Students 2.1 Outstanding Achievements, special Awards and Recognition Received (Inside and Outside PUP) Inside PUP (University Wide) Name of Student Nature of Achievement/ Award/Recognition Date Outside PUP Name of Student Nature of Achievement/ Award/Recognition Level (International, National, Regional, Provincial, Municipal, Barangay) Sponsor Place Date 2.2 Board Examination Performance Board Topnotchers Name of Graduate Type of Licensure/Board Examination Place/Rank (1st, 2nd, etc.) Date of Examination National and PUP Rate of Passing in Board Examinations Type of Licensure/Board Examination Date off Examination National PUP No. of Examinees No. of Passers Passing Rate No. of Examinees No. of Passers Passing Rate
PUP Passing Rate – TARGET FOR THE SUCCEEDING FISCAL YEAR Type of Licensure/Board Examination Schedule of Examination PUP No. of Examinees No. of Passers Passing Rate Attendance in Seminars, Leadership Training and Student Development Programs (Local, National, International) Name of Student Sponsor Venue Date Networking and Linkages Name of Students Involved Name of Agency/Company/ Organization Nature of Business/Service (i.e. Educational Institution, Government Agency, Telecommunication, Travel Agency, Hotel and Hospitality Service, Food Service, BPOs, NGOs, POS, etc.) Nature of Networking or Linkages Please indicate if: Academic Linkages, Benefactors, Research and Extension Linkage, Educational and Cultural Exchange, Government Agencies Partners, National/Institutional Membership, Non-Government Organizations Partners, OJT/Training Stations etc. Duration (Indicate inclusive period) Contact Person Name Tel. No. Address
FACULTY 3.1 Faculty Enrolled in Graduate Studies Name of Faculty Name of School (No abbreviation, please) Degree/ Program (No abbreviation, please) Current Semester/School Year TOTAL No. of Units Enrolled Units Earned Faculty Members Graduated During the Current School Year Name of Faculty Name of School (No abbreviation, please) Degree /Program (No abbreviation, please) Current Semester/School Year Faculty Scholarship Name of Faculty School (No abbreviation please) Degree/Program (No abbreviation please) Type of (Study Grant, Research Fellowship, etc) Funding Agency (No abbreviation, please) Duration (Pls. indicate inclusive period) FROM TO Faculty Recipient of Thesis and Dissertation Aids
Name of Faculty Member Title/Theme/Topic Nature (Pls. indicate if Seminar, Workshop, Conference, Convention, etc.) Name of Sponsor Venue Level Please check if Date Local Regional National International Networking and Linkages Faculty Members Involved Name of Agency/ Company/Organization Nature of Business/Service (i.e. Educational Institution, Government Agency, Telecommunication, Travel Agency, Hotel and Hospitality Service, Food Service, BPOs, NGOs, POS, etc.) Nature of Networking or Linkages Please indicate if: Academic Linkages, Benefactors, Research and Extension Linkage, Educational and Cultural Exchange, Government Agencies Partners, National/Institutional Membership, Non-Government Organizations Partners, Faculty Development/Training, Consultancy, OJT/Training Stations etc. Duration (indicate inclusive period) Contact Person Name Tel. No. Address Administrative Personnel
4.1 List of personnel Name Dept./Office Assigned Position Employment Status Check if Check if If designation, specify the Plantilla Position Permanent Casual Plantilla Designation 4.2 Attendance in Seminars, Workshops, Conferences, etc. Name of Personnel Title/Theme/ Topic Sponsor of Seminar/s if Date Regional National International Involvement in Services Name of Agency/Company/ Organization/Department Nature of Business/Service Nature of Involvement Please Indicate If: Instruction, Training, Research, Consultancy, Linkages, Network Personnel Involved Duration (Indicate Inclusive Period) Contact Person Name Tel. No. Address Recipients of Scholarships, Grants, Trainings, etc. Name of Personnel Type of Grant/ Scholarship/Training, etc. Course/Degree/ Program School Funding Agency Duration (Pls. specify inclusive period) (no abbreviation please)
