Republic of the Philippines

Department of Education
Region III

SCHOOLS DIVISION OF NUEVA ECIJA

Old Capitol Compound, Burgos Avenue, Cabanatuan City, 3100

INDIVIDUAL RATING FORM FOR HEAD TEACHER III (Elementary - Natural Vacancy)
Name: ________________________________________ Designation: __________________________Date: ________________
School: _______________________________________ District: ________________ Mobile Number: ____________________

PERTINENT PAPERS
☐Letter of Intent ☐Service Record ☐Eligibility/PRC License
☐Personal Data Sheet ☐Transcript of Records/Diploma ☐Certification of Trainings Attended
☐Latest Appointment ☐Performance Rating for the last 3 Years ☐Certification on Authenticity Veracity of Documents

QUALIFICATION STANDARDS
☐Education Bachelor's degree in Elementary Education; or Bachelor's degree with 18 professional education units
☐Experience HT for 2 years; TIC for 2 years; or Teacher for 5 years
☐Training 24 hours of relevant training
☐Eligibility RA 1080 (LET or PBET)

I. CRITERIA Points Documents Presented

A. Performance Rating 30 ☐Very Satisfactory for the Last Three Years
☐9.4 - 10 30 Pts. ☐7.3 - 7.9 15 Pts. ☐Performance Rating/RPMS
☐8.7 - 9.3 25 Pts. ☐6.6 - 7.2 10 Pts. ☐Certification of Computation for the last three years with average and weight
☐08.0 - 8.6 20 Pts. For CB-PAST x 2.5 For RPMS x 2
B. Experience 10 ☐Service Record ☐Certificate of Employment
☐Relevant to the duties and functions of the ☐Certification ☐Latest Appointment
position to be filled (1 point per year). ☐Computation ☐Designations/Revocation
C. Outstanding Accomplishments 25
C.1. Outstanding Employee Award (5 pts.)
☐Awardee in the School 1 pt. ☐Certificate of Recognition
☐Nomination in the division/awardee in the district 2 pts. ☐Memorandum of the Search
☐Nomination in the district/awardee in the division 3 pts. ☐Invitation/Program
☐Nomination in the department/awardee in the region 4 pts. ☐Pictures of the Awarding Ceremony
☐National Awardee 5 pts. ☐Pictures of Trophy/Plaque
GSP Award BSP Award
☐National Level Award 2.0 pt. Service Award for Unit Leaders Merit/Usa/Tamaraw Award ☐Certificate of Recognition
☐Regional Level Award 1.75 pt. ☐Bronze 0.25 pt. ☐Bronze 0.25 pt. ☐Memorandum of the Search
☐Council Level Award (Gold) 1.50 pt. ☐Silver 0.50 pt. ☐Silver 0.50 pt. ☐Invitation/Program
☐Council Level Award (Silver) 1.25 pt. ☐Gold 0.75 pt. ☐Gold 1.00 pt. ☐Pictures of the Ceremony
☐Council Level Award (Bronze) 1.00 pt. ☐Cou 0.50 ☐Reg'l 0.50 ☐Nat'l 0.50 ☐Pictures of the Plaque
C.2. Innovations (5 pts.)
☐Conceptualized 1 pt. ☐Innovative work plan properly documented, approved by SDS
 ☐Started the implementation 2 pts. ☐Approved Work Plan
☐Fully implemented in the school 3 pts. ☐Certification that it is being started/fully implemented or adopted
☐Adopted in the district 4 pts. ☐Pictures of Project Implementation
☐Adopted in the division 5 pts. ☐Attendance/Documents of utilization
C.3. Research and Development Projects (10 pts.)
☐School Level 6 pts. ☐Approved Research duly signed by authorized SDO officials
☐District Level 8 pts. ☐Approved Research Proposal duly signed by authorized SDO officials
☐Division Level 10 pts.

C.4. Publication/Authorship (5 pts.)

☐Articles published in a journal/newspaper 2 pts. ☐Original Newspaper/Magazine/Journal

magazine of wide circulation ☐Book with ISBN No.

☐C0-Authorship of a Book (shall be divided by the number of authors) ☐Certification of Published Articles in the Division website
☐Sole Authorship of a Book 5 pts.
C.5. Consultant/Resource Speaker in Trainings/Seminars/Workshops/Symposia (5 pts.)
☐District Level 1 pt. ☐Certificate of Recognition
☐Division Level 2 pts. ☐Memorandum of the Training/Seminar/Workshop
☐Regional Level 3 pts. ☐Other supporting documents i.e, travel order, pictures
☐National Level 4 pts. ☐Invitation of the Agency
☐International Level 5 pts. ☐Pictures while having the training as Speaker/Trainer
D. Education 10 ☐Diploma with SO number of Board Resolution
☐Completed Academic Requirements for Master's Degree 6 pts. ☐Transcript of Records ("Compre Passed" in the TOR)
☐Master's Degree 7 pts. ☐Certificate of Completion from the Registrar with Prospectus
☐Completed Academic Requirements for Doctoral Degree 9 pts. ☐Enrolment form, Class cards, etc.
☐Doctoral Degree 10 pts. ☐Permit to Study
E. Training 5
☐Participant in Specialized Training 10 pts. ☐Certificate of Participation
Scholarship programs, Short Courses, Study Grants shall be ☐Memorandum of the Training
given one (1) point for every nonth of attendance but ☐Other supporting documents i.e, travel order, pictures
not to exceed five (5) points. ☐Official Receipt of the Training Program
☐Participant in three (3) or more training activities ☐Authority to Travel
in each level conducted for at least three (3) days not ☐Apictures of Attendance in the Training
credited during the last promotions:
☐District Level 2 pts. ☐Chair/Co-Chair in a technical/planning committee

☐Division Level 4 pts. ☐District Level 2 pts.

☐Regional Level 6 pts. ☐Division Level 4 pts.

☐Participant in one (1) trainingconducted for at least three (3) days ☐Regional Level 6 pts.
not credited during the last promotions: ☐National Level 8 pts.

☐National Level 8 pts. ☐International Level 10 pts.

 ☐International Level 10 pts.

E.Potential (5 points) 5 pts.

Result of the Panel Interview

F. Psychosocial Attributes and

Personality Traits (5 points) 5 pts. Result of the Test

TOTAL
CONFORME: CERTIFIED CORRECT:

__________________________________ __________________________________
Signature Over Printed Name of Applicant PSB Member, Evaluation Committee
Date: _________________

Reference: DepED Order No. 42, s. 2007

ral Vacancy)
e: ________________
__________________

city of Documents

onal education units

SCORE

with average and weight

ertificate of Recognition
emorandum of the Search
vitation/Program
ctures of the Ceremony
ctures of the Plaque
d or adopted

ized SDO officials

the Division website