Republic of the Philippines
Department of Education
Region VIII
DIVISION OF EASTERN SAMAR
Borongan
____________
Date
APPOINTMENT PROPOSAL
A. THE EXISTING VACANCY: (To be filed up by the Div. Office)
1. Name of Incumbent New Item No.
4
Page 5
Date of Publication 5
2. Civil Service Eligibility ____________________________________________________________________
3. Highest Degree Earned ____________________________ Major ___________ Minor_____________
4. Station (School) Grade/Year _________________________
5. Period of Vacancy ________________________________ Cause _____________________________
B. THE RECOMMENDEE:
1. Name MA. CONCEPCION A. FLORES Sex FEMALE Civil Status SINGLE d
2. Maiden Name (if married) ______________________________________________________________
3. Residence BRGY. 02 POBLACION QUINAPONDAN, EASTERN SAMAR
y
4. Highest Degree Earned BACHELOR OF SECONDARY EDUCATION When 2023
2
Where EASTERN SAMAR STATE UNIVERITY Major SOCIAL STUDIES
Minor_______________
5. Civil Service Examination Passed:
Title of Examination Place Date Rating
y BLEPT_____________________ TACLOBAN SEPTEMBER 24, 2023 83.80
6. Special Qualifications ____________________________
7. Length of Teaching Experience 2 YEARS Latest Performance Rating VERY
SATISFACTORY
8. Latest salary received per annum _ ____ Effective ___________________________
9. Rank in the District _______________________________ Category ___________________________
10. C.S. Status of Appointment _ ______ First Day of Service
C. REMARKS: ____________ _______ __
__________________ _ __
_________________ _ __
Prepared by: Recommending Approval:
GARY PAUL F. MACASA Ed D REY F. BULAWAN, Ed.D. A
Principal/School Head OIC-Asst. Schools Division Superintendent
Recommended by: APPROVED:
RUDY M . PALANA GORGONIO G DIAZ JR. PhD
District Supervisor Schools Division Superintendent
Copy furnished:
Asst. Schools Div. Supt.
District Supervisor
Plantilla Clerk
Record Section
Teacher Concerned
Pertinent Paper’s needed:
Original Appointment: Promotion: Reclassification:
1. CS Form 212 with ID photo 1. CS Form 212 with ID photo 1. PAL
2. CS Form 211 (Med. Certificate) 2. Form 32 (Panunumpa) 2. CS Form 212 w/ ID photo
3. Form 32 (Panunumpa) 3. Form 1 3. Panunumpa
4. Form 1 4. Transcript of Records (authenticated) 4. Form 1
5. Transcript of Records (authenticated) 5. PRC License-duly authenticated 5. Transcript of Records (duly authenticated)
6. PRC License-duly authenticated 6. Report of Rating-duly authenticated 6. PRC License-duly authenticated
7. Report of Rating-duly authenticated 7. PRC Board Certificate-duly authenticated 7. Report of Rating-duly authenticated
8. PRC Board Certificate-duly authenticated 8. Appointment 8. PRC Board Certificate-duly authenticated
9. Asstes and Liabilities 9. Performance Rating for the last three (3) 9. Appointment
10. NBI Clearance rating periods 10. Ranking
11. Division Ranklist 10. Updated service record 11. In Service Training
12. Authority to Fill 11. ERF (for T2 and T3)L 12. Updated Service Record
13. Performance Rating for the last three (3)
Rating Periods