QAAD Form 6B- Permit to Convert to an Integrated School

1. QAAD Form No. 6b
Date
Dr. Carmelita T. Dulangon
Director III
Officer-in-Charge
Office of the Regional Director
Sudlon, Lahug, Cebu City
Thru: ___________________________
Schools Division Superintendent
Division of __________________
___________________________
Madam:
Greetings!
The undersigned would like to apply for Permit to Convert ____________________________________________
___________________________ (Name and Address of the elementary/ high school) to ___________________Integrated
School, effective School Year _______________.
For approval of this application, the school hereby submits the following supporting documents:
1. Endorsement of the Schools Division Superintendent
2. Standard Letter-request for Permit to Convert to an Integrated School (QAAD Form No.6b)
3. Reports, Comments and Recommendations (Inspection Report) of the Division Inspection Team/Task Force
4. Four-Year Integrated School (IS) Implementation Plan (Feasibility Study)
5. List of Parents with Signature
6. Tentative List of Enrollees for the new Kindergarten and/or Elementary or High School Department
7. Pertinent Documents of the School Site
 Sketch Plan
 Proof of Ownership of the School Site—Declaration/Deed of Donation of the school site
 Comprehensive Floor Plan of academic and non-academic rooms indicating the classes accommodated in each classroom
8. Resolution of the Sangguniang Barangay/Bayan/Panlunsod to convert the school to an integrated school
9. Certification of adequate Local Government Unit (LGU) support/funds to support the Integrated School Implementation
until such time that the national government can take over
10. Certification that there is no other elementary/high school, public or private, within 2-kilometers radius
11. Certification that the following are available and adequate for the new grade/year level/s to be opened:
 classroom teacher/s to handle the class/es
 classroom/s (shoproom/s for Tech-Voc schools)
 chairs/desks, tables, blackboards
 textbooks and other reference materials
 equipment for Science, Math, TVE, MAPEH and other learning areas
 funds for the initial operation of the school
12. Plantilla of Personnel
13. Credential of the Teacher/s who will handle the classes
• Appointment/Designation
• Transcript of Records
• PRC License/Rating
Thank you and God bless.
Very truly yours,
________________
School Head
QAAD Form No. 6b together with the supporting documents should be submitted to the Division Office before the School Year applied opens.