Republic of the Philippines
Department of Education
National Capital Region
SCHOOLS DIVISION OFFICE - MALABON CITY
EQUIVALENT RECORD FORM
(Submit to Department of Education in five copies)
DELA CRUZ JUAN C. DELA CRUZ JUAN C.
Name: Date of Birth: Sex:
Surname Given Middle
Employee No: Authorize position Title:
Item: No: Authorized Salary:
I. Educational Attainment and Civil Service Eligibility:
Titles Degree or Highest Name Of Institution Year Civil Service Rating Date
Grade Attained Received Examination
II. Service Record ATTACH DULLY CERTIFIED SERVICE RECORD: YRS.
MONTHS
& DAYs AS OF
III. Equivalent Units
A. Total No of years teaching (Public only) Equivalent
B. Degree to Degree Present Degree: Equivalent
C. Areas Equivalents: School Year No. of Units Description
1. Professional Study
2. Teaching experiences
a. Public Schools:
b. Private Schools:
3. Admin. Supervisory
Total
Experience:
a. Public Schools:
b. Private Schools:
4. Others: (Seminar, Workshops etc.)
LATEST EFFICIENCY RATING:
Note: Teachers Do Not Write Below Teacher’s Printed Name and Signature
OLIVIA Q. MARTIN, Ed. D.
Principal
IV Division Action Date Processed Range Salary Range Scheduled Salary Remarks
Classification Assignment
Php SA: NBC# 562 s. 16
RECOMMENDING APPROVAL
HELEN GRACE V. GO, CESO V EFLEDA S. MAGADIA
Schools Division Superintendent Administrative Officer V
V. DEPARTMENT OF EDUCATION – REGIONAL OFFICE ACTION:
Classification: Range:
Date Approved/Processed: Post Audited at Range:
(For Future Reference)
Regional Director Evaluator
VI. Department of Education PROPER ACTION
Ninoy Aquino Elementary School Compound,
Maya-maya St., Kaunlaran Village, Longos,
Malabon City Tel: 02-2851605 Altogether delivers.