Republic of the Philippines

Office of the President

COMMISSION ON HIGHER EDUCATION
Expanded Tertiary Education Equivalency and Accreditation Program (ETEEAP)

ETEEAP APPLICATION FORM

INSTRUCTION:

Please type or print clearly, provide complete and detailed information required. Do not leave blank unanswered;
write “Not Applicable” as the case may be. All declarations that you make herewith are under oath. Discovery of any false
claim in this application form will disqualify you from participating in the program. Use additional sheets if necessary.

I. PERSONAL INFORMATION

1. NAME (Last Name, First Name, Middle Name)

_HERNANDEZ, RALF JOSEPH, GAMBA
2. Address : POBLACION 14, TINGLOY, BATANGAS
Code: 4023
3. Telephone No(s). : 09919718532
4. Birth Date : DECEMBER 07, 1988
5. Birthplace : STA CRUZ, MANILA
6. Civil Status : SINGLE
7. Sex : MALE Nationality : FILIPINO
8. Languages and Dialects Spoken : FILIPINO AND ENGLISH
9. Degree Program or field being applied for :
First Priority : BSBA
Second Priority : __N/A_____________________________________________
Third Priority : __N/A__________________________________________
10. Statement of your goals/objectives/purposes in applying for the degree.
My goal is to have a better opportunity if ever I get to finish the study. I don’t want to limit myself
just because I only graduated in a two year course. I want to prove to myself that I could do this
and it is not impossible.
11. Indicate how much time you plan to devote for personal learning activities so that you can finish the
requirements in the prescribed program. Be specific.
I am devoted in fulfilling this program 100%. I will find ways or make way just to make sure I
have enough time and not to miss any of my responsibilities as a student.
12. For overseas applicants, describe how you plan to obtain accreditation/equivalency. (e.g. when you plan to
come to the Philippines)
_________________________________N/
A______________________________________________________________________________________
_________________________________________________
13. How soon do you need to complete equivalency/accreditation?
_____ less than one (1) year _√___ 1 year
_____ 2 years _____ 3 years

II. EDUCATION:

This section will require you to provide information on your past formal, non-formal and informal
learning experiences.

1. Formal Education
Course/Degree Program
ASSOCIATE IN OFFICE
MANAGEMENT
Inclusive Dates of
Name of School/Address
Attendance
LYCEUM OF THE PHILIPPINES 2007-2009
UNIVERSITY-BATANGAS

Page 1 of 8
Property of CHED-ETEEAP
 Note : All entries should be supported by authenticated photocopy of appropriate certificates/documents obtained
from the institution through the program.

2. Non-Formal Education
Non-formal education refers to structured and short-term training programs conducted for a particular
purpose such as skills development, values orientation, and the like.
Inclusive Dates of
Title of Training Program Title of Certificate Obtained
Attendance
DISASTER RESILIENCE DISASTER RESILIENCE JULY 27, 2023
ORIENTATION ORIENTATION
FREE CIVIL SERVICE EXAMINATION CERTIFICATE OF COMPLETION FEBRUARY TO MARCH
REVIEW SESSIONS FOR COMPLETING THE FREE 2023
CIVIL SERVICE EXAMINATION
REVIEW SESSIONS

