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I. Educational Attainment and Civil Service Eligibility:: Equivalents Record Form

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Republic of the Philippines

Department of Education
Region X – Northern Mindanao
DIVISION OF ILIGAN CITY
Iligan City

EQUIVALENTS RECORD FORM

Name: _________________________________________________ Date of Birth: ___________________ Sex: ________


(Surname) (Given Name) (M. I.)
Employee No.: __________________________ Authorized Position Title: ______________________
Item Number: __________________________ Authorized Salary: ________________________
Actual Salary: ________________________

I. Educational Attainment and Civil Service Eligibility:


CS Eligibility
Title, Degree or Highest
Name of Institution Year Date
Degree Attained Exam Rating
Received Taken

II. Service Record: (Attached duly certified and updated Service Record)
III. Equivalent Units:
A. Total no. of years teaching: (public only) __________________________ Equivalent: _____________
B. Degree to degree equivalent: (present degree) __________________________ Equivalent: _____________
C. Areas of Equivalents: School Year Units Earned Description
1. Professional Study
2. Teaching Experiences:
a. Public School
b. Private School
3. Adm. Supervisory Exp.
a. Public School
b. Private School
4. Others (Seminars,
Workshops, etc.)
TOTAL
LATEST EFFICIENCY RATING: _____________

_____________________________________________ _______________________
PSDS/PRINCIPAL/HEAD TEACHER Teacher’s Signature

NOTE: Teachers Do Not Write Below


IV. DIVISION ACTION
Classification Date Range Salary Scheduled
Remarks
Processed Assignment Range Salary

Certified Correct: Recommending Approval:

__________________________ __________________________________ _____________________________


Division Processing Officer Assistant Schools Division Superintendent Schools Division Superintendent

V. DepED REGIONAL OFFICE ACTION:

EVALUATED BY: DEPARTMENT OF EDUCATION


DATE: __________________________ REGION X, CAGAYAN DE ORO CITY
POST-AUDIT OF TEACHING POSITION
CLASS TITLE: ________________________
_________________________________ SALARY GRADE: _____________________
TEACHER CREDENTIALS EVALUATOR SUBJECT TO AVAILABILITY OF AN ITEM

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