Innovation Templates

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Republic of the Philippines

Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

ANNEX 2 – TECHNICAL GUIDELINES

1. All documents containing proposals for innovation projects must adhere to the
following standard format:

Paper Size: A4 size (8.27 x 11.69 inches)


Font Style and Size: Bookman Old Style; 11
Margins: 1 inch on all sides
Spacing: Single

2. Ensure all in-text citations and lists of references are made by APA 7th edition
guidelines

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

ANNEX 3: REQUISITE COMPONENTS FOR AN INNOVATION PROJECT


PROPOSAL OUTLINE

A. Endorsement from the Head of the Office

B. General Information

I. Implementing Identity (Division/Unit/Section)


II. Project Proposal Title
III. Type of Innovation
IV. Brief Description of the Proposal
V. Scope of Implementation
VI. Implementation Period
VII. Total Funding Requirement

C. Background and Rationale

D. Project Description

I. Goal
II. Outcome
III. Objectives
IV. Inputs
V. Expected Outputs
VI. Logical Framework

E. Methodology

I. Method
II. Project Beneficiaries
III. Impact Estimation
IV. Work and Budget Plan
V. Monitoring and Evaluation Plan
VI. Exit Plan

F. References

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

ANNEX 4: INNOVATION PROJECT PROPOSAL TEMPLATE

I. Proponent/s
(Write the name/s of the proponent/s, positions, and brief description of roles
and responsibilities in the Innovation Project)

Lead (Name)
Proponent: (Position)
(Brief Description of Roles and Responsibilities in the Innovation Project)
Co-Proponent*: (Name)
(Position)
(Brief Description of Roles and Responsibilities in the Innovation Project)

Co-Proponent*: (Name)
(Position)
(Brief Description of Roles and Responsibilities in the Innovation Project)

*If needed.

II. Implementing Entity:


(Indicate the Functional Division/Unit/Section/School)

III. Type of Innovation


(Indicate the type of Innovation: Process or Product)

IV. Brief Description of the Proposal:


(Briefly describe the innovation in terms of its type, project target, usage or
application, and its significance)

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

V. Scope of Implementation:
(Specify the Scope: Regional/Division/School)

VI. Total Funding Requirement:


(Indicate the amount of funds needed for the innovation project and source)

VII. Implementation Period:


(Please specify the duration for implementing the innovation project)

VIII. Background
(Please provide the circumstances or situation that led to the proposal for the
innovation project.)

IX. Rationale
(Indicate data-driven reasons why the innovation is necessary [refer to sources
of innovation], and what needs to be addressed or innovated)
X. Project Description
(Provide information for the following)

A. Goal:

B. Outcome:

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

C. Objectives:

D. Inputs:

E. Expected Outputs:

F. Logical Framework (LogFrame)


(Lay out the overview process, inputs, activities, outputs, and outcome)

XI. Methodology

A. Method (Briefly discuss the design)

B. Target Beneficiary

C. Impact Estimation

D. Work and Budget Plan


(Action Plan reflecting specific strategies, activities, and resources)

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

Phase Activity Time Resources Budgetary Expected


Frame Human Material Financial Requirement Output/s
Pre-
Impleme
ntation
Impleme
ntation
Post-
Impleme
ntation

E. Monitoring and Evaluation Plan

No. INDICATOR BASELINE TARGET DATA FREQUENCY RESPONSIBLE REPORTING


SOURCE
(What is (What is (How often (Who will (Where will
the the (How will it will it be measure it?) it be
current target be measured?) reported?)
value?) value?) measured?)

F. Exit Plan
(Exit strategy should clarify how your project will be brought to a close while
sustaining its benefits)
Plan Component/Method Action Steps Timeline

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

ANNEX 5 – DECLARATION OF ANTI-PLAGIARISM AND ABSENCE OF CONFLICT


OF INTEREST

Declaration of Anti-plagiarism

1. I/We, ___________________________, ___________________________,


___________________________, understand that plagiarism is the act of taking and
using another’s ideas and works and passing them off as one’s own. This
includes explicitly copying the whole work of another person and/or using some
parts of their work without proper acknowledgment and referencing.

2. I/We hereby attest to the originality of this innovation project proposal and
have cited properly all the references used. I/We further commit that all
deliverables and the final innovation project emanating from the proposal shall
be of original content. I/We shall use appropriate citations in referencing other
works from various sources.

3. I/We understand that violation of this declaration and commitment shall be


subjected to consequences and shall be dealt with by the Department of
Education.

___________________________________
Signature over Proponent’s Name
Date: ________________

___________________________________
Signature over Proponent’s Name

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

Date: ________________

___________________________________
Signature over Proponent’s Name
Date: ________________

Declaration of Absence of Conflict of Interest

1. I/We, ___________________________, ___________________________,


___________________________, understand that conflict of interest refers to
situations in which financial or other personal considerations may compromise
my judgment in implementing, evaluating, and reporting the innovation.

2. I/We declare that I/we do not have a personal conflict of interest that may arise
from my application and submission of my/our innovation proposal. I/We
understand that my/our innovation proposal may be returned to me/us if
found out that there is a conflict of interest during the initial screening.

3. Further, in case of any form of conflict of interest (possible or actual) which may
inadvertently emerge during the conduct of my/our innovation, I/we will duly
report it to the innovation committee for immediate action.

4. I/We understand that I/we may be held accountable by the Department of


Education for any conflict of interest which I/we intentionally concealed.

___________________________________
Signature over Proponent’s Name
Date: ________________

___________________________________
Signature over Proponent’s Name
Date: ________________

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

___________________________________
Signature over Proponent’s Name
Date: ________________

ANNEX 9 – COMPLETED INNOVATION PROJECT REPORT TEMPLATE

I. Cover Page

II. Table of Contents

III. Executive Summary

IV. General Objective of the Innovation

V. Description of the Innovation

VI. Activities Undertaken during the Implementation

VII. Highlight Accomplishments/ Improvements made by the innovation in


the concerned area. Indicate the impact of the innovation to be
supported by statistical analysis.

VIII. Budget Utilization (Actual)

IX. Sustainability

X. Appendices
A. Approved innovation Proposal
B. Certificate of Utilization
C. Certificate of Adoption, if adopted by another school/office
D. Data Analysis Report/Actual Computation of Raw Data

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

E. Pictorials
F. Minutes of the Meetings, if there are
G. Attendance logs, if necessary
H. Other significant / relevant supporting documents

ANNEX 10 – CERTIFICATE OF UTILIZATION OF INNOVATION

Certificate of Utilization of Innovation

This is to certify that the innovation entitled __________________________________


_____________________________________________________________, introduced and
implemented by ____________________________________ was fully utilized from _________
to _________________________at ______(school or Office)_______________________________.

Given this, _________day of ______________,20__ at __(School/Office)_______.

________________________________
Head of Office

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

ANNEX 11 – CERTIFICATE OF ADOPTION OF THE INNOVATION PROJECT BY


ANOTHER SCHOOL/OFFICE

Certificate of Adoption of the Innovation

This is to certify that the innovation project submitted and approved by this office,

Title of innovation:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Proponent/s:
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
School/Unit/Section/Division:
_______________________________________________________________

has been adopted and implemented by other concerned users/personnel from


_____(date)___to _______(date)____ as manifested through the attestation by the
school/unit/section/division head below. This is issued for whatever legal purpose it
may serve this____ day of the month of __________20____.

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph


Republic of the Philippines
Department of Education
REGION III – CENTRAL LUZON
SCHOOLS DIVISION OF AURORA

_________________________________________
Head of Office

ANNEX 13- OUTCOME AND IMPACT VALIDATION CERTIFICATE TEMPLATE

Certificate of Outcome and Impact Validation of Innovation

This is to certify that the outcome and impact of the innovation entitled________
________________________________________________________, introduced and
implemented by ______________________________________________was validated by the
Innovation Committee based on the End Project Impact and Outcome Evaluation
criteria prescribed in the Region’s Implementation Guidelines on Innovation
Management.

Given this __________day of _____________, 20____ at ________school/Office___.

Recommending Approval:

______________________________________________________________
Assistant Schools Division Superintendent

Approved:

______________________________________________________________
Schools Division Superintendent

Address: Sitio Hiwalayan, Brgy. Bacong, San Luis, Aurora 3201

Telephone No.: (042) 7249190 local 1010

Email Address: [email protected]; Website: https://www.depedaurora.ph

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