Republic of the Philippines

DEPARTMENT OF EDUCATION
REGION VI – WESTERN VISAYAS
DIVISION OF CAPIZ

EQUIVALENT RECORD FORM

NAME: __________________________________________________ Date of Birth: _______________ Sex: __________
(Surname) (Given Name) (Middle Name)
Employee No.: ________________________ Authorized Position Title: _________________________
Item No. _____________________________ P.D. No.:______________________ Authorized Salary:_____________

I. Educational Attainment and Civil Service Eligibility:

Titles, Degrees, or Highest Grades Name of Institution Year Received Civil Service Rating Date
Attained Examination

II. Service Records (ATTACH DULY CERTIFIED SERVICE RECORD)

III. Equivalent Units

A. Total Number of Years in Teaching: (Public Only) ___________________ Equivalent: _________________

B. Degree to Degree Equivalent (Present Degree) _____________________ Equivalent: _________________
C. Areas of Equivalent :School Year :No. of Units : Description

1. Professional Study :_______________________:________________:___________________

2. Teaching Experiences
a. Public Schools :_______________________:________________:___________________
b. Private Schools :_______________________:________________:___________________

3. Adm.Supervisory Eperience
a. Public Schools :_______________________:________________:___________________
b. Private Schools :_______________________:________________:___________________
4. Others (Seminars, Workshops,etc.) :_______________________:________________:___________________
:_______________________:________________:___________________

TOTAL: :_______________________:________________:___________________

LATEST EFFICIENCY RATING __________________

ELPHEGE C. PACLIBAR __________________________________

Principal I Teacher’s Signature

NOTE: TEACHERS DO NOT WRITE BELOW

IV. Division Action

Classification Date Processed Grade Assignment Salary Grade Scheduled Salary REMARKS

RECOMMENDING APPROVAL: CERTIFIED CORRECT

Salvador O. Ochavo Jr., EdD, CESO V MA.SHARON S. BARRIENTOS

Schools Division Superintendent Administrative Officer

DepEd Regional Office Action:

REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF EDUCATION ________________________________
REGION VI – WESTERN VISAYAS CONTROL NO. ________________________________
DURAN ST., ILOILO CITY
POST AUDIT OF TEACHING POSITION
CLASS TITLE _____________
SALARY GRADE _____________
SUBJECT TO AVAILABILITY OF ITEM

FOR THE REGIONAL DIRECTOR: