Republic of the Philippines

Department of Education
Region XII
DIVISION OF SOUTH COTABATO
JUNIOR HIGH SCHOOL SENIOR HIGH SCHOOL
NEW DUMANGAS NATIONAL HIGH SCHOOL
School ID: 316706 School ID: 431803
New Dumangas, Tboli, South Cotabato

Department of Education
BRIGADA ESKWELA
National Schools Maintenance Week

STATEMENT OF INTEREST FORM

I am interested to be a part of the National Schools Maintenance Week.

NAME:

NAME OF COMPANY/ ORGANIZATION:

ADDRESS OF COMPANY/ ORGANIZATION:

TELEPHONE NO.

CONTACT PERSON :

NAME OF PUBLIC SCHOOL/S:

ADDRESS OF SCHOOL/S:

FORM OF INTERVENTION: (Choose any of the two or you can choose both.)

a. Donations-in-kind for:
(please check desired donation)
____Painting the roofs (adds two or more years to the life of the roof)
____Cementing existing foothpaths and drains
____Repairing leaking water pipes
____Repairing comfort rooms and toilets
____Painting exterior walls of classrooms
____Repairing or replacing ceiling boards
____Repairing, refinishing or repainting chairs, desks and furniture
____Cleaning-up the gardens
____Repairing or replacing broken windows, jalousies, doors
____Replacing school signs
____DRR-CCA related activities (clean-up drive, repair and maintenance of drainage to avert flooding and
dengue outbreak)
____Food-for-Work Program (repair of classroom and other facilities)
____Any other types of repairs needed to be done

Specific material/donation to be given: _________________________________________________

_________________________________________________
_________________________________________________

b. Volunteer man-days/labor support:

Nature of volunteer services ___________
Time and date/s of availability ___________

Please submit filled-out form to the principal of the school that you plan to help.
Thank you so much!
Name & Signature: