NOT FOR SALE R epublic of the Philippines PRC OPTForm No.

101-2
This form is pre-numbered (Rev. 04-2011)
REPRODUCTION Professional Regulation Commission
IS NOT ALLOWED
Manila
PASTE HERE TEACHERS APPLICATION FORM (TAF)
PASSPORT SIZE PHOTO
with COMPLETE Name Tag
in plain white background
CHECK MAJOR:
SECONDARY ENGLISH AGRICULTURE & FISHERY ARTS
PERRC NO. _________
(Permanent Examination and
Registration Record Card)
(taken within 3 mos.)
SOCIAL STUDIES FILIPINO BIOLOGICAL SCIENCES
MATHEMATICS MAPEH PHYSICAL SCIENCES
1ST TIMER (NEW)
Scanned/Photocopied
picture not acceptable VALUES EDUCATION TLE/TECHNOLOGY EDUCATION REPEATER
WARNING: This application must be filled out personally by the applicant. All documents submitted shall form part of the records of this Commission
and are subject to verification. Any false statement or misrepresentation made in this application is a ground for disqualification and criminal
prosecution/administrative sanction for falsification. PERSONAL APPEARANCE SHALL BE REQUIRED IN THE FILING OF THIS APPLICATION.
Part I – PERSONAL INFORMATION
LAST NAME FIRST NAME MIDDLE NAME

PERMANENT MAILING ADDRESS (House No., Street, Town Prov./City) ZIP CODE PRC RURBAN CODE (Town/City/Prov.)

Gender CITIZENSHIP CONTACT NUMBERS (LANDLINE & MOBILE) / E-MAIL ADDRESS

MALE FEMALE
Civil Status DATE OF BIRTH PLACE OF BIRTH (City, Town Province) PRC RURBAN CODE (Town/City/Prov.)
SINGLE MARRIED WIDOW/ER

SPOUSE NAME & CITIZENSHIP FATHER’S NAME & CITIZENSHIP MOTHER’S MAIDEN NAME & CITIZENSHIP

HAVE YOU EVER BEEN CONVICTED IN A FINAL JUDGMENT BY ANY COURT, MILITARY TRIBUNAL OR ADMINISTRATIVE BODY?
YES NO (If yes, attach hereto a copy of the decision)
Part II – EDUCATIONAL INFORMATION
MAJOR FIELD COURSE DATE GRADUATED NAME OF SCHOOL SCHOOL
COURSE COMPLETED LOCATION
OF STUDY CODE (mm/yyyy) CODE

BACHELOR’S
DEGREE
FOR Equivalent
Non-BSED No. of units
Graduates in Prof. Ed.
GRADUATE
DEGREE
Part III – PREVIOUS LICENSURE EXAMINATION FOR TEACHERS (LET) TAKEN
LAST MONTH & YEAR PLACE OF EXAMINATION STATUS CODES (REFER AT THE BACK)
EXAMINATION
TAKEN Manila Others:__________________ EX CODE: _______ NX CODE: _______

I HEREBY CERTIFY that the information and/or ACTION TAKEN ACTION TAKEN BY THE BOARD
statements in this application including the exhibits submitted in BY THE APPLICATION PROCESSOR APPROVED DISAPPROVED
support thereof are all true and correct of my own knowledge, Remarks: ___________________________ Remarks: ___________________________
and that I am fully aware that any false information or statement
in this application or in its attachments shall render me liable for ____________________________________ ____________________________________
criminal prosecution and /or administrative sanction.
Processed by: ________________________ Chairman: _______________ Date________
I AM WILLING TO BE SUBJECTED TO A VALIDATING Date: _______________________________ Member: ________________ Date________
EXAMINATION IN CASE THE TEST RESULTS IN MY PLACE OF ACTION TAKEN ACTION TAKEN
EXAMINATION ARE STATISTICALLY IMPROBABLE. BY THE CASH SECTION BY THE ISSUING OFFICER

RIGHT THUMBMARK Amount: ____________________________ Remarks: ___________________________

____________________________
O.R. No: ____________________________ ____________________________________
Signature of Applicant
Date: ______________________________ Issued by: ___________________________
____________________________
Date Accomplished Cashier: ___________________________ Date: _______________________________

Subscribed and sworn to before me this ____ day of _______________ 20____ at ______________. Affiant applicant exhibited to me
his/her Community Tax Certificate No. _______________ issued at _________________ on _________________.

