Department of Education Regional Office VIII (Eastern Visayas)

Republic of the Philippines

Department of Education
REGION V III-EASTERN VISAYAS
Division of Eastern Samar
School________________________

EQUIVALENT RECORD FORM (ERF)

Name:______________________________________________ Date of Birth_________________Sex_________
(Surname) (Given) (Middle Name)
Employee No.:_________________________Authorized Position Title (Present):__________________________
Item No.______________________________P.D. No.______________Authorized Salary___________________

I. Educational Attainment and Civil Service Eligibility

Degree/Course Highest Name of School or Year PRC/CSC Rating Date of

Educational Attainment Institution Received Eligibility Obtained Conferment/
Examination

II. Service Record: Attached duly Certified Service Record

III. Equivalent Units:
A. Total No. of years teaching: (Public only)________________Equivalent__________________
B. Degree-to-Degree Equivalent: (Present Degree)__________Equivalent__________________
C. Areas of Equivalents: School Year No. of Units Description
1. Professionals Study ___________:____________:____________________________
2. Teaching Experience
a.Public School ___________:____________:____________________________
b. Private School ___________:____________:____________________________
3. Others (Seminars,workshops, etc.)____________________________________________

TOTAL:_____________________________________________________
PERFORMANCE RATING (Latest Rating Period):___________________________

__________________________
Teacher’s Signature
Endorsed by:

_____JOSE GIL J. JARGUE___________

School Head
NOTE: (Teachers do not write below)
-----------------------------------------------------------------------------------------------------------------------------------------------------
IV. Division Action:

Classification Date Range Assignment Salary Scheduled Remarks

Processed Grade Salary

Certified Correct: Recommending Approval:

CARMELITA C. ALJIBE, MPA BERNARDO A. ADINA

Administrative Officer V Schools Division Superintendent

Approved:
Department of Education Regional Office VIII (Eastern Visayas)

EVELYN R. FETALVERO, CESO VI

Regional Director