Republic of the Philippines

DEPARTMENT OF EDUCATION
Region I
SCHOOLS DIVISION OFFICE
DAGUPAN CITY

DIVISION MEMORANDUM NO. lJ.L, s. 2019

To Assistant Schools Division Superintendent

Chief Education Supervisors, CID and SGOD
Education Program Supervisor, ESP
Public Schools District Supervisors
Public Elementary and Secondary School Heads/Principals
Public Elementary and Secondary School Guidance Designates/
4Ps Coordinators
All Others Concerned

From Office of the Schools Division Superintendent

Subject SEARCH FOR OUTSTANDING 4Ps STUDENT GRANTEE

Date March 12, 2019

. . ... .
ct: fhe Schools Divfsioh'Office t~~~~~·,.~~lf·, 19Ptb F~9{rpation D
''·
School (?pvernance and 9pera1)phs OiviSlon'Will'rconduct its 1
4Ps Sti.[dent,Grantee for the S~l\Qpf,'ft~~f~018-2019.

2. Thei~i~":~~.t~f~gictivity is recq~;i~~ toi s1~6.~t~

w;~·,;ek~illed in e
diffi~liltle~,~fldqballenge~
cc:::~''::'-\:7·:-·><·:;'.'~!.t~'--;- _,,_-;,. '··- · · _ ,
.·.;.:<-=-- :·:-
;brought
J
by poverty and other circu

3~r~T~;9)4;~itY.,,·~%~t4:(;t~8tppminee must:
w. a''. Be a Par'ltaWid'Pamily~ng Pilipino Program (4Ps) benefici 9;
b. ~~ ~·gr«<:il.Ji~il"'IQii(@r~~e 6 or Grade 12) student or a Grade 1 o completer this SY
. 20' ' ./ ''i i•i
9~~~~9ii:lf
~'f. l11e ®'l'••'iiooa:?
4. The following documents should be submitted to the School Governance and
Operations Division on or before March 25, 2019:
a. Certificate of Final Rating signed by the Principal/School Head;
b. Certificate of Good Moral Character attested by the School Guidance Designate;
c. Nomination Form signed by the Section Adviser and Principal (See Enclosure 1);
d. A copy of DSWD-issued Compliance Verification-Form 2 (CV-F2) for the latest
Reporting Period with the student's name highlighted.

5. Widest dissemination of the content of this memorandum is desired.

LORNA G. BUGAYONG, Ph.D., CESO VI

Schools Division Superint~
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region I
SCHOOLS DIVISION OFFICE
DAGUPAN CITY
Enclosure 1

SEARCH FOR OUTSTANDING 4Ps STUDENT GRANTEE

NOMINATION FORM
~-----------------------,
I I
I
Please submit this duly filled out nomination form on or before March 25, 2019 together I

with
ALL the following requirements: Attach here your latest 2"x
2" ID photo.
1. Certificate of Final Rating signed by School Head/Principal
2. Certificate of Good Moral Character attested by the
School Guidance Designate
3. A copy of DSWD-issued CV Form 2 for the latest Reporting with the student's
name highlighted I I

l------------------------·
PERSONAL INFORMATION
Name: _
Address: _

School: ------,-...---------------i<-----------
Date,ofBirth: __
____, ,_.,..._ ~~x (M/F):
Contatt
; ;-. Number: -.,,-+-~---- (,: ,,:'y/u;:_;.[1mail,address:
. . . . . . -~"''µ.::; t-_,\,i·~ ~ B ----

Pamilyang
:.,
Pilipino
;'-~ .;
f;>~p,g~am
~f
(~P,s) -~r9nt~-~: i-~-~ .
_;f 1- l~,.J { ~ (! -~ ,. :~ ;;: ,, _/-} ~'""""-
~'-"'-C"-·

Track/Strand (if applicable):

I/We respectfully nominate (name), a Grade (grade

Leve~ student of (schoo~ on the Search for Outstanding 4Ps Student
Grantee for the School Year 2018-2019.

I/We hereby certify that the information given here is true, correct and complete, and you are hereby authorized
to verify the same through an official inquiry if needed.

(Section Adviser's Signature over Printed Name) (Principal's Signature over Printed Name )