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 Attainment
Name of School Year Completed Equivalent
Master’s Degree Completed/
(write in full with Units Earned
specialization) (if not completed)
II. Years of Teaching Experience: _____________
Private :________________________
Public :________________________
III. Trainings Attended
Title Sponsoring Agency
Inclusive Number of
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 Salary Grade REMARKS
Date Range Salary
Processed Assignment Schedule
Certified Correct: Recommending Approval:
MARIA NICHOLETTE C. ROJO ROMEO M. ALIP, Ph. D., CESO V
AO IV-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