ERF Form Republic of the Philippines DEPARTMENT OF EDUCATION Region I DIVISION OF ILOCOS SUR Vigan City NAME: Employee

No. Item No. G.A.A No. I. Educationa Attainment and Civil Service Eligibility: Date of Birth Authorized Position Title Authorized Position Title Sex

Title, Degrees or Name of Institution Highest Grade Atained

Year Received

CS Exam

Rating

Date

Master of Arts in Education with 36 units in Doctor of Education II. Service Records: Attached duly certified Service Record III. Equivalent Units: A. Total Number of Years Teaching (Public Only) B. Degree to Degree Equivalent BSE, BSN, MAEd (Present Degree) C. Areas of Equivalents 1. Professional Study 2. Teaching Experience a. Public School b. Private School 3. Adm. Supervisory Experience a. Public School b. Private School 4. Others(Seminars, Workshops, etc.) Total

Equiv. Equiv.

LATEST EFFICIENCY RATING: Teacher's Signature CERTIFIED AND VERIFIED CORRENT

Principal I Note: Teachers DO not Write Below IV. Division Action: Classification Date Processed Grade Assignment Salary Grade Scheduled Salary REMARKS

RECOMMENDING APPROVAL:

CERTIFIED CORRECT:

SCHOOLS DIVISION SUPERINTENDENT V. DEPED REGIONAL OFFICE ACTION: Classification Post-Audited at Grade (For future reference) Date approved/processed:

ADMINISTRATIVE OFFICER III

Grade

Evaluator

Regional Director