EQUIVALENT RECORD FORM (ERF)
(submit in four copies)
Name: ____________________________________________________ Date of Birth: _______________________ Sex: _______________
(Surname) (Given Name) (M.I)
Employee Number: _________________________________________ Authorized Position Title: __________________________________
Item Number: ______________________________________________ Actual Salary: ___________________________________________
I. EDUCATIONAL ATTAINMENT AND CIVIL SERVICE ELIGIBILITY
Title, Degree of
Year
Highest Grade Name of Institution Civil Service Eligibility Rating Date
Received
Attained
II. SERVICE RECORDS (Please attach duly certified service record)
III. EQUIVALENT UNITS
A. Total Number of Years Teaching: _______________________________________ Equivalent: ________________________
B. Degree to Degree Equivalent (Present Degree) : _______________________________ Equivalent: ________________________
C. Areas of Equivalent Inclusive Dates No. of Units Description
1. Professional Study
2. Teaching Experience
a. Public School
b. Private School
3. Administrative Supervisory Experience
a. Public School
b. Private School
4. Others (Seminars, Workshops, etc.)
TOTAL
LATEST EFFICIENCY RATING: _________________________
Conforme:
________________________________________ _____________________________________________
Teacher’s Name and Signature School Principal/School Head/PSDS/DIC
Note: Teachers do not write below:
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IV. DIVISION ACTION
Classification Date Processed Range Assignment Salary Range Scheduled Salary Remarks
CERTIFIED CORRECT: REVIEWED BY: RECOMMENDING APPROVAL:
JUNE C. GUERRA SHIRLENE E. CRABAJALES JOSITA B. CARMEN, CESO V
HRMO Administrative Officer V Schools Division Superintendent
V. REGIONAL ACTION
Evaluated by: Certified Correct: Approved:
FE M. BARING MERIAM C. DELA RITA MA. GEMMA M. LEDESMA, CESO V
TCE II Supervising Admin. Officer Regional Director
Republic of the
Philippines
Department of
Education
Name of Applicant :
Current Position :
District :
School :
Contact No. :
Messenger :
Current Email Ad. :