Republic of the Philippines
DEPARTMENT OF EDUCATION
Region I
PANGASINAN DIVISION II
Brgy. Canarvacanan, Binalonan, Pangasinan
DISTRICT SUMMARY REPORT
Division:
District:
School:
Address:
School ID:
No. of Bens:
Month:
A. STATUS OF IMPLEMENTATION
a.1. No. of Feeding Days - a.2. Date Started -
a.3. Date Ended - a.4. No. of days (double feeding) -
Inclusive Dates (Double Feeding):
B. BUDGET
b.1. Amount Allocated - b.2. Amount Downloaded -
b.3. Amount Disbursed - b.4. Amount Liquidated -
C. MENU COMPLIANCE
Note: If two (2) feeding sessions (DOUBLE FEEDING) occurred please indicate the
2 menus served on the same Day/Column.
Day 1 Day 2 Day 3 Day 4 Day 5
WEEK 1 Ex.: Nilagang Ginisang
Baboy Kamote
AM – Fried
Chicken and
Malunggay
Soup
PM – Misua
with Patola
Soup
Day 6 Day 7 Day 8 Day 9 Day 10
WEEK 2
WEEK 3 Day 11 Day 12 Day 13 Day 14 Day 15
WEEK 4 Day 16 Day 17 Day 18 Day 19 Day 20
D. PROBLEMS ENCOUNTERED DURING THE IMPLEMENTATION
(If none, remove this part)
Prepared by : _______________________
Feeding Coordinator
Conformed:
District Nurse
Noted:
School Head