CHECKLIST OF REQUIREMENTS
Name of Applicant: Mary Grace S. Dayang
Position Applied For: Teacher 1
Course: BSED- MATHEMATICS
Contact Number: 09556048262
Religion: Roman Catholic
Person with Disability: YES ( ), NO (/)
Solo Parent: YES ( ), NO (/)
Status of Verification
Submission (To be filled-out by the
Basic Documentary Requirements (To be filled-out by HRMPSB)
the applicants; Status of Remarks
Check if Submissio
submitted) n
(Check if
completed)
(a) Letter of intent specifying the position applied for and
addressed to the Head of Office:
Senen P. Pauline EdD, CESO V
Schools Division Superintendent
DepEd, Division of Cebu Province
(b) Duly accomplished Personal Data Sheet (PDS) (CS Form
No. 212, Revised 2017)
(c.1 Photocopy of Certificate of Eligibility/ Report of Rating
)
(c.2 Photocopy of valid and updated PRC License/ID, if
) applicable
(d) Photocopy of scholastic/ academic record. E.g. Transcript
of Records (TOR), including graduate/ post-graduate
(CAR, Master’s Degree, etc.), if applicable
(e) Certificate of Employment, Contract of Service, Updated
Service, Updated Service Record, whichever is/are
applicable
(f) Photocopy of Certificate of Training, if applicable
(g) Photocopy of Performance Ratings covering one (1) year
performance in the last rating period/prior to the
assessment, if applicable
(h) Omnibus Sworn Statement and Certification/ Waiver and
Data Privacy Consent Form pursuant to Data Privacy Act
and Checklist of Requirements
(i) Checklist of Requirements
Other requirements as may require:
Certified Copy of GWA
Certified Copy of Diploma
Certified copy of Voter’s Certification
NBI Clearance
Birth Certificate
OMNIBUS CERTIFICATION AND WAIVER
This is to certify all information above are true and correct; and that the documents submitted are
authentic. This is also to authorize the Department of Education - Cebu Province Division to
publish the initial rank list at the division office’s official website/Facebook page and use my
personal information for the purpose of recruitment, selection and hiring.
_________________________
Name and Signature of Applicant
Attested:
_______________________________________________________
Name and Signature of Chairperson, School Sub-Committee (HRMPSB)