PRC Administering Officer

Documentary
Administration of Oath is FREE (Office Order No.2009-377 & 2009-379 both dated September 3, 2009
Stamp
Republic of the Philippines
PROFESSIONAL REGULATION COMMISSION
Manila

PASTE HERE
PASSPORT SIZE PHOTO
with COMPLETE Name Tag
in plain white background
(taken within 3 mos.)
Scanned/Photocopied
picture not acceptable
APPLICATION STUB (This also serves as your Notice of Admission)
Mr./Ms. ______________________________________________ MAJOR:
This is to inform you that your application for the SECONDARY (FOR PRC USE ONLY)
Teacher Licensure Examination to be given on SEPTEMBER 25, 2011 ACKNOWLEDGEMENT ON THE RECEIPT OF
has been CONDITIONALLY APPROVED PENDING FINAL REVIEW TEST BOOKLETS & ANSWER SHEETS
AND VERIFICATION of your credentials.
Very truly yours, I acknowledge receipt of the test booklets
& answer sheets of the above-named
_________________________ examinee on the subjects indicated below:
PRC Issuing Officer / Date
Room Watcher’s Signature Date

General Ed. ______________ ________

Professional Ed. ______________ ________

FAILURE TO SUBMIT THE EVALUATED APPLICATION FORM TO THE
PERRC NO. __________ NOTE: ISSUING OFFICER WILL EXCLUDE THE APPLICANT FROM THE LIST
OF EXAMINEES AND FORFEITURE OF THE AMOUNT PAID.
Major ______________ ________
 REQUIREMENTS

• Original and photocopy of Birth Certificate issued by the National Statistics Office (NSO) in security paper

• Original and photocopy of Marriage Certificate issued by NSO in security paper (for married female applicants)

For NON-AVAILABILITY OF RECORDS - Negative Certification issued by NSO and Certificate of Live Birth/Marriage
from the Local Civil Registrar (LCR) duly authenticated by authorized NSO Statistician

For NON-READABLE entries in NSO Birth/Marriage Certificate - A clear copy of LCR Form 102 or Form 1A duly
signed/certified by the Local Civil Registrar

• FOR EDUCATION GRADUATES: Original and photocopy of the Official Transcript of Records with SCANNED
PICTURE, remarks “FOR BOARD EXAMINATION PURPOSES ONLY”, bearing the exact date of graduation and
Special Order Number

• FOR NON-EDUCATION GRADUATES: Original and photocopy of the Official Transcript of Records for degree
earned bearing the exact date of graduation and Special Order Number and Official Transcript of Records for 18
units in Professional Education courses with SCANNED PICTURE, remarks “FOR BOARD EXAMINATION PURPOSES
ONLY”

• Original and photocopy of College Diploma if exact date of graduation is not indicated on the Official Transcript of
Records

• CHED recognition or permit to operate for graduates of new schools/programs

• Three (3) recent identical copies of passport size pictures in plain white background with complete name tag

• One (1) piece window envelope with metered postage stamp for ordinary mail (for Report of Rating)

• Examination fee of PhP900.00

• Current Community Tax Certificate (Cedula)

INSTRUCTION IN APPLYING FOR EXAMINATION

1. Secure Teachers Application Form (TAF) from the PRC Public Assistance Unit (PAU) at the ground floor.
2. Present duly accomplished TAF and required documents to processor at OPT-Application Windows for evaluation
and issuance of Permanent Examination and Registration Record Card (PERRC).
3. Proceed to PRC Customer Service Center for documentary stamp and window envelope with metered postage
stamps.
4. Pay examination fee at the Cashier. Get Official Receipt.
5. Submit ALL DOCUMENTS to Issuing Officer at OPT-Application Windows or other designated windows for issuance
of Application Stub and Program of Examination.
6. Keep Application Stub and Official Receipt and present them to proctors on examination day.
7. Verify from the PRC Website at www.prc.gov.ph or Masterlist posted at the various filing centers two to
three days before the examination day, for the Room Assignments.

INSTRUCTION IN FILLING-UP THE CODES

1. Refer to the MASTERLIST OF ADDRESS /RURBAN CODES posted at the premises of the filing center for
the CODES of the Town, City or Province of your Residence and Postal Address and Place of Birth (This is
different from the ZIP CODE)
2. Refer to the MASTERLIST OF SCHOOL CODES also posted at the filing center for the
School/College/University and Location
3. Refer to the MASTERLIST OF COURSE CODES for the Course Code
4. For STATUS CODES, use the following:

a. EX CODE - Examination Type Code

Print “1” for Complete/First Timer and “2” for Repeaters

b. NX CODE - Number of Times Taken

Print “0” for None
Print “1” for Once
Print “2” for Twice...and so on

IMPORTANT

1. Keep this stub with you. Application Number will be used when you fill out the Identification Sheet on the day of
examination (present this stub when you verify your test results/apply for registration).
2. Verify from the PRC Website at www.prc.gov.ph or Masterlist posted at the various filing centers two to
three days before the examination day, for the Room Assignments.
3. Bring pencits (No. 1 or 2), ballpen ( with black ink only), one piece long brown envelope, one long transparent
plastic envelope, this stub and Official Receipt with you in the examination room.
4. Report to your school assignment before 6:30 am on examination day. Late examinees will not be admitted.
Failure to come on your scheduled examination will mean forfeiture of examination fee.
D-OPT-SAT/CLC
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