4.5 Officership/Membership in Professional Organization Name of Personnel Position Organization Inclusive (no abbreviation please) 4.6 Outstanding Achievement Name of Personnel Awards Received Conferring Body/Agency Check if Place Date (no abbreviation please) Local Regional National International 4.7 List of Personnel Presently Enrolled Name of Personnel School Degree/Major Year OF SUPPORT (Ex. Financial Assistance, Scholarship Grant, BENEFACTOR (Name of Sponsor/Agency/ Organization/ etc) (no abbreviation please) 4.8 List of Personnel Who Graduated During the Current SchoolYear Name of Personnel School Degree/Major Year OF SUPPORT (Ex. Financial Assistance, Scholarship Grant, BENEFACTOR (Name of Sponsor/Agency/ Organization/ etc) (no abbreviation please)
Equipment (Computer/LCD/ Projector/ Karaoke, etc.) Furniture/Fixtures Type Location / Room No. Specific Type Please if Total No. Specific Type Please Check if No. No. of Serviceable No. of No. of Serviceable No. of Office Classrooms Library/learning resource center Accreditation Room Audio-Visual Room Faculty Lounge Other, pls. specify 5.2 Laboratory Rooms and Equipment Laboratory Rooms (Pls. specify) Location/ Room No. Capacity Equipment Ratio of Serviceable Computer or Other Equipment to Students Specific Type Please Check if Number No. of Serviceable No. of C. Research and Development (Please attach Abstract of completed research output) Faculty Research - ACTUAL RESEARCH OUTPUT FOR THE QUARTER OF THE CURRENT FISCAL YEAR
6. Refereed Publications – TARGET OUTPUT FOR THE NEXT FISCAL YEAR 6.1 BOOKS Name of Author/s Proposed Title of Book Target Level of Publication Local National International 6.2 JOURNALS Name of the Faculty Member/s Role in the Journal Publication/Editorial Board (i.e., Editor-in-chief, Managing Editor, Referee, etc.) Proposed Name of Journal Target of Publication Local National International 7. Faculty Inventions 7.1 ACTUAL OUTPUT FOR THE CURRENT FISCAL YEAR Name of Inventor/s Nature of Invention(s) (IT Product, Equipment, Machinery, etc.) Utilization of Invention Name of Commercial Product Copyright/Patent No. Date Date Started Date Completed Development Service End-Product 7.2 TARGET OUTPUT FOR THE NEXT FISCAL YEAR Name of Inventor/s
Name of Training Program (Please indicate the classifications of training programs as shown below) Name of Involved Faculty Member/s Role/Nature of Participation (Speaker, Resource Person, Facilitator, Organizer) Source of Funding Amount of Funding Duration No. of Hours No. of Trainees/ Beneficiaries Number of Information, Education and Communication (IEC) Materials Developed (Ex. Printed Materials, such as: brochures, posters, wall calendars, billboards, etc., Mass Media, such as: print and broadcast media, DVDs/VCDs, etc.; and giveaway materials) Training and Extension Services Expected Over-all Assessment (Pls. check) Date Started Expected Date of Completion Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Very Good Outstanding Very Good Outstanding Very Good Outstanding Very Good Outstanding 1
Name/Title of Activity Name of Student Involved Clientele/Beneficiary/ies (Name of community, organization, etc.) Number of beneficiaries Date indicate inclusive period) Over-all Assessment (Pls. check) Very Good Outstanding STUDENT EXTENSIONPROGRAMS/PROJECTS– TARGET FOR THE SUCCEEDING FISCAL YEAR of Activity Name of Student/sInvolved Clientele/Beneficiary/ies (Name of group, community, organization, etc.) Number of beneficiaries Date (Pease indicate inclusive period) Over-all Assessment (Pls. check) Q1 Q2 Q3 Q4 Very Good Outstanding Very Good Outstanding Very Good Outstanding Very Good Outstanding Submitted by: ________________________________________________ Name, Designation and Signature of the Head of the Office Date:____________________