Annex C: Checklist of Documentary Requirements

Name of Applicant: KASSANDRA B. CRUZ Application Code: HRUTP-23A-S-3979

Position Applied: SHS ENGLISH TEACHER School: COMMONWEALTH SENIOR HIGH SCHOOL
Education: (Please include Major/Specialization)
Bachelor: BACHELOR OF SCIENCE IN SCEONDARY EDUCATION MAJOR IN ENGLISH
Masteral: ____N/A_______________________________________________________________
Doctoral: ____N/A______________________________________________________________
Contact Number: 09273729957 Email: ckcruz.1521@gmail.com
Ethnicity: ____N/A _____________________________ Religion: ROMAN CATHOLIC .
Person with Disability ________ Yes ✔ No Solo Parent: ______ Yes ✔No
Source of Information about Vacancies: _REFERRALS .
(e.g. FB page, job website, school page, referrals, etc.)

Mark a ( ) check for each corresponding category, as evident in the submitted application.

Verification (to be filled-out by the HR

Personnel-in-Charge
Status of Submission
(To be filled out by
the applicant; check Status of
Basic Documentary if submitted Submission (Check
if complied) Remarks
Requirements
Letter of Intent addressed to the Schools
a Division Superintedent
Duly accomplished Personal Data Sheet
b and Work Experience Sheet
Photocopy of valid and updated PRC
c license/ID
Photocopy of Certificate of
d Eligibility/Report of Rating
e Photocopy of Transcript of Records
Photocopy of Certificate of Employment or
Contract of Service or duly signed Service
f Records, whichever is/are applicable
Photocopy of Performance Rating covering
1 year performance prior to the deadline of
g submission, if applicable
Photocopy of Relevant Trainings and
h Sepcialization
i Checklist of Requirements
j Omnibus Sworn Statement

Attested:

____________________________________________ __________________________
HR Personnel-in-Charge Date

DATA PRIVACY CONSENT

I hereby grant the Department of Education, Schools Division Office, Quezon City, the right to collect and
process of my personal information as stated above, for purposes relevant to the recruitment, selection
and placement of personnel of the Department and for purposes of compliance with laws, rules, and
regulations being implemented by the Civil Service Commission.

KASSANDRA B. CRUZ
Name and Signature of Applicant

MAY 18, 2023

Date