PROMOTING H-EALTH THROUGH I- A LECTURE ON THE BASIC COVID FEBRUARY 14, 2022
NFECTION C-ONTROL (PHIC): A 19 PREVENTION STRATEGIES IN
LECTURE ON THE BASIC COVID 19 THE WORKPLACE
PREVENTION STRATEGIES IN THE
WORKPLACE
MANAGING MENTAL HEALTH MANAGING MENTAL HEALTH DECEMBER 15-20, 2021
BENIPISYONG PHILHEALTH: BENIPISYONG PHILHEALTH: DECEMBER 13-15, 2021
“MAASAHAN, SAANMAN, “MAASAHAN, SAANMAN,
KAILANMAN” KAILANMAN”
WEBINAR SERIES ON FUTURES WEBINAR SERIES ON FUTURES NOVEMBER 8, 2021 TO
THINKING FOR ENHANCING THINKING FOR ENHANCING NOVEMBER 9, 2021
PUBLIC SECTOR PRODUCTIVITY PUBLIC SECTOR PRODUCTIVITY
WEBINAR SERIES ON WEBINAR SERIES ON OCTOBER 13, 2021 TO
PRODUCTIVITY AND QUALITY PRODUCTIVITY AND QUALITY OCTOBER 15, 2021
FRAMEWORKS IN THE PUBLIC FRAMEWORKS IN THE PUBLIC
SECTOR SECTOR
FOURTH QUARTERLY DIALOUGE FOURTH QUARTERLY DIALOUGE NOVEMBER 16, 2017
OF IHCP’S (HOSPITALS, ASC, FDC) OF IHCP’S (HOSPITALS, ASC, FDC)
FOR CY 2017 FOR CY 2017
1ST GMCL’S FIRE DRILL EXERCISE CERTIFICATE OF ATTENDANCE FEBRUARY 10, 2017
AND TRAINING IN THE 1ST GMCL’S FIRE DRILL
EXERCISE AND TRAINING
ON THE JOB TRAINING AT BOY CERTIFICATION OF COMPLETION MARCH 2, 2009
SCOUT OF THE PHILIPPINES OF 200 HOURS OF ON THE JOB
TRAINING
PERSONALITY DEVELOPMENT CERTIFICATE OF PARTICIPATION JANUARY 27, 2009
SEMINAR 2009 IN THE PERSONALITY
DEVELOPMENT SEMINAR 2009
FIFT NATIONAL OFFICE CERTIFICATE OF PARTICIPATION NOVEMBER 28, 2008
ADMINISTRATION STUDENT’S IN “THE S-FACTORS OF
CONVENTION SUCCESSFUL OFFICE
PROFESSIONALS”
SEMINAR ON PERSONALITY CERTIFICATE OF PARTICIPATION SEPTEMBER 20, 2008
DEVELOPMENT TO PERSONALITY
DEVELOPMENT
TRAINING COURSE IN SAP CERTIFICATION OF MARCH 15, 2008
BUSINESS ONE COMPLETETION FOR
COMPLETING TRAINING COURSE
IN SAP BUSINESS ONE
SEMINAR ON PERSONALITY CERTIFICATE OF PARTICIPATION SEPTEMBER 14, 2007
DEVELOPMENT TO PERSONALITY
DEVELOPMENT
Note : All entries should be supported by authenticated photocopy of appropriate certificates/documents obtained
from the institution through the program.

3. Other Certification Examinations

Please give detailed information on certification examinations taken for vocational and other skills.
Title of Certification Name/Address of Date Certified Rating
Page 2 of 8
Property of CHED-ETEEAP
 Examination Certifying Agency
CAREER SERVICE CSC 4, PANAY, QUEZON JULY 26, 2023 80.07
EXAMINATION- CITY
PROFESSIONAL
Note : All entries should be supported by authenticated photocopy of appropriate certificates/documents obtained
from the institution through the program.

III. PAID WORK AND OTHER EXPERIENCES

1. Post/Designation
SOCIAL INSURANCE ASSISTANT I
2. Inclusive Dates of Employment
From : February 16, 2021 to Present
3. Name and Address of Company
Calamba Local Health Insurance Office/CMC Annex Building Crossing, Real, Calamba City,
Laguna
4. Terms/Status of Employment
Job Order
5. Name and Designation of Immediate Supervisor
Ms. Ana Racquel M. Tiongco/Social Insurance Officer III
6. Reason(s) for moving on to the next job.
_____________________________________N/A______________________________________________
_______________________________________________________________________________________

7. Describe actual functions and responsibilities in position occupied:

Social Insurance Assistant I or P-AIMS (Philhealth Accounts Information Management Specialist
assists and monitor the group of Employers assigned. We conduct Employer Engagement
Activities to keep them abreast with the programs, policies and services of PhilHealth with
maximum of 90 percent target of the assigned employers. Increase collection Efficiency, Ensure the
compliances of requirements needed in different requests made by the employers. Payroll
verification, Updating contact details and other information needed to make the Employer’s Profile
complete. Issue Billing Statements to non-remitting Employers. Adopt appropriate reporting
format for our Monthly reports.
8. In case of self-employment, name three (3) reference persons:
_________________________N/A___________________________________
Note : Use another sheet if necessary, following the above format.

