Division of Pasig City
City of Pasig
School District 1, Pasig 1
NAGPAYONG ELEMENTARY SCHOOL
August 1, 2013
The Asst. Schools Division Superintendent
Officer-In-Charge
Office of the Schools Division Superintendent
Division of Pasig City
Pasig City
Madam:
I have the honor to submit herewith the following pertinent papers for ERF evaluation for
Teacher II.
1. Equivalent Record Form
2. Notarized Sworn Statement
3. Permit to Study
4. Original and Xerox copies of Transcript of Records
a. BEED
b. Masteral
5. Service Record
Very truly yours,
________________________________
Teacher I
1st Endorsement
Nagpayong Elementary School
August 1, 2013
Respectfully forwarded to the Assistant Schools Division Superintendent, Officer-In-Charge,
Division of Pasig City, through the Coordinating Principal, District I, Pasig I, the pertinent papers of
___________, contents noted and recommending favorable action.
________________________________
Principal
___________________
Coordinating Principal
Republic of the Philippines
Department of Education
National Capital Region
Division of Pasig City
District I, Pasig I
NAGPAYONG ELEMENTARY SCHOOL
School
EQUIVALENT RECORD FORM
NAME: _______________Date of Birth: ____________ Employee No: ____________
Authorized Position Title: Teacher 2 Form No._____________ PSI HP Blg. _________
Authorized Salary: __________Item No.: _______________________ CY: __________
I. EDUCATIONAL ATTAINMENT AND CIVIL SERVICE ELIGIBILITY:
Title, Degree or Name of Institution Year Civil
Highest Grade Received Service Rating Date of
Examination
Attained Eligibility
II. SERVICE RECORDS (Attached Duly Certified Service Record)
III. EQUIVALENT UNITS:
A. Total No. of year in Teaching: (Public Only) __14 years Equivalent ______
B. Degree to Degree Equivalent _____ _ Equivalent ______
C. Areas of Equivalent: School Year: No. of Units: Description:
1. Professional Study __2001-2013 51 MAED. Educ. Management
2. Teaching Experiences
a. Public Schools __1999 to present__-14 years
b. Private Schools 1998-1999 – 1 year
3. Admin. Supervisory Experience
a. Public School _________NA___________
b. Private Schools _______ NA __________
4. Others: (Seminars, Workshop, etc.) (See attached page)
TOTAL: _________________
___ARLENE S. CAGUNOT
________________ Teacher’s Signature
Principal CELIA C. PAULINO
Coordinating Principal
LATEST EFFICIENCY RATING: VS School: Nagpayong Elementary
NOTE: Teachers DO NOT WRITE BELOW District: I, Pasig I
IV. Division Action Date Range Salary Salary
Processed Assignment Range Schedule REMARKS
RECOMMENDING APPROVAL:
________________________
Asst. Schools Division Superintendent
Officer – In - Charge
V. DEP-ED and REGIONAL OFFICE ACTION: _____________________________________
Classification _____________________ Range ___________________________
Date Approved Processed ____________ Post Audited at Range ______________
(For future Reference)
_________________________ _______________________
Regional Director Evaluator
VI. DEP.ED. PROPER ACTION TITLE: _________________________
_________________________________ Salary: _________________________
Surname, First Name, Middle Name
Division of Pasig City
City of Pasig
School District I, Pasig I
NAGPAYONG ELEMENTARY SCHOOL
CERTIFICATION
TO WHOM IT MAY CONCERN:
I hereby certify under the oath that I’ve been actually in the school listed in
the accompanying Transcript of Records and that I have actually earned the units
indicated therein. As required, the Bureau of State Colleges and Universities has
been furnished with authentic copies of the sworn statement and its enclosures.
_____________________
Teacher 1
SUBSCRIBED AND SWORN TO before me this ______ of in
Pasig City affiant exhibiting His/Her Residence Certificate No.
_______________ issued at Pasig City on ______________.
___________________________________
Signature of Person Administering the Oath
Republic of the Philippines
Department of Education
National Capital Region
Division of Pasig City
District I, Pasig I
NAGPAYONG ELEMENTARY SCHOOL
School
EQUIVALENT RECORD FORM
NAME: ________________________ Date of Birth: ____________ Employee No: _________
Authorized Position Title: Teacher 1 Form No._____________ PSI HP Blg. _________
Authorized Salary: _ _________ Item No.: _____________________________ CY: 2013
I. EDUCATIONAL ATTAINMENT AND CIVIL SERVICE ELIGIBILITY:
Title, Degree or Name of Institution Year Civil
Highest Grade Received Service Rating Date of
Examination
Attained Eligibility
II. SERVICE RECORDS (Attached Duly Certified Service Record)
III. EQUIVALENT UNITS:
A. Total No. of year in Teaching: (Public Only) _________ Equivalent ______
B. Degree to Degree Equivalent _____ MAED Equivalent ______
C. Areas of Equivalent: School Year: No. of Units: Description:
3. Professional Study ______ ______ MAED. Educ. Management
4. Teaching Experiences
a. Public Schools _________________
b. Private Schools ___ _ __
3. Admin. Supervisory Experience
c. Public School _________NA___________
d. Private Schools _______ NA __________
4. Others: (Seminars, Workshop, etc.) (See attached page)
TOTAL: _________________
________________________
ZENAIDA G. SAN BUENAVENTURA Teacher’s Signature
Principal CELIA C. PAULINO
Coordinating Principal
LATEST EFFICIENCY RATING: VS School: Nagpayong Elementary
NOTE: Teachers DO NOT WRITE BELOW District: I, Pasig I
IV. Division Action Date Range Salary Salary
Processed Assignment Range Schedule REMARKS
RECOMMENDING APPROVAL:
___________________
Asst. Schools Division Superintendent
Officer – In - Charge
V. DEP-ED and REGIONAL OFFICE ACTION: _____________________________________
Classification _____________________ Range ___________________________
Date Approved Processed ____________ Post Audited at Range ______________
(For future Reference)
_________________________ _______________________
Regional Director Evaluator
VI. DEP.ED. PROPER ACTION TITLE: _________________________
_________________________________ Salary: _________________________
Surname, First Name, Middle Name
