Republic of the Philippines

DEPARTMENT OF EDUCATION
REGION III-CENTRAL LUZON
Schools Division of Olongapo City
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EQUIVALENT RECORD FORM

(Submit in Five Copies)
Name: Date of Birth: , , Gender:
(Surname) (Given) (M.I.)

Employee No. : Authorized Position Title:

Item No. : SG: Authorized Annual Salary:

I. Educational Attainment

Masters Degree Completed/ Name of School Year Completed Equivalent

(write in full with Units Earned
specialization) (if not completed)

II. Years of Teaching Experience:

Private :
Public :

III. Trainings Attended

Title Inclusive Number of Sponsoring Agency
Dates Hours

IV. For Head Teacher Positions and Other Related Teaching Positions
Years of Experience in Present Position:

V. Latest Performance Rating:

(Teacher’s Signature)

VI. Schools Division Action (For Schools Division Evaluator Only)

Classification Date Range Salary Grade Salary REMARKS
Processed Assignment Schedule

Certified Correct: Recommending Approval:

AO IV-Personnel Schools Division Superintendent

Schools Division Evaluator

V. DepEd Regional Office Action

Classification: Post Audited Assignment:
Date Processed: Salary Grade :
Salary Schedule :
Remarks :

Approved:

Evaluator NICOLAS T. CAPULONG, Ph.D.

OIC-Assistant Regional Director