Republic of the Philippines
DEPARTMENT OF EDUCATION
Region III – Central Luzon
SCHOOLS DIVISION OF TARLAC PROVINCE
San Roque, Tarlac City
EQUIVALENT RECORD FORM
(Submit in 5 copies)
Name: ________________________. Date of Birth: _______________Gender: __________
(Surname) (Given Name) (M.I.)
Employee No. ___________________ Authorized Position Title: TEACHER I
Item No. ___________________________ SG: 11 Authorized Annual Salary:P 249,048.00
I. Educational Attainment
Masters Degree Completed/Units
Year
(write in full with Earned (if not Name of School Equivalent
Completed
specialization) completed)
II. Years of Teaching Experience: __________
Private: _______________
Public :________________
III. Trainings Attended
Title Number
Inclusive Dates Sponsoring Agency
of Hours
IV. For Head Teacher Positions and Other Related Teaching Positions
Years of Experience in Present Position: N/A A
V. Latest Performance Rating: ______ ____________________
(Teacher’s Signature)
VI. Schools Division Action (For Schools Division Evaluator Only)
DATE RANGE SALARY SALARY
CLASSIFICATION REMARKS
PROCESSED ASSIGNMENT GRADE SCHEDULE
.
Certified Correct: Recommending Approval:
JOVITA G. DIZON Dr. IMELDA P. MACASPAC
Administrative Officer V Officer In-Charge
Schools Division Evaluator Schools Division Superintendent
VII. DEPED REGIONAL OFFICE ACTION:
Classification: _________________ Post Audited Assignment: ____________
Date Approved/Processed: __________ Salary Grade: _____________
Salary Schedule:___________
Remarks: ________________
Approved:
____________________________ __________________________________
Evaluator