Document Code: SDO-QF-SGOD-PRS-13

Quality Form Revision: 00

Effectivity date: 05-25-2018

RESEARCH PROPOSAL APPLICATION
FORM AND ENDORSEMENT OF Name of Office:
IMMEDIATE SUPERVISOR SGOD-PRS
(Annex 1 of DO No. 16, s. 2017)

A. RESEARCH INFORMATION

Research Title:

Short Description of the Research:

Research Category (check only one) Research Agenda Category (check only one main
o National research theme)
o Region o Teaching and Learning
o Schools Division o Child Protection
o District o Human Resource Development
o School o Governance

(check only one) (check up to one cross-cutting theme, if applicable)

o Action Research o DRRM
o Applied Research o Gender and Development
o Inclusive Education
o Others (please specify):
______________________________

Fund Source Amount

(e.g. BERF, SEF, others)*

TOTAL:
* Indicate also if proponent will use personal funds.

B. PROPONENT INFORMATION
Lead Proponent/Individual Proponent

LAST NAME: FIRST NAME: MIDDLE NAME:

BIRTHDATE (mm/dd/yyyy) SEX: POSITION/DESIGNATION:

STATION:

CONTACT NUMBER 1: CONTACT NUMBER 2: CONTACT NUMBER 3:

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 Document Code: SDO-QF-SGOD-PRS-13

Quality Form Revision: 00

Effectivity date: 05-25-2018

RESEARCH PROPOSAL APPLICATION
FORM AND ENDORSEMENT OF Name of Office:
IMMEDIATE SUPERVISOR SGOD-PRS
(Annex 1 of DO No. 16, s. 2017)

EDUCATIONAL ATTAINMENT
(DEGREE TITLE):
TITLE OF THESIS / RELATED RESEARCH PROJECT
Enumerate from bachelor’s
degree up to doctorate degree

Bachelor Degree

Masteral Degree

Doctoral Degree

SIGNATURE OF PROPONENT:

IMMEDIATE SUPERVISOR’S CONFORME

I hereby endorse the attached research proposal. I certify that the proponent/s has/have the capacity to implement
a research study without compromising his/her/their office functions.

_________________________________________________
Name and Signature of Immediate Supervisor
Position/Designation: _______________________________
Date: ____________________________________________

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