ERF-Teacher 2/3

Republic of the Philippines

Department of Education
REGION XII
SCHOOLS DIVISION OFFICE OF COTABATO

CHECKLIST OF REQUIREMENTS
Name of Applicant: MARIA GVLENN P. MACANAS Application Code:
Position Applied For: TEACHER III Ethnicity: ILOCANO
Office of the Position Applied For: DEPED AMAS, KIDAPAWAN CITY Person with Disabilty: Yes ( ) No ( )
Contact Number: 9754273433 Solo Parent: Yes ( ) No ( )
Religion: ROMAN CATHOLIC

Status of Verification (To be filled-out by the

Submission HRMO/HR Office/sub-committee)
Basic Documentary Requirement (to be filled-out by the Status of
applicant; Check if Submission Remarks
submitted) (Check if complied)
Checklist of Requirements and Omnibus Sworn Statement on the
Certification on the Authenticity and Veracity (CAV) of the
1 documents submitted and Data Privacy attached form of School
Records
2 Endorsement from the Division Office
3 Letter of Intent addressed to the Head of Office
4 Duly Accomplished ERF
Duly accomplished PDS (CS Form 212, Revised 2017) with Work
5
Experience sheet
6 Photocopy of valid and updated PRC License/ID
Photocopy of scholastic/academic records such Transcript of Record
7 (TOR), Diploma and Special Order, including completion of graduate
and post-graduate units/degrees (Masteral and Doctoral)
Omnibus Certification of Authenticity and Veracity of School Records
8
(HEIs, LUCs and SUCs by Division HRMO)
9 Photocopy of Certificate(s) of Training
10 Photocopy of updated and duly signed Service Record
11 Photocopy of Latest Appointment
12 Photocopy of Performance Rating
Certificate of Employment (for Teachers with Private School teaching
13
experience)
Copy of Approved Study Leave/Permit to Study per Semestral Basis
14
or Scholarship (If applicable)

Attested

JARWIN T. TAMBA
School Head/Administrative Officer II

OMNIBUS SWORN STATEMENT

CERTIFICATION OF AUTHENTICITY AND VERACITY
I hereby certify that all information above are true and correct, and of my personal knowledge and belief, and the documents
submitted herewith are original and/or certified true copies thereof.

DATA PRIVACY CONSENT

I hereby grant the Department of Education the right to collect and process my personal information as stated above, for
purposes relevant to the recruitment, selection, and placement of personnel of the Department and for purposes of compliance
with the laws, rules, and regulations being implemented by the Civil Service Commission.

MARIA GVLENN P. MACANAS

Name and Signature of Applicant

Subscribed and sworn to before me this _______ day of _____, year ________.

Person Administering Oath

In consonance with Republic Act No. 8792 or the "Electronic Commerce Act of 2000", (electronic documents shall have the legal
effect, validity or enforceability as any other document or legal writing and a) (where the law requires a document to be in
writing, that requirement is met by an electronic document if the said electronic document maintains its integrity and reliability
and can be authenticated so as to be usable for subsequent reference.

Capitol Compound Amas, Kidapawan City

[email protected]
Smart: 09616315330 / 09519806756
Globe: 09668270675 / 09271917810 Page 1 of 1
ERF-SPET1-3

Republic of the Philippines

Department of Education
REGION XII
SCHOOLS DIVISION OFFICE OF COTABATO

CHECKLIST OF REQUIREMENTS
Name of Applicant: Application Code:
Position Applied For: Ethnicity:
Office of the Position Applied For: Person with Disabilty: Yes ( ) No ( )
Contact Number: Solo Parent: Yes ( ) No ( )
Religion:

Status of Verification (To be filled-out by the

Submission HRMO/HR Office/sub-committee)
Basic Documentary Requirement (to be filled-out by the Status of
applicant; Check if Submission Remarks
submitted) (Check if complied)
Checklist of Requirements and Omnibus Sworn Statement on the
Certification on the Authenticity and Veracity (CAV) of the
1 documents submitted and Data Privacy attached form of School
Records (Annex C)
2 Endorsement from the Division Office
3 Letter of Intent addressed to the Head of Office
4 Duly Accomplished ERF
Duly accomplished PDS (CS Form 212, Revised 2017) with Work
5
Experience sheet
6 Photocopy of valid and updated PRC License/ID
Photocopy of scholastic/academic records such as but not limited to
Transcript of Record (TOR), Diploma and Special Order, including
completion of graduate and post-graduate units/degrees
7 (BSED/BEED) with specialization in SPED/has a minimum of 18
units if SPED (SPET 1) or 38 units in SPED (SPET II) and Masters in
SPEd (SPET III)

