Republic of the Philippines

Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF ASTURIAS I
SAN ISIDRO ELEMENTARY SCHOOL
SAN ISIDRO, ASTURIAS, CEBU

FORM 3: PERFORMANCE CONTRACT – PART A

PERFORMANCE CONTRACT FOR TECHNICAL ASSISTANCE

This Agreement is made by and between the following

parties:

Party A: Grade 4 Teacher: HYACINTH B. SILVA 09275851038

(NAME OF TEACHER) (CONTACT NO.)

Party B: School Head/TA Provider: RESELYN J. FERNANDEZ PRINCIPAL I

_______________
(NAME) (POSITION)

In consideration of the mutual promises and agreements of the parties here to, as here in after, set forth, it is agreed as
indicated in the attached sheets. In witness whereof, the parties here to have caused this agreement to be executed by its appropriate
personnel and the schedule above written.

Signed:

Party A: ___ HYACINTH B. SILVA RESELYN J. FERNANDEZ

Party B: ___________________

Printed Names:

REALONA C. GATDULA
Witnesses: ____________ RUBY A. MONTERO
______________________________

Printed Names:

Date: November 20, 20234

FORM 3: PERFORMANCE CONTRACT – PART A

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Macupa Elementary School

Address: Macupa Tuburan, Cebu
Email Address: macupaes@gmail.com
 Republic of the Philippines
Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF ASTURIAS I
SAN ISIDRO ELEMENTARY SCHOOL
SAN ISIDRO, ASTURIAS, CEBU

PERFORMANCE CONTRACT FOR TECHNICAL ASSISTANCE

This Agreement is made by and between the following

parties:

Party A: Grades II, III, and IV Teacher: MARETES B. PEKITPEKIT

09275851038
(NAME OF TEACHER) (CONTACT NO.)

Party B: School Head/TA Provider: EDITHA A. MONDEJAR HEAD TEACHER 1

_______________
(NAME) (POSITION)

In consideration of the mutual promises and agreements of the parties here to, as here in after, set forth, it is agreed as
indicated in the attached sheets. In witness whereof, the parties here to have caused this agreement to be executed by its appropriate
personnel and the schedule above written.

Signed:

MARETES B. PEKITPEKIT
Party A: ___ EDITHA A. MONDEJAR
Party B: ___________________

Printed Names:

JESSAH PEKITPEKIT
Witnesses: ____________ JOAN P. TAPIL
______________________________

Printed Names:

Date: September 20, 2021

FORM 3: PERFORMANCE CONTRACT – PART A

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Macupa Elementary School

Address: Macupa Tuburan, Cebu
Email Address: macupaes@gmail.com
 Republic of the Philippines
Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF ASTURIAS I
SAN ISIDRO ELEMENTARY SCHOOL
SAN ISIDRO, ASTURIAS, CEBU

PERFORMANCE CONTRACT FOR TECHNICAL ASSISTANCE

This Agreement is made by and between the following

parties:

JESSAH PEKITPEKIT
Party A: Kinder/Grade 1 Teacher: 09275851038
(NAME OF TEACHER) (CONTACT NO.)

Party B: School Head/TA Provider: EDITHA A. MONDEJAR HEAD TEACHER 1

_______________
(NAME) (POSITION)

In consideration of the mutual promises and agreements of the parties here to, as here in after, set forth, it is agreed as
indicated in the attached sheets. In witness whereof, the parties here to have caused this agreement to be executed by its appropriate
personnel and the schedule above written.

