SCHOOL SCREENING COMMITTEE FORM for TEACHER I

(COMPLETENESS, VERACITY, ACCURACY AND AUTHENTICITY OF DOCUMENTS)

Name of Teacher Applicant

SURNAME:_____________________ FIRST NAME:_________________ MIDDLE NAME:_______________________
School/District Applied for:________________________________________________________
Applying as Teacher I in ( ) Kindergarten ( ) SPED ( ) Elementary ( ) Secondary, Major:_______________________

IN THIS ORDER/ARRANGEMENT: Completenes Veracity Remarks

s Accurac Authenticit
y y
A. CSC Form 212 (Revised 2005) in two copies with the latest
2×2 ID picture.
B. Certified photocopy of PRC Professional Identification card
C. Certified photocopy of ratings obtained in the Licensure
Examination for Teachers/ Professional Board Examination for
Teachers
D. Certified copy of transcript of records.
Note: A customized MS Excel format to compute the GWA can be
downloaded at tinyurl.com/ISABELAAPPLICANT2. The
applicant must use it to compute the weighted average. Print and
submit a hardcopy. A softcopy must be sent through the link
tinyurl.com/GWAISABELA

E. Copies of Service Records, Performance Rating, and School

Clearances for those with Teaching Experiences. (if available)
F. Certificates of specialized training, if any
G. Certified copy of the Voter’s ID and or any proof of residency
as deemed acceptable by the School Screening Committee
H. NBI clearance
I. Certificate of Employment
J. Omnibus certification of authenticity and veracity of all
documents submitted, signed by the applicant
GWA General Weighted Average (do not include the failed, dropped, incomplete grades)

Verified and Certified by: (refer to DO 7, s. 2015 composition for the SSC)

_________________________________ _______________________________
Member Member

_________________________________ _______________________________
Member Member

______________________________
Chairperson