DepEd – DIVISION OF QUEZON
Sitio Fori, Brgy. Talipan, Pagbilao, Quezon
Cell # 09175824627 or at www.depedquezon.com.ph
“Creating Possibilities, Inspiring Innovations”
QUALITY
ASSURED
COMPANY
ISO 9001
Registration Number:
QAC/R63/0216
TECHNICAL ASSISTANCE REQUEST FORM
Name of Researcher: MARILOU T. BILANGEL
Employee No.
5314654
Date Submitted: April , 2020
E-mail Address: marilou.bilangel@deped.gov.ph_
Researcher’s Mobile No.: 09194360499
Name of School: GUMACA WEST CENTRAL SCHOOL
School District: GUMACA WEST
Type of Research-Related Output (Please check)
_____ Checking of Research Title
_____ Checking of Research Proposal
_____ Checking of Specific Questions
_____ Checking of Complete Action Research
_____ Checking of Research Plan
_____ Others (Please specify.)
____________________________________
Research Theme (Please check)
_____ Teaching and Learning
_____ Disaster Risk Reduction Management
_____ Child Protection
_____ Inclusive Education
_____ Human Resource Dev’t.
_____ Gender and Dev’t.
_____ Governance
_____ Others (Please specify.)
______________________________________
MARILOU T. BILANGEL
_____________________________________________________
SIGNATURE OVER PRINTED NAME OF THE RESEARCHER
DEPEDQUEZON-SGO-PAR-04-001-001
Email address: quezon@deped.gov.ph
Comments: Txt HELEN – 09178902327 (Smart/Sun/TalknTxt) 2327 (Globe and TM)
Cell No: 09175824629
This form is a property of SCHOOLS DIVISION OFFICE - QUEZON PROVINCE. Therefore, unauthorized use is strictly prohibited unless otherwise
permitted by the Schools Division Superintendent.