Signed:

Party A: ___ JESSAH PEKITPEKIT EDITHA A. MONDEJAR

Party B: ___________________

Printed Names:

MARETES B. PEKITPEKIT
Witnesses: ____________ JOAN P. TAPIL
______________________________

Printed Names:

Date: September 20, 2021

FORM 3: PERFORMANCE CONTRACT – PART B (SCHOOL)

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Macupa Elementary School

Address: Macupa Tuburan, Cebu
Email Address: macupaes@gmail.com
 Republic of the Philippines
Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF ASTURIAS I
SAN ISIDRO ELEMENTARY SCHOOL
SAN ISIDRO, ASTURIAS, CEBU

DIVISION/SCHOOL: CEBU PROVINCE/MACUPA ELEMENTARY SCHOOL/TUBURAN 1

SCHOOL YEAR: 2021-2022 DATE: May 4, 2021

CLOSING THE GAPS

PARTY A
(ACTIVITIES TO BE UNDERTAKEN DO/SCHOOL)

PRIORITY AREA/STREA: Self-Learning Modules Completion

CRITICAL GAPS IN TAKING SUPPORT BY TA

STRATEGY #1: SCHEDULE
ACTIONS PROVIDER (PARTY B)
Create a school monitoring tool that Send a communication to 1 day after the set
Some of the parents did not come to
will track the percentage of the respective parent of schedule
claim the modules of their children and
accomplishments of every school in the learners.
some are so delayed in returning them.
terms of printing of modules.
CRITICAL GAPS IN TAKING SUPPORT BY TA
STRATEGY #2: SCHEDULE
ACTIONS PROVIDER (PARTY B)
Conduct a random visit on some Some of the printers malfunctioned. Schedule the printing per A day after the
grades to keep track of their grade level while the incidence.
progress and needs in terms of repair of the printer is
SLMs preparation. ongoing.

TECHNICAL ASSISTANCE REPORTING LOG

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Macupa Elementary School

Address: Macupa Tuburan, Cebu
Email Address: macupaes@gmail.com
 Republic of the Philippines
Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF ASTURIAS I
SAN ISIDRO ELEMENTARY SCHOOL
SAN ISIDRO, ASTURIAS, CEBU

Quarter/Month: December 2021

School Year: 2021-2022
COMMENTS, REMARKS,
CLIENT CONSULTANTS REFERRED
and AGREEMENTS
Date
Designation or
Name Initial Name & Position Initial
Position

Prepared by:
EDITHA A. MONDEJAR
School Head

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Macupa Elementary School

Address: Macupa Tuburan, Cebu
Email Address: macupaes@gmail.com
 Republic of the Philippines
Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF ASTURIAS I
SAN ISIDRO ELEMENTARY SCHOOL
SAN ISIDRO, ASTURIAS, CEBU

TECHNICAL ASSISTANCE REPORT

Division: CEBU PROVINCE District: TUBURAN I

School: MACUPA ELEMENTARY SCHOOL Month/Quarter: NOVEMBER 2021/QUARTER 1

SITUATIONAL ANALYSIS/CONTEXT:
Some of the parents did not came to claim the modules of their children and some are so delayed in returning it.

TECHNICAL ASSISTANCE OBJECTIVES:

To ensure 100% completion of every learner per grade level.

WHAT WAS UNDERTAKEN?

Planning Made Action Taken Results
Create a school monitoring tool that will Send a communication to the 99% of the parent claimed the SLMs of
track the percentage of respective parent of the learners. their children.
accomplishments of every school in 1 % was delivered to their home during
terms of printing of modules. classroom visitation.

Technical Assistance Provider: Mentees:

______________________________________ _____________________________________
Name, Signature and Date Name, Signature and Date

_____________________________________
Name, Signature and Date

_____________________________________
Name, Signature and Date

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Macupa Elementary School

Address: Macupa Tuburan, Cebu
Email Address: macupaes@gmail.com
 Republic of the Philippines
Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF ASTURIAS I
SAN ISIDRO ELEMENTARY SCHOOL
SAN ISIDRO, ASTURIAS, CEBU

