CHED FACULTY DEVELOPMENT PROGRAM II

Name of Applicant Scola!" ###########################################

SHEI$" ############################################################
P!o%!am applie& fo!" #################################################
Doc'ment( S')mitte&"
Document/s (All must be ORIGINAL unless indicated as
photocopy)
Complied
Not
Complied
Date Complied
F
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*+ D'l, Accompli(e& Scola!(ip Application Fo!m (A1)
-+ Recommen&ation Fo!m (A2)
.+ Ce!tification f!om Scool Hea& (A3)
/+
Rei!in% A%!eement Fo!m (A4) 0if not pe!manent in
SHEI1
2+ SHEI In(tit'tional Fac'lt, Plan (A5)
3+
T!an(c!ipt of Reco!&( 0fo! e4e!, co'!(e ta5en" 6A76S8
MA7MS8 'nit( ea!ne&1 9 Photocopy
:+ S'ppo!tin% Doc'ment( an& Ce!tification(
Li(t of co'!(e( offe!e& ), SHEI$
Total Colle%e7Uni4e!(it, En!ollment 0fo! -
!ecent te!m(1
Teacin% Loa& 0fo! - !ecent te!m(1 9
Photocopy
Ce!tification tat %!antee a( no pen&in%
a&mini(t!ati4e ca!%e(
Ce!tification tat %!antee a( no pen&in%
(cola!(ip p!o%!am )ein% 'n&e!ta5en
Ce!tificate of Emplo,ment in&icatin% te
follo;in%"
a+ Official De(i%nation
)+ Stat'( of Emplo,ment 0F'll<Time7Pa!t<Time1
c+ Ten'!e 0Pe!manent8 P!o)ationa!,8 Cont!act'al
o! Tempo!a!,1
&+ Date i!e&+
=+ Me&ical Ce!tificate
Docto!>( Ce!tificate 0to )e a&mini(te!e& ), a
Go4e!nment p,(ician1
U!inal,(i( 0;itin * mont 4ali&it,1
Fecal,(i( 0;itin * mont 4ali&it,1
Complete 6loo& Co'nt 0;itin * mont 4ali&it,1
?<!a, !e('lt 0;itin 3 mont( 4ali&it,1
@+
N6I 0;itin * ,ea! 4ali&it,1 o!
Police Clea!ance 0;itin * mont 4ali&it,1
*A
+
6i!t Ce!tificate 0I(('e& ), NSO1
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*+ Si%ne& Scola!(ip Cont!act 02 copie(1
-+ Co<ma5e! Un&e!ta5in% 02 Nota!iBe& copie(1
.+ Potocop, of te Income TaC Ret'!n of Co<ma5e!
/+
Potocop, of an, 4ali& ID7Pa((po!t of all te
(i%nato!ie( in te cont!act
2+ App!o4e& Plan of St'&,
3+
Ce!tification of F'll<Time St'&, Lea4e (i%ne& ), te
Hea& of te In(tit'tion 0fo! f'll<time (cola!( onl,1
$SHEI 9 Sen&in% Hi%e! E&'cation In(tit'tion
Pict'!e of
Applicant
0D!ite ,o'! name at te )ac5
of te pict'!e1