SBFP Form 1 (2023)
Department of Education
Region IV-A CALABARZON
Master List Beneficiaries for School-Based Feeding Program (SBFP) ( SY 2024-2025 )
Division : RIZAL Name of Principal :
City/ Municipality/Barangay : Name of Feeding Focal Person :
Name of School / School District :
School ID Number :
BMI Parent's Beneficiary of
Date of Nutritional Status
Age in for 6 consent Participation SBFP in
Grade/ Date of Birth Weighing / Weight Height (NS)
No. Name Sex (MM/DD/YYYY) Measuring
Years /
(Kg) (cm)
y.o. for milk? in 4Ps Previous
Section Months and (yes or (yes or no) Years (yes or
(MM/DD/YYYY)
above no) no)
BMI-A HFA
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Prepared by: Approved by:
Feeding Focal Person School Head
p
SBFP Form 2 (2023)
Department of Education
Region IV-A CALABARZON
SCHOOL-BASED FEEDING PROGRAM (SBFP) SUMMARY OF BENEFICIARIES & START OF FEEDING (SY: 2024-2025)
Schools Division Office: RIZAL
City/ Municipality/Barangay : ____________________________
Name of School / School District : _________________________
School ID Number: _________________________
Date of Start of Feeding: __________________________
Last Mile School: ___Y ___N
No. of Secondary Targets No. of Pupils
Number of who are
Undernourished No. of Date Feeding
No. of 4Ps beneficiaries
School Children by Sex Severely
Overweight
Severely
No. of Pupils-
at-risk-of-
No. of
Stunted/
No. of No. of Learners
Beneficiaries in previous Started/Ended
Wasted Normal + Stunted Normal Tall Indigent Indigenous Dewormed years
Grade Level Wasted Stunted dropping-out Severely Learners Peoples (IPs)
Obese (PARDOs) Stunted (Repeaters)
1. Kinder F
Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. Grade I F
Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3. Grade II F
Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4. Grade III F
4. Grade III
Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5. Grade IV F
Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6. Grade V F
Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7. Grade VI F
Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Grand Total F
Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Prepared by: Approved by:
SBFP DepEd Focal School Head
Note: This form shall be prepared by the school before the start of feeding and after feeding, to be compiled by the SDO, and for final compilation by the RO, for submission to DepEd
BLSS-SHD
SBFP Form 3 (2023)
SCHOOL-BASED FEEDING PROGRAM
RECORD OF DAILY FEEDING
FOR THE MONTH OF _________________, SY 2024 - 2025
Region: IV-A CALABARZON School: ______________________________________________________________
SDO: RIZAL School ID Number: _________________________
District: CAINTA Grade: __________ Section _____________________
ACTUAL FEEDING
No. NAME OF PUPIL SEX
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Prepared by:
B. Deworming D. Actual Feeding
( x ) - not dewormed (H ) - Present, served with Hot meals
Feeding Coordinator / School Nurse ( √ ) - dewormed (M ) - Present, served with Milk
(H/M ) - Present, served with Hot meals & Milk
Approved by: ( A ) - Absent, not served
(H2/M2/(H/M2)) - Present, served twice
School Head
SBFP Form 4 (2023)
DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
REGION/SDO/DISTRICT: IV-A CALABARZON / RIZAL / CAINTA
NAME OF SCHOOL:
SCHOOL ID NO.:
SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT
LIST OF AUTHORIZED CONSIGNEES (SY: 2024-2025)
NAME & DESIGNATION TEL. NO. MOBILE NO. EMAIL ADD SPECIMEN SIGNATURE
SCHOOL INSPECTION TEAM (SY: (2024-2025)
NAME & DESIGNATION TEL. NO. MOBILE NO. EMAIL ADD SPECIMEN SIGNATURE
Note: Only authorized consignees are allowed to receive the goods.
Use long hand signature.
SBFP Form 5 (2023)
DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
REGION/DIVISION/DISTRICT: IV-A CALABARZON / RIZAL / CAINTA
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________
SCHOOL-BASED FEEDING PROGRAM - MILK COMPONENT
LIST OF BENEFICIARIES (SY 2024-2025)
Classification of Students in terms of Milk Tolerance (Please check one)
Name Sex Grade & Section Without milk intolerance With milk intolerance but
Not allowed by parents to
and will participate in milk willing to participate in
participate in milk feeding
feeding milk feeding
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Prepared by: APPROVED BY:
School Feeding Coordinator School Head
SBFP Form 6 (2023)
DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
REGION/DIVISION/DISTRICT: IV-A CALABARZON / RIZAL / CAINTA
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________
SCHOOL-BASED FEEDING PROGRAM
NFP DELIVERIES (SY 2024-2025)
No. of Packs Received No. of Packs for
Grade Level Sex Number of Beneficiaries Date Delivered New Replacement Total (New + Replacement/ Remarks
Replacement) Rejected
Kinder M 15 August 19, 2024 120 120 0 GOOD
F 30 August 22, 2024 110 110 10 10 nutribun with molds
Total 45 August 27, 2024 120 10 130 0 10 nutribuns with molds from previous delivery replaced
Grade 1 M 15
F 10
Total 25
Grade 2 M 20
F 30
Total 50
Grade 3 M
F
Total 0
Grade 4 M
F
Total 0
Grade 5 M
F
Total 0
Grade 6 M
F
Total 0
M
GRAND TOTAL: F
Total 120
Prepared by: Approved by:
School Feeding Coordinator School Head
elivery replaced
SBFP Form 6 (2023)
DEPARTMENT OF EDUCATION
Region IV-A CALABARZON
REGION/DIVISION/DISTRICT: IV-A CALABARZON / RIZAL / CAINTA
NAME OF SCHOOL: ______________________________________________________________________________
SCHOOL ID NO.: ______________________________________________________________________________
SCHOOL-BASED FEEDING PROGRAM
MILK DELIVERIES (SY 2024-2025)
No. of Packs Received
New Replacement Total (New + No. of Packs for
Grade Level Sex Number of Beneficiaries Date Delivered Remarks
Replacement) Replacement/ Rejected
Kinder M
F
Total 0
Grade 1 M
F
Total 0
Grade 2 M
F
Total 0
Grade 3 M
F
Total 0
Grade 4 M
F
Total 0
Grade 5 M
F
Total 0
Grade 6 M
F
Total 0
M
GRAND TOTAL: F
Total 0
Prepared by: Approved by:
School Feeding Coordinator School Head
