monthly Summary of SARDO
Note: A copy to be given to the principal. Month: _____

No Name of SARDO Risk Factor Interventions

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Prepared by:
___________________________________
SCHOOL DORP COORDINATOR
 Month: _______________________________

Saved Not Saved

Reasons why not saved Recommendations
(Pls. Check)

Noted by:
_________________________________
SCH. PRINCIPAL
S-DORP Form 5 - CONSOLIDATED SARDO & TRACKING REPORT

Note: A copy should be given to the school ICT Coordinator for SARDO E-Tracking.

Areas
GRADE LEVEL

IDENTIFIED SARDO Specific Problems/Causes

NOT SAVED

Economic
Absences
Academic
Behavior
FEMALE
SAVED

Abuse
MALE

H&N
Tardy

MODULAR
MISOSA
OHSP

4 P's
OI
Name of Pupil/Student 1 2 3 4 5 6 7 8
1 2 3 4

SUBTOTAL

GRAND TOTAL

Submitted by:

Teacher I
 MONTH OF: JUNE, 2013
SY 2013 - 2014
DISTRICT: SIATON WEST 1

Name of School: MALOH CS

Please put a check mark on the space provided for each choice.
WHEREABOUTS
Periodic Grades Reasons why Achievement
Employed

Still in Sch.

Graduated
child was not

Promoted
SII Means of

College
saved inspite of
Verification
the

Abroad

Others
Local
5 6 7 8 9 10 11 12 Eng. Fil SciMath AP TLE MAP EP interventions NAT AWARD

Noted by:
NESTOR R. PAJANTOY
OIC
DORP Form 6 - MONTHLY SUMMARY REPORT OF DORP IMPLEMENTATION Prepared by:
SY 2012-2013 - SCHOOL / DISTRICT DORP COOR
FOR THE MONTH OF: ______________________________________ Submitted by:____________________________________
Note: To be e-mailed to the Division DORP Coordinator and the Planning Office. PRINCIPAL / DISTRICT SUPER
DISTRICT/School (FOR SECONDARY): ____________________________________________
IDENTIFIED SARDO'S Saved SARDO'S
INTERVENTIONS
DROPOUT RISK FACTORS/CAUSES 1st Year 2nd Year 3rd Year 4th Year 1st Year 2nd Year 3rd Year 4th Year (LIST DOWN
PLS.)
M F T ME M F T ME M F T ME M F T ME M F T M F T M F T M F T

FAMILY/DOMESTIC
1. Had to take care of siblings
2. Early marriage/pregnancy
3. Parents' attitude toward schooling
4. Family problems
5. Others
INDIVIDUAL
1. Illness
2. Overage
3. Death
4. Drug abuse
5. Poor academic performance
6. Lack of interest/distractions
7. Hunger/malnutrition
8. Others
COMMUNITY/GEOGRAPHICAL
1. Distance between home and school
2. Armed conflict
3. Calamities/Disasters
4. Others
SCHOOL
1. Teacher factor
2. Physical condition of classroom
3. Peer influence
4. Others
FINANCIAL
1. Child labor, work
2. Others
TOTALS
NOTE:
If there are 2 or more reasons why a student dropped out, select only one that is considered the main cause. Thus, a student must be counted only once. Causes of dropouts should not be limited to the reasons stated in For
* ME: MONTHLY ENROLMENT Note: For the school level, same form will be prepared to be submitted to the District Supervisor.
CHOOL / DISTRICT DORP COORDINATOR
_______________________________________
PRINCIPAL / DISTRICT SUPERVISOR

WHEREABOUTS
REASONS WHY
CHILD IS NOT Employed
Still in Sch.

Graduated
Promoted

SAVED
College

Abroad

Others
Local
ed to the reasons stated in Form 18-E.
MONTHLY SUMMARY REPORT ON DORP IMPLEMENTATION
SY 2012-2013

DISTRICT (FOR ELEMENTARY): ____________________________________________

UNSAVED SARDO'S Saved SARDO'S

INTERVENTIONS REASONS WHY
DROPOUT RISK FACTORS/CAUSES 1st Year 2nd Year 3rd Year 4th Year 1st Year 2nd Year 3rd Year 4th Year (LIST DOWN CHILD IS NOT
PLS.) SAVED
M F T M F T M F T M F T M F T M F T M F T M F T

FAMILY/DOMESTIC
1. Had to take care of siblings
2. Early marriage/pregnancy
3. Parents' attitude toward schooling
4. Family problems
5. Others
INDIVIDUAL
1. Illness
2. Overage
3. Death
4. Drug abuse
5. Poor academic performance
6. Lack of interest/distractions
7. Hunger/malnutrition
8. Others
COMMUNITY/GEOGRAPHICAL
1. Distance between home and school
2. Armed conflict (incl. tribal wars & clan feuds)
3. Calamities/Disasters
4. Others
SCHOOL
1. Teacher factor
2. Physical condition of classroom
3. Peer influence
4. Others
FINANCIAL
1. Child labor, work
2. Others
TOTALS
 Still in Sch.

Promoted

Graduated

College

Local

WHEREABOUTS
Abroad
Employed

Others