Equivalent Record Form

DEPED ERV form

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DEPARTMENT OF EDUCATION
REGION III-CENTRAL LUZON
Schools Division of
_

EQUIVALENT RECORD FORM
Name:
(Surname)

(Given)

(Submit in Five Copies)
Date of Birth:
(M.I.)

Employee No. :
Item No. :
I.

, ,

Gender:

Authorized Position Title:
Authorized Annual Salary:

SG:

Educational Attainment
Masters Degree
(write in full with
specialization)

Completed/
Units Earned

Name of School

Year Completed

Equivalent

(if not completed)

II. Years of Teaching Experience:
Private
:
Public
:
III. Trainings Attended
Title

Inclusive
Dates

Number of
Hours

Sponsoring Agency

IV. For Head Teacher Positions and Other Related Teaching Positions
Years of Experience in Present Position:
V. Latest Performance Rating:
(Teacher’s Signature)
VI.

Schools Division Action (For Schools Division Evaluator Only)

Classification

Date
Processed

Certified Correct:

AO IV-Personnel
Schools Division Evaluator
V. DepEd Regional Office Action
Classification:
Date Processed:

Range
Assignment

Salary Grade

Salary
Schedule

REMARKS

Recommending Approval:

Schools Division Superintendent

Post Audited Assignment:
Salary Grade :
Salary Schedule :
Remarks
:
Approved:

Evaluator

NICOLAS T. CAPULONG, Ph.D.
OIC-Assistant Regional Director