VERIFICATION OF TEACHING/ADMINISTRATIVE EXPERIENCE FORM

SOCIAL SECURITY NUMBER: ___________________________________________________________________

This is to certify that: _________________________________________________________________________
MAKINANO
(Last Name) LOUIELA
(First Name) GULTIANO
(Middle Name)
Any other name(s) Used _______________________________________________________________________
GOLDEN HERITAGE POLYTECHNIC COLLEGE
Was employed by: ____________________________________________________________________________
CAGAYAN DE ORO CITY PHILIPPINES
City of: _______________________________________State of /Country of: _____________________________

*BEGINNING *ENDING *POSITION *NUMBER *HOURS PER *FULL-TIME

MONTH-DAY-YEAR MONTH-DAY-YEAR OF DAYS DAY PART TIME
WORKED
ELEMENTARY
JUNE 04, 2012 MARCH 31, 2013 MATH 200 HOURS 8 HOURS FULL-TME
TEACHER
xxx xxx xxx xxx xxx xxx

*Must be completed

Authorized Signature, Title & Organizational Stamp (Official stamp or seal is required if verification is from a
country outside the United States). I attest, under penalty of perjury, that to the best of my knowledge, this
employee was authorized and worked as an educator within the school district and the above verification is
genuine and relates to the individual.

NECHELL D. DICHOSA, PhD December 04, 2023

School Principal Date

Email Address:
goldenheritageregistrar@gmail.com

Golden Heritage Vamenta Blbd., Carmen,

Cagayan de Oro City, 9000
________________________________________
MAILING ADDRESS

Not Valid Without

School Seal