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Usc-Ces Form A Ces Ppa Concept Note

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RECEIPT INFORMATION

Delivered/
Submitted
By
Received
By

USC-CES Form A CES PPA Proposal (Concept Note)

(for CES Office Use Only)


Dat
e
Tim
e

2.

IMPORTANT REMINDERS: Follow set deadlines for


submission.

1.

Form A only: for one-time activities or those to be


implemented within one semester only.

Forms A & B: for Course-based CES and Medium and Long term CES

USC-CES Form A CES Program/Project/Activity Proposal


]
(Concept
Note)
(Write the Title of the Program/Project/Activity)
(Indicate Department and School)
(inclusive date)

I.

Rationale and Contextualization


This portion will serve as the justification for your proposal. Please provide the following minimum information for the rationale and
introduction of your program/project/activity:
a. Current condition of the community
b. Problem/need identified by the unit that you intend to address
c. Data source as well as the process underwent to generate the data
d. How will the unit respond to the condition? What expertise and competencies from the unit or in collaboration with others
will be useful to address the identified condition?

II. Goal, Objectives, and Outcomes

This section must enumerate the following items:


a. Over-all goal of the proposed program/project/activity
b. The specific objectives that will be useful in achieving the goal (be sure they are SMART)
c. What are the expected outcomes after implementing the program/project/activity
III. Participants, Partners and Beneficiaries
This part must explicitly provide the specific roles/responsibilities or deliverables as well as benefits of the following:
a. Implementing team from USC/Unit
b. Internal and external partners
c. Beneficiaries and/or partner community/organization/institution

USC-CES Form A CES PPA Proposal (Concept Note)

IV. Outline of Activities

Tentative Date

V. Budgetary Requirements

Activities

Participants Needed

Person/s In-charge

Date of Form D Activity


Report Submission
Form D must be submitted 10 working
days after the activity.

USC-CES Form A CES PPA Proposal (Concept Note)

A. Particulars
A.

Meals and Snacks

B.

Transportation

C.

Materials

Frequency

Quantity

Amount

Total

TOTAL:

Php

B. Tranches for Budget Release and Monitoring (will be filled once the RIS is approved.
Activity

RIS No.

TOTAL AMOUNT RELEASED:

VI. Signatories

DATES

Amount

RIS Approval

Php

Budget Release

Liquidation
Report

USC-CES Form A CES PPA Proposal (Concept Note)

Prepared By:

Date:
Name and Signature of Proponent
(Faculty / Representative / Coordinator )

Noted By:

Date:
Name and Signature of Department/Unit Head
(for department/unit proposals only)

Recommending
Endorsement:

Date:
Name and Signature of School/College CES Coordinator
(for all department and college proposals)

Endorsed By:

Date:
Name and Signature of School/College Dean
(for all department and college proposals)

Recommending Approval:

Brenette L. Abrenica, MAPA, MPS

Date:

Name and Signature of CES Director


(to be affixed only after thorough review, validation, and discussion with proponents)

Approved By:

Fr. Anthony S. Salas, SVD, MM

Date:

Name and Signature of the Vice President for Academic Affairs

Received and Recorded By:

Date:
Name and Signature of USC-CES Staff

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