ANNEX 6: TECHNICAL ASSISTANCE PLAN TEMPLATE

SCHOOL OPERATIONAL TECHNICAL PLAN

School Year: 2021-2022
Month: November 2021

School: MACUPA ELEMENTARY SCHOOL

Prioritized Resources
Expected Time
Needs of the TA Objectives Strategies/Activities Person/s
Results frame Materials Budget
Clients Responsible
Self-Learning To ensure 100% Create a school-based At the end of Nove School Head Monitoring Tool ₱ 1, 500
Modules distribution, monitoring tool that can November, all mber Teachers
Completion retrieval, and track the percentage of the learners 2021 Parents
completion of accomplishments of must attain
learners’ SLM in every teacher in the 100%
every grade retrieval and completion completion of
level. of learners’ SLMs. the Self
Conduct an Learning
unannounced visit in Modules in all
every classroom to subjects in all
facilitate and keep record grade levels.
of SLMs completion.
Conduct school staff
conference and give
technical assistance to
SLMs related concerns.
Address teachers’ SLMs
related issues and
concerns immediately.
Learners’ To address Evaluate the result of Learners CIGPs Nove School Head Quarterly ₱ 1, 000
Performance learners’ assessment. are addressed mber Teachers Assessment
difficulties, Conduct LAC sessions through 2021 Result
issues, and on learners’ remediation and Table of
concerns concerns/gaps/ home visitation. Specifications
regarding the problems. Test Item
modular Provide interventions to Analysis
learning. address learners CIGPs.
Learning To ensure 100% Conduct classroom All classrooms Nove School Head Checklist for ₱ 3, 500
Environment child-friendly, visitation and evaluation. are child- mber Teachers Classroom
motivating, Mentor and give technical friendly, safe, 2021 Evaluation
conducive, safe, assistance to teachers in properly
and properly classroom structuring. structured and
structured Provide constructive conducive to
learning feedback on the learning.
environment. evaluation result.
Assessment To capacitate Assess teachers’ needs. 100% accuracy Nove School Head MELC ₱ 500
and Reporting teachers in Conduct LAC Session of the mber Teachers
formulating according to the needs of assessment 2021
appropriate the teachers. given to
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Macupa Elementary School

Address: Macupa Tuburan, Cebu
Email Address: macupaes@gmail.com
 Republic of the Philippines
Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF ASTURIAS I
SAN ISIDRO ELEMENTARY SCHOOL
SAN ISIDRO, ASTURIAS, CEBU

assessment for Check the summative learners

the learners. assessment of teachers
regularly.
Mentor and give technical
assistance in test
construction.

Technical Assistance Provider: Mentees:

______________________________________ _____________________________________
Name, Signature and Date Name, Signature and Date

_____________________________________
Name, Signature and Date

_____________________________________
Name, Signature and Date

INDIVIDUAL/TEAM TECHNICAL ASSISTANCE REPORT FORM

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Macupa Elementary School

Address: Macupa Tuburan, Cebu
Email Address: macupaes@gmail.com
 Republic of the Philippines
Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF ASTURIAS I
SAN ISIDRO ELEMENTARY SCHOOL
SAN ISIDRO, ASTURIAS, CEBU

Division/School: Cebu Province/Macupa Elementary School Date: ____________________

Objectives of the TA: To ensure 100% completion of all learners per grade level. EDITHA A. MONDEJAR
TA Provider: ______________________

PLANNED ACTUAL
Observation/s Action Taken
Objectives Strategy/ies Activities OVs Remarks
or Findings & Agreement
To ensure 100% Online Create a school Accomplished Some of the Send a 99% of the parent
completion of Monitoring monitoring tool SLMs parents did not communication to claimed the SLMs
every learner per that will track the Monitoring came to claim the the respective of their children.
grade level. percentage of Sheet modules of their parent of the 1 % was delivered
accomplishments children and some learners. to their home
of every school in
are so delayed in during classroom
terms of printing
of modules. returning it. visitation.

Technical Assistance Provider: Mentees:

______________________________________ _____________________________________
Name, Signature and Date Name, Signature and Date

_____________________________________
Name, Signature and Date

_____________________________________
Name, Signature and Date

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Macupa Elementary School

Address: Macupa Tuburan, Cebu
Email Address: macupaes@gmail.com