Registration Officers Copy

Republic of the Philippines

Department of Education
Region XI
SCHOOLS Division of Island Garden City of Samal
Peñaplata, District II, Island Garden City of Samal, Davao del Norte

ENGLISH PROFICIENCY TEST (EPT) for TEACHER 1 APPLICANTS

Last Name: Sanchez First Name: Jeymarie Middle Name: Supilanas

Address: Purok 5, Tagbitan-ag, Island Garden City of Samal Religion: Catholic
Date of Bith: March 4, 1993 Age: 30 Sex: Fem
Degree: Bachelor of Elementary education Major: GENERALIST Year Graduated: 2018-
Eligibility: Let Passer Date Obtained: 09/2019 Rating: 84.8
Education Background
LEVEL NAME OF SCHOOL ADDRESS SCHOOL YEA
ELEMENTARY Tagbitan-ag Elementary School Island Garden City of Samal 2004-2005
HIGH SCHOOL Tagbitan-ag National Highschool Island Garden City of Samal 2008-2009
University of Mindanao Peňaplata College sland Garden City of Samal 2018-2019
COLLEGE

PWD. Yes: No: x (If Yes Please Specify)

Testing Center: Date of Examination:

Applicant's Cellphone number: 9777902846 Email Add: jeymarie1993@gmail.com

JEYMARIE S. SANCHEZ
Applicant's Signature Over Printed Name

Applicant's Copy
Republic of the Philippines
Department of Education
Region XI
SCHOOLS Division of Island Garden City of Samal
Peñaplata, District II, Island Garden City of Samal, Davao del Norte

ENGLISH PROFICIENCY TEST (EPT) for TEACHER 1 APPLICANTS

REGISTRATION FORM
Sanchez Jeymarie Supilanas
Last Name First Name Middle Name
Testing Center: Date of Examination:
Applicant's Cellphone number: 9777902846 Email Add: jeymarie1993@gmail.com
PWD. Yes: 0 No: x (If Yes Please Specify)
Validated by:
JUNELO C. FORNOLLES
Division Testing Coordinator
Registration Officer's Signature Over Printed Nam
INSTRUCTIONS TO THE EXAMINNEES:
1. Bring with you this form during the examination day for verification, together with (1) valid Identification Card

2. Arrive at the Testing Center thirty (30) minutes before the time.

3. Please adhere to health safety protocols by wearing face mask, face shield and observe social distancing

4. Please wear appropriate decent attire, Strictly NO WEARING OF SHORTS, SLEEVELESS and SLIPPERS
5. Submit this form in Hard Copy to Schools Division Office and a Soft Copy with E-Signature to the link to be provided by Division Testing C
 ame: Supilanas

Female
2018-2019
84.80%

SCHOOL YEAR
2004-2005
2008-2009
2018-2019

@gmail.com

NCHEZ
r Printed Name

pilanas
dle Name

@gmail.com

OLLES
ordinator
Over Printed Name
by Division Testing Coordinator