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Equivalent Record Form: Region Iii-Central Luzon

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Republic of the Philippines

Department of Education
REGION III-CENTRAL LUZON
Division of Nueva Ecija
STO DOMINGO NATIONAL TRADE SCHOOL

EQUIVALENT RECORD FORM

RAMOS MYRA
Name:________________________________________________Date R. MAY 9, 1976
of Birth:____________________
(Surname) (Given) (M.I.)
Employee No: _______________________________Authorized Position Title:_____________________
Item Mo: __________________P.D. No._____________ ___Authorized Salary:_________________
I Educational Attainment and Civil Service Eligibility
Title, Degree or Highest Name of Year Civil Service
Attained Institution Received Examination Rating Date
Master of Arts in Education Marinduque 2016
major in Educational State College
Management/Mathematics
Teaching

II. Service Record ATTACHED DULY CERTIFIED SERVICE RECORD


III. Equivalent Units
A. Total No. of years teaching (Public only) ____________19 ___________ __ ___________
B. Degree to degree equivalent (present degrees) ____________
Masters Degree _____________ ___________
C. Areas Equivalent School Year No. of Units Descriptions
1. Professional Study 2016
____________ 54
_____________ Graduate
___________
2. Teaching Experience Public School
a. Public school 19
19
____________ _____________StatePublic School
College
___________
b. Private school ____________ _____________ ___________
3. Adm. Supervisory Experience ____________ _____________ ___________
a. Public school ____________ _____________ ___________
b. Private school ____________ _____________ ___________
4. Others (seminars, workshop, etc.) ____________ _____________ ___________
TOTAL ____________ _____________ ___________
LATEST EFFICIENCY RATING: ________________________
RECOMMENDING APPROVAL: _________________
__________________ Teacher’s Signature

Principal
NOTE: Teachers do no write below
IV. Division Action Date Range Salary Ranged Scheduled Remarks
Classification Processed Assignment Salary

Recommending Approval: Certified Correct:

RONALDO A. POZON Ph.D. REYMO R. ALDMA


Schools Division Superintendent Administrative Officer V

V. DEPED Regional Office Action


Classification: __________________________ Range ___________________________
Date of approval/processed ______________ Post Audited Range ___________________________
(for future reference) ___________________________

______________________________________ __________________________________
Regional Director Evaluator

PROPER ACTION ________________________

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