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This form shall be accomplished by the head of the pr

than one level, only one form shall be accomplished. He/she

inaccuracy or false data/information reported. He/sheshal

Name of Institution :

(Official name)

(If renamed, please indicate

Address :

# Str eet

Municipality

Level

With Permit (Permit No.)

With Recognition (Recognition No.)

Permit on Process (Yes or No)

Certified True and Correct by :

Head of Institution :

(Signature O

Designation :

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A. ELEMENTARY EDUCATION

Ta le 1. P PIL DATA Y 2 1 -2 11 A f ul 31

Particulars

. ,

Pre-School Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 TOTAL (Grades 1-7)

Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female

TOTAL ENROLMENT

Monograde

Multigrade

Particulars

Included in this enrolment, number of:

SPED, graded

Repeaters

Transferees In

Balik-Aral

Muslim Pupils

Indigenous People

Total Number of Monograde Classes

Total Number of Multigrade Classes

Included in these classes, for Muslim Pupils:

Monograde Classes

Multigrade Classes

Table 2. ELEMENTARY AGE PROFILE, SY 2010-2011

Grade 1

TotalsinthGrade 6Pre-school Grade 2 Grade 3 Grade 4 Grade 5 Grade 7 TOTAL (Grades 1-7)

With ECD Experience Without ECD Experience

Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female

4 and below

5

6

7

ese

boxesmusttal

ge

8

9

10

11

12

ly.

13

14

15

16 -18

19 & above

TOTAL

Table 3. CURRENT SY ENROLMENT AND NUMBER OF CLASSES BY SHIFT, SY 2010-2011 (As of July 31)

1st Shift 2nd Shift TOTAL

Male Female Male Female Male FemaleParticulars

Number of Classes

Certified True andCorrect by :

Head of Institution : Date :(Signature Over Printed Name)

Designation :

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Table 4. PUPIL DATA FOR PREVIOUS SCHOOL YEAR2009-2010 (As of March 31)

Pre-School Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 TOTAL (Grades 1-7)

Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female Male Female

Enrolment

Number of Completers/Promotees/Graduates

Number of Dropouts

Number of Transferred Out

Number of Failures

Table 5. EXISTING NUMBER OF ROOMS IN THE SCHOOL, SY 2010-2011

Instructional rooms Non-instructional rooms

Table 6. EXISTING CLASSROOM FURNITURE, SY 2010-2011 Table 7. EXISTING NUMBER OF TOILETS, SY 2010-2011

Certified True and Correct by :

Head of Institution : Date :

(Signature Over Printed Name)

Designation :

Used as

offices

Total non-

instructional

rooms

Used as

canteen

Used as

librariesUsed as clinic

Not currently

usedOther uses

Particulars

Used as

academic

classrooms

Used as

Science

Laboratories

Used as H.E.

rooms

Used as I.A./

Workshops

Total

instructional

rooms

Used as

computer

rooms

Not currently

used

multipleClassroom furniture for pupils

DesksSets of chairs and

tablesArmchairs

Number of toilets

Girls

(toilet bowl)

BoysShared

(girls and boys)(urinal)

(toilet bowl)single

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B. SECONDARY EDUCATION

Table 1. STUDENT DATA, SY 2010-2011 (As of July 31)

Year 1 Year 2 Year 3 Year 4 Year 5 TOTAL (Years 1-5)

Totalsintheseboxesmustt

ally.

ParticularsMale Female Male Female Male Female Male Female Male Female Male

TOTAL ENROLMENT

Included in this enrolment, number of:

SPED, graded

Repeaters

Female

Transferees In

Balik-Aral

Muslim Students

Indigenous People

Total Number of Classes

Included in these classes, for Muslim Students:

Number of Classes

Table 2. SECONDARY AGE PROFILE, SY 2010-2011

Year 5

TotalsinthYear 4Year 2 Year 3 TOTAL (Years 1-5)Age

Year 1

a e ema e a e ema e a e ema e a e ema e a e ema e a e

10 and Below

11

12

13

14

eseboxesmustt

al

ema e

15

16

17

18

19

ly.

20 and Above

TOTAL

Table 3. CURRENT SY ENROLMENT AND NUMBER OF CLASSES BY SHIFT, SY 2010-2011 (As of July 31)

1st Shift 2nd Shift Night Classes TOTAL

Male Female Male Female Male Female Male Female

EnrolmentNumber of Classes

Certified True andCorrect by :

Head of Institution : Date :(Signature Over Printed Name)

Designation :

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Table 4. STUDENT DATA FOR PREVIOUS SCHOOL YEAR2009-2010 (As of March 31)

Year 1 Year 2 Year 3 Year 4 Year 5 TOTAL (Years 1-5)

Male Female Male Female Male Female Male Female Male Female Male Female

Enrolment

Number of Promotees/Graduates

Number of Dropouts

Number of Transferred Out

Number of Failures

Table 5. EXISTING NUMBER OF ROOMS IN THE SCHOOL, SY 2010-2011

Instructional rooms Non-instructional rooms

Table 6. EXISTING CLASSROOM FURNITURE, SY 2010-2011 Table 7. EXISTING NUMBER OF TOILETS, SY 2010-2011

C. PERSONNEL DATATable 1. SEX PROFILE OF PERSONNEL, SY 2010-2011 (As of July 31)

Pre-School Elementary Secondary

Male Female Total Male Female Total Male Female Total

No. of Teachers with Full-time Teaching Load

No. of Teachers with Part-time Teaching Load

No. of Administrative and Support Personnel

Certified True and Correct by :

Head of Institution : Date :

(Signature Over Printed Name)

Designation :

Not currently

usedOther uses

Used as

officesUsed as clinic

Not currently

used

Total non-

instructional

rooms

Used as

computer

rooms

Used as

libraries

Used as I.A./

Workshops

Used as

canteen

Particulars

Used as

academic

classrooms

Total

instructional

rooms

Used as

Science

Laboratories

Used as H.E.

rooms

Particulars

Classroom furniture for pupilsDesks

Sets of chairs and

tablesArmchairs

Number of toilets

Girls

(toilet bowl)

BoysShared

(girls and boys)(urinal)

(toilet bowl)single multiple

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Table 8. STUDENT DATA ON EDUCATION SERVICE CONTRACTING & EDUCATION VOUCHER SYSTEM, SY 2010-2011 (As of July 31)

Year 1 Year 2 Year 3 Year 4 Year 5 TOTAL (Years 1-5)

Male Female Male Female Male Female Male Female Male Female Male Female

Enrolment

Education Service Contracting (ESC)

Education Voucher System (EVS)

Table 9. STUDENT DATA FOR PREVIOUS SCHOOL YEAR2009-2010 (As of March 31)

E S C

E V S

E S C

E V S

E S C

E V S

E S C

E V S

E S C

E V S

Table 10. AGE PROFILE OF ESC AND EVS GRANTEES, SY 2010-2011

Year 5

Male Female Male Female Male Female Male Female Male Female

10 and Below

11

12

13

14

15

16

17

18

19

20 and Above

TOTAL

Certified True and Correct by :

Head of Institution : Date : Date :

(Signature Over Printed Name)

Designation :

Male Female

TOTAL (Years 1-5)Year 2 Year 3 Year 4

Number of Transferred In

Year 4

Male Female

AgeYear 1

Enrolment

Number of Promotees / Graduates

Number of Dropouts

Number of Transferred Out

Male Female Male FemaleMale Female Male FemaleParticulars

Year 1 Year 2 Year 3 Year 5 TOTAL (Years 1-5)

Male Female

Particulars