Experience Verification Form SOUTH CAROLINA Offfice of Educator Services 8301 Parklane Road STATE DEPARTMENT asl ta aeel Eee OF EDUCATION (803) 896-0325 | Call Center certification @ed.se.gov | Email The following must be completed by the Educator. For information on experience credit. please refer to State Board Regulation 43-57.2 and the Guidelines for Granting Experience Credit Last Name: CABE First Name: JOCEL MI: D_ Former Name: N/A. Last Four Digits of Social Security Numb. A SC Certificate ID (if available Address: LATIGO DR., CONCEPCION, BARAS, RIZAL. Phone: 09685259881 ‘The following must be completed by the employer's Human Resources/Payroll Personnel. ‘Qualifing verifiers must have direct access to detailed personnel employment records, including days worked. Name of Employing Entity: DEPARTMENT OF EDUCATION ‘Type of Entity (Definitions on Page 2): ll Public School/District C0 Institution of Higher Education (IHE) O Private School CO Education Regulatory Entity Industry O Service Provider O or Non-Education Based School Accreditation (If Applicable): C] Regionally Accredited Ml State Education Agency Accredited CO Other Accreditation: Please provide a detailed record, including time worked each school year (instructions available on page 2): Begin Date| End Date | Days | Hours |Certif THE Semester ~ Position Tile, Subject Taught, and ct Service | of Service | Worked Per] Worked Per| Required | Hours Taught Ages or Grades Serviced ‘urn | nrPDr| School Year| Day AN) | maton | te cher pried rma marion plese ule he sen (lady dprvorledora whch teehee ep cron [Can (08/19/2019 Present | 203 [ieee ‘Teacher I, Science and TLE, 11+ years old = | | | 7 a | | | HRPayroll Personnel Signature: Date: Oct.7,2022_ Printed Name: REYISH FRANCOIS C. CAPISTRANO! Title: ADMINITRATIVE AIDE I Email Address: reyishfrancose apistrano@deped gov.ph Adress: (Baras Elementary School) JP Rizal St, Concepcion, Bars, Rizal ___ Phone: 0939 5526338 Employer Website Address: Please affix a seal, stamp, or business card if available. Page 1