Omnibus Certification of Authenticity and Veracity of School Records

8
(HEIs, LUCs and SUCs by Division HRMO)
9 Photocopy of Certificate(s) of Training/Recognition related to SPED
10 Photocopy of updated and duly signed Service Record
11 Photocopy of Latest Appointment
12 Photocopy of Performance Rating in the last
Copy of Approved Study Leave/Permit to Study per Semestral Basis
13
or Scholarship (If applicable)
Certification that the teacher has at least 3 years of experience in
teaching children with special needs (Designation/Assignment
14
OrderSchool Level) (Attested by the Division Focal Person for SPED)

Certificates of the one-month summer training in SPED conducted at

15 the PNU, UP, YMCA Open College, Manila and other institutions
through DepED shall be given 9 units (if applicable)

Attested

__________________________________________
School Head/Administrative Officer II

OMNIBUS SWORN STATEMENT

CERTIFICATION OF AUTHENTICITY AND VERACITY
I hereby certify that all information above are true and correct, and of my personal knowledge and belief, and the documents
submitted herewith are original and/or certified true copies thereof.

DATA PRIVACY CONSENT

I hereby grant the Department of Education the right to collect and process my personal information as stated above, for
purposes relevant to the recruitment, selection, and placement of personnel of the Department and for purposes of compliance
with the laws, rules, and regulations being implemented by the Civil Service Commission.

0
Name and Signature of Applicant

Subscribed and sworn to before me this _______ day of _____, year ________.

Person Administering Oath

In consonance with Republic Act No. 8792 or the "Electronic Commerce Act of 2000", (electronic documents shall have the legal
effect, validity or enforceability as any other document or legal writing and a) (where the law requires a document to be in
writing, that requirement is met by an electronic document if the said electronic document maintains its integrity and reliability
and can be authenticated so as to be usable for subsequent reference.
Capitol Compound Amas, Kidapawan City
[email protected]
Smart: 09616315330 / 09519806756
Globe: 09668270675 / 09271917810 Page 1 of 1
ERF-MASTER TEACHER 1-2

Republic of the Philippines

Department of Education
REGION XII
SCHOOLS DIVISION OFFICE OF COTABATO

CHECKLIST OF REQUIREMENTS
Name of Applicant: Application Code:
Position Applied For: Ethnicity:
Office of the Position Applied For: Person with Disabilty: Yes ( ) No ( )
Contact Number: Solo Parent: Yes ( ) No ( )
Religion:

Status of Verification (To be filled-out by the

Submission HRMO/HR Office/sub-committee)
Basic Documentary Requirement (to be filled-out by the Status of
applicant; Check if Submission Remarks
submitted) (Check if complied)
Checklist of Requirements and Omnibus Sworn Statement on the Certification on
1 the Authenticity and Veracity (CAV) of the documents submitted and Data Privacy
attached form of School Records (Annex C)
2 Endorsement from the Division Office
3 Letter of Intent addressed to the Head of Office
4 Duly Accomplished ERF
Comparative Assessment of MT Applicants duly signed by the Division Selection
5
Committee approved by the SDS (HRMPSB)
Certificate of Demonstration Teaching and Lesson plan and evaluation for the last
6
five (5) school years (with Memorandum/Program of Activity)
Leadership Potential
• Curriculum Materials/Teaching Technique/Simplified work/Income generating
• Subject Coordinator/Club Adviser
• Special Committee Chairman
• Educational Research
• Project Coordinator/Committee Member
• In-Service Training
• Trainer or coach/Coordinator
• Authorship
Duly accomplished PDS (CS Form 212, Revised 2017) with Work Experience sheet
7
8 Photocopy of valid and updated PRC License/ID
Photocopy of scholastic/academic records such as but not limited to Transcript of
9 Record (TOR), Diploma and Special Order, including completion of graduate and
postgraduate units/degrees (Masteral and Doctoral)
Omnibus Certification of Authenticity and Veracity of School Records (HEIs, LUCs
10 and SUCs by Division HRMO)

11 Photocopy of updated and duly signed Service Record

12 Photocopy of latest appointment
Photocopy of Performance Rating in the last rating period(s) covering one-year
13
performance in the current/latest position
Copy of Approved Study Leave/Permit to Study per Semestral Basis or
14
Scholarship (If applicable)
15 Latest Approved Class Program (Elementary) and Teaching Load for (Secondