Republic of the Philippines

Department of Education
Region VIII
DIVISION OF EASTERN SAMAR
Borongan
________________
Date
APPOINTMENT PROPOSAL

A. THE EXISTING VACANCY: ( To be filed up by the Div. Office )

1. Name of Incumbent New Item No. 4
Page 5
Date of Publication 5
2. Civil Service Eligibility ____________________________________________________________________
3. Highest Degree Earned ____________________________ Major ___________ Minor_____________
4. Station (School) Grade/Year _________________________
5. Period of Vacancy ________________________________ Cause _____________________________
B. THE RECOMMENDEE:
1. Name Sex Civil Status d
2. Maiden Name (if married) ______________________________________________________________
3. Residence y
4. Highest Degree Earned When 2
Where Major Minor_______________
5. Civil Service Examination Passed:
Title of Examination Place Date Rating
y
6. Special Qualifications ____________________________________________________________________
7. Length of Teaching Experience Latest Performance Rating ___________
8. Latest salary received per annum ____________________ Effective ___________________________
9. Rank in the District _______________________________ Category ___________________________
10. C.S. Status of Appointment ________________________ First Day of Service ___________________
C. REMARKS: ____________ _______ __
__________________ _ __
_________________ _ __

Prepared by: Recommending Approval:

HENRIETTA T. MANAGBANAG, Ph.D. A

Principal/School Head OIC-Asst. Schools Division Superintendent

Recommended by: APPROVED:

___________________ __ BERNARDO A. ADINA, CESO VI A

District Supervisor Schools Division Superintendent

Copy furnished:
Asst. Schools Div. Supt.
District Supervisor
Plantilla Clerk
Record Section
Teacher Concerned

Pertinent Paper’s needed:

Original Appointment: Promotion: Reclassification:

1. CS Form 212 with ID photo 1. CS Form 212 with ID photo 1. PAL

2. CS Form 211 (Med. Certificate) 2. Form 32 (Panunumpa) 2. CS Form 212 w/ ID photo
3. Form 32 (Panunumpa) 3. Form 1 3. Panunumpa
4. Form 1 4. Transcript of Records (authenticated) 4. Form 1
5. Transcript of Records (authenticated) 5. PRC License-duly authenticated 5. Transcript of Records (duly authenticated)
6. PRC License-duly authenticated 6. Report of Rating-duly authenticated 6. PRC License-duly authenticated
7. Report of Rating-duly authenticated 7. PRC Board Certificate-duly authenticated 7. Report of Rating-duly authenticated
8. PRC Board Certificate-duly authenticated 8. Appointment 8. PRC Board Certificate-duly authenticated
9. Asstes and Liabilities 9. Performance Rating for the last three (3) 9. Appointment
10. NBI Clearance rating periods 10. Ranking
11. Division Ranklist 10. Updated service record 11. In Service Training
12. Authority to Fill 11. ERF (for T2 and T3)L 12. Updated Service Record
13. Performance Rating for the last three (3)
Rating Periods