9. Post/Designation
Billing Staff/Benefit Staff
10. Inclusive Dates of Employment
From : October 5, 2016 to January 15, 2021
11. Name and Address of Company
National Highway Beside Walter Mart Banlic, Banlic, Cabuyao City, Laguna
12. Terms/Status of Employment
Regular
13. Name and Designation of Immediate Supervisor
Ms. Celeste Bayran/Head of Billing Section
14. Reason(s) for moving on to the next job.
Applied at PhilHealth.
15. Describe actual functions and responsibilities in position occupied:
As Billing Staff, We make sure to monitor the list of miscellaneous and other expenses of the
patient. We also check the list of requirements of the patient for the use of PhilHealth Benefits and
other HMO’s (Health Maintenance Organizations) benefits. Giving them partial Billing Statement
to make them aware of the status of their bills and provide them the Final Billing when their
Doctors request to bill them out.
16. In case of self-employment, name three (3) reference persons:
________________________N/A____________________________________
Note : Use another sheet if necessary, following the above format.
Page 3 of 8
Property of CHED-ETEEAP
 17. Post/Designation
Finance Department/Data Entry Operator/Data Controller
18. Inclusive Dates of Employment
From : August 18, 2014 to April 01, 2016
19. Name and Address of Company
Saudi BinLadin Group-Architecture, Building and Construction/Human Resources Division,
Jeddah, Kingdom of Saudi Arabia
20. Terms/Status of Employment
Contractual
21. Name and Designation of Immediate Supervisor
Mr. Moniem Mohammed/Department Head and Accountant
22. Reason(s) for moving on to the next job.
Disaster happened resulting to non-operation of the company.
23. Describe actual functions and responsibilities in position occupied:
Inputting data’s from the different vouchers given by the Accountants. Manually check the
number series of each voucher, making sure of its completeness. Render overtime for emergency
request of Accountants for the copy of vouchers. Assisting warehouse staff in collecting boxes of
vouchers.
24. In case of self-employment, name three (3) reference persons:
____________________________________________________________
__________________________N/A__________________________________
____________________________________________________________
Note : Use another sheet if necessary, following the above format.

25. Post/Designation
Membership Department-Data Controller II
26. Inclusive Dates of Employment
From : October 1, 2012 to August 13, 2014
27. Name and Address of Company
Philippine Health Insurance Corporation/CMC Annex Building, Crossing, Real, Calamba City,
Laguna
28. Terms/Status of Employment
Job order
29. Name and Designation of Immediate Supervisor
Ms. Ana Racquel M. Tiongco-Social Insurance Officer III
30. Reason(s) for moving on to the next job.
Urgent need for the study of sibling.
31. Describe actual functions and responsibilities in position occupied:
Frontline Duties and Universal counter for the needs of the member. We checked their information
in the system and make amendments according to their request. We make sure to correctly input
data in the system.
32. In case of self-employment, name three (3) reference persons:
_________________N/A___________________________________________
____________________________________________________________
____________________________________________________________
Note : Use another sheet if necessary, following the above format.

33. Post/Designation
Membership-Data Encoder I
34. Inclusive Dates of Employment
From : October 13, 2009 to October,01 2012
35. Name and Address of Company
36. Philippine Health Insurance Corporation/CMC Annex Building, Crossing, Real, Calamba City,
Laguna
Page 4 of 8
Property of CHED-ETEEAP
 37. Terms/Status of Employment
Job Order

38. Name and Designation of Immediate Supervisor

Ms. Ana Racquel M. Tiongco-Social Insurance Officer III
39. Reason(s) for moving on to the next job.
Promoted
40. Describe actual functions and responsibilities in position occupied:
41. Frontline Duties and Universal counter for the needs of the member. We checked their information
in the system and make amendments according to their request. We make sure to correctly input
data in the system.
42. In case of self-employment, name three (3) reference persons:
________________________N/A____________________________________
____________________________________________________________
____________________________________________________________
Note : Use another sheet if necessary, following the above format.

IV. HONORS, AWARDS, AND CITATIONS RECEIVED

In this section, please describe all the awards you have received from schools, community and civic
organizations, as well as citations for work excellence, outstanding accomplishments, community service, etc.

1. Academic Award
Name and Address of Conferring
Award Conferred Date Awarded
Organization
N/A N/A N/A

2. Community and Civic Organization Award/Citation

Name and Address of Conferring
Award Conferred Date Awarded
Organization
N/A N/A N/A

3. Work Related Award/Citation

Name and Address of Conferring
Award Conferred Date Awarded
Organization
“CONTRACTOR PERSONNEL OF THE YEAR PHILIPPINE HEALTH INSURANCE MARCH 22, 2013
2012” CORPORATION
“CONTRACTOR PERSONNEL OF THE YEAR PHILIPPINE HEALTH INSURANCE FEBRUARY 28, 2014
2013” CORPORATION

V. CREATIVE WORKS AND SPECIAL ACCOMPLISHMENTS

In this section, enumerate the various creative works you have accomplished and other special
accomplishments. Examples of these are inventions, published and unpublished literary fiction and non-fiction
writings, musical work, products of visual performing arts, exceptional accomplishments in sports, social,
cultural and leisure activities, etc. which can lead one to conclude the level of expertise you have obtained on
certain fields of interest. Include also participation in competitions and prizes obtained.

1. Description :
__________N/A_________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

2. Date Accomplished : _________N/A_______________

Page 5 of 8
Property of CHED-ETEEAP
 3. Name and Address of Publishing Agency (if written, published work), or an
Association/Institution which can attest to the quality of the work.
___________N/A__________________________________________
_____________________________________________________
Note : Use additional sheet if necessary, following the same format.

VI. LIFELONG LEARNING EXPERIENCE

In this section, please indicate the various life experiences from which you must have derived some learning
experience. Please include here unpaid volunteer work.

1. Hobbies/Leisure Activities
Leisure activities which involve rating of skills for competition and other purposes (e.g. “belt concept in
Tae-kwon-do) may also indicate your level for ease in evaluation. On the other hand, watching Negosiyete
on a regular basis can be considered a learning opportunity.
____________________________________________N/
A______________________________________________________________________________________
________________________________________

2. Special Skills
Note down those special skills you think must be related to the field of study you want to pursue.
Keyboarding skills, Stenography

Work-Related Activities
Some work-related activities are occasions for you to learn something new. For example, being assigned
to projects beyond your usual job description where you learned new skills and knowledge. Please do not
include formal training programs you already cited. However, you may include here experiences that can be
classified as on-the-job training or apprenticeship.

On-site visitation of the underprivileged is necessarily to maintain a good public service to the
Filipino people. We learned how PhilHealth is important and us as a Public servant in making sure
of giving support and to the National Health Insurance Corporation. First hand we hear from
them the actual thing that is happening and what we can be of help to them. To experience these
and make an impact to the people in need means we are giving back and make them feel how
important they are in the society.

Volunteer Activities
List only volunteer activities that demonstrate learning opportunities, and are related to the course you
are applying for credit. (e.g. counseling programs, sports coaching, project organizing or coordination,
organizational leadership, and the like)

One time, other project based were losing budget and we volunteer to make overtime every
Saturday without salary. This helped other project-based to keep their job in times of financial
burden in the Corporation.

Page 6 of 8
Property of CHED-ETEEAP
 Travels : Cite places visited and purpose of travel
Include a write-up of the nature of travel undertaken, whether for leisure, employment, business or other
purposes. State in clear terms what new learning experience was obtained from these travels and how it
helped you become a better person.

Employment abroad gave me a much further view of my importance especially to the company
I was assigned to. This experience is very life changing opportunity one can take. I get to
experience the hardships of being an overseas Filipino worker and I learn that loving your work
can sometimes be your escape from over thinking. I learned to focus, learning new things and be
welcoming to new ideas that help me to become more professional and knowledgeable.

VII. To sum up please write an essay on how your attaining a degree contribute to your personal development, your
community, your workplace, society, and country.

As a Public servant, it is necessary to be a good example to our people. Having a degree is very
important to maximize my capability and to ensure access to better opportunities. By obtaining the
Bachelor’s Degree, I can be promoted and live a life sure and not having constant fear of losing the job.
If I can attain the Degree, I can be more effective in the Public Service.

I declare under oath that, the foregoing claims and information I have disclosed are true and correct.
Done in 2023 , on this ____9th__ day of ______August_________.

Signed :

RALF JOSEPH G. HERNANDEZ

Printed Name and Signature of Applicant

Community Tax Certificate 14180407

Issued on FEBRUARY 14, 2023 at BUROL, CALAMBA CITY, LAGUNA.

Page 7 of 8
Property of CHED-ETEEAP

Qualifications of a Candidate
The basic qualifications of the candidate are the minimum
criteria for an applicant to qualify for admission to the
program. The deputized HEIs have the prerogative to add
on to these their own admission criteria.
1. The candidate must be a Filipino citizen.
2. The candidate must possess a high school diploma or
the PEPT placement equivalent to first year college.
The candidate must have graduated from high school or
obtained a PEPT placement at first year college. This
ensures that competencies for basic skills and functional
knowledge must have been obtained in preparation for
tertiary level education.
3. The candidate must have been employed for an
aggregate of five (5) years in industry related to the
academic degree program or discipline he is vying
for.
The candidate must demonstrate substantial experience in
the field related to the degree program. He must have
experiences in decision-making and planning, some
supervisory responsibilities, and opportunity to function
within an organization.
4. The candidate must be at least 25 years old. He/She
must present a birth certificate to support the claim.
The candidate must be mature and responsible in order to
succeed in the rigorous process of assessment. He/She must
be able to cope with the discipline required in the
alternative learning program should he/she opt to avail of
the competency enhancement scheme.
5. The candidate must be proficient in a branch of the
discipline applied for. To validate this, he must
submit any of the following evidences: 1) certificate of
proficiency issued by the government regulatory
body, 2) certificate of proficiency issued by the
employer(s), 3) certificate of proficiency issued by a
licensed practitioner in the field (where applicable),
or 4) a business registration certificate.
The candidate must show a certification that he has
achieved a certain level of competence in the discipline for
which he/she aspires a degree. Furthermore, the HEIs shall
authenticate the documents before these are accepted as
valid certification of a candidate’s proficiency.
The certificate of proficiency in some fields can be obtained
from the Technical Education and Skills Development
Authority (TESDA). The Professional Regulation
Commission also gives licensure examinations for certain
technician occupations. Presentation of authentic
certificates from any of these two bodies shall be considered
a straightforward compliance of this requirement.
6. Ability of the candidate to submit an accomplished
ETEEAP Application Form.
The ETEEAP Application Form is a package of
information intended to assist the HEI faculty and staff to
determine whether the applicant is eligible or not for the
program.
The Expanded Tertiary Education Equivalency and
Accreditation Program (ETEEAP) is an educational
assessment scheme that recognizes knowledge, skills, and
prior learning obtained by individuals from non-formal
and informal education experiences. By establishing
Page 8 of 8
Property of CHED-ETEEAP
What is the ETEEAP?
equivalency competence standards and a comprehensive
assessment system employing written test, interview,
skills demonstration and other creative assessment
methodologies, higher education institutions may
administer competency-based evaluation. A Panel of
Assessors is convened to determine the candidate’s
knowledge, skills and attitudes relevant to a particular
discipline, and the administering higher education
institution awards appropriate equivalency credit or
academic degree to successful candidate
The mandate to implement the Program is embodied
in Executive Order 330 issued by President Fidel V.
Ramos on May 10, 1996 as an offshoot of the
recommendation of the First Employment Summit in
September 1995.
CHECKLIST OF DOCUMENTS REQUIRED FOR
INDIVIDUAL APPLICANTS
 1x1 ID picture (original)
 NSO authenticated birth certificate
 Barangay clearance/ NBI clearance/ Passport
 Service Record / Certificate of Employment
 Most recent academic record/diploma
 Comprehensive resume
 Certificates of training and workshops
completed
 Certificates of individual proficiency in the
discipline or field of interest
 Other documents or evidence of capability and
knowledge in the field applied for equivalency
and accreditation
 Accomplished ETEEAP application form (2
copies)
Note: Submit photocopy of all required documents in a
folder
THE ETEEAP TECHNICAL SECRETARIAT
Office of Programs and Standards
Commission on Higher Education
3rd Flr., CHED-HEDC Bldg.,
CP Garcia Avenue corner University Ave.,
UP Campus, Diliman, Quezon City
Tel No: +632-441-1231
For additional information, please check our website
at http://www.ched.gov.ph, click on Projects and
Programs.