Republic of the Philippines
DEPARTMENT OF EDUCATION
REGION III-CENTRAL LUZON
Schools Division of
_
EQUIVALENT RECORD FORM
(Submit in Five Copies)
Name: Date of Birth: , , Gender:
(Surname) (Given) (M.I.)
Employee No. : Authorized Position Title:
Item No. : SG: Authorized Annual Salary:
I. Educational Attainme nt
Masters Degree Completed/ Name of School Year Completed Equivalent
(write in full with Units Earned
specialization) (if not completed)
II. Years of Teaching Experience:
Private :
Public :
III. Trainings Attended
Title Inclusive Number of Sponsoring Agency
Dates Hours
IV. For Head Teacher Positions and Other Related Teaching Positions
Years of Experience in Present Position:
V. Latest Performance Rating:
(Teacher’s Signature)
VI. Schools Division Action (For Schools Division Evaluator Only)
Classification Date Range Salary Grade Salary REMARKS
Processed Assignment Schedule
Certified Correct: Recommending Approval:
JB B. MANALANG LEONARDO D. ZAPANTA, Ed. D., CESO VI
AO V-Personnel Schools Division Superintendent
Schools Division Evaluator
V. DepEd Regional Office Action
Classification: Post Audited Assignment:
Date Processed: Salary Grade :
Salary Schedule :
Remarks :
Approved:
Evaluator