Annex C

CHECKLIST OF REQUIREMENTS
(Teacher I Position)

Name of Applicant: JOYCE T. CORTEZ Application Code SHSTVL2402-AC-0075

Position Applied For: TEACHER I Religion ALLIANCE
School applying to: DAVAO CITY NATIONAL HIGH SCHOOL Ethnicity BAGOBO TAGABAWA
Cluster / District: CLUSTER 1 Person with disability Yes ( ) No ( / )
Contact Number: 09483826956 Solo Parent Yes ( ) No ( / )

Status of Verification
(To be filled-out by the HRMO/HR Office/Sub-
Submission
Committee)
Basic Documentary Requirements (To be filled-out
by the applicant. Status of
Check if Submission Remarks
submitted) (Check if complied)
Letter of intent addressed to the Schools Division
Superintendent indicating the following: *
a.  Applicant Code Number
 Strand & Track for SHS / Subject Area for JHS
 The school applying to
Duly accomplished Personal Data Sheet (PDS)
b. (CS Form No. 212, Revised 2017) and Work Experience
Sheet*
Photocopy of valid and u p d a t e d PRC License/ID with at
c.
least 6 months validity from the time of application**

d. Photocopy of Certificate of Eligibility/Report of Rating**

Photocopy of Transcript of Records (TOR), and Certification,

e. Authentication and Verification (CAV) in bachelor’s degree and
highest educational attainment*
Photocopy of Certificate/s of Training relevant to
f.
teaching, if applicable
Certified photocopy of Voter’s ID or any proof of
g.
Residency (ex. Barangay Certificate/Clearance)
h Photocopy of Certificate of Employment, Contract of
. Service, or duly signed Service Record relevant to teaching.
For Senior High School TVL applicants: NC II with at
i. least 6 months validity after submission of application*
Checklist of Requirements and Omnibus Sworn
Statement on the Certification on the Authenticity and
j. Veracity (CAV) of the documents submitted and Data
Privacy Consent Form*
*Mandatory requirements
**Mandatory requirements to all applicants except for SHS applicants who are non-LET passers
Note: Original copies of the documents above shall be presented upon submission of documents for verification

Attested:

________________________________________
HRMO/School Receiving In-Charge with signature

OMNIBUS SWORN STATEMENT

CERTIFICATION OF AUTHENTICITY AND VERACITY

I hereby certify that all information above are true and correct, and of my personal knowledge and belief, and the documents
submitted herewith are original and/or certified true copies thereof.

DATA PRIVACY CONSENT

I hereby grant the Department of Education the right to collect and process 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 the laws, rules, and regulations being implemented by the Civil Service Commission.

JOYCE T. CORTEZ
Name and Signature of Applicant

Subscribed and sworn to before me this __________ day of _________________________, year ____________.

Person Administering Oath

In consonance with Republic Act No. 8792 or the " Electronic Commerce Act of 2000" , (e)lectronic documents shall have the legal effect, validity or enforceability as any other
document or legal writing and a) (w)here the law requires a document to be in writing, that requirement is met by an electronic document if the said electronic document
maintains its integrity and reliability and can be authenticated so as to be usable for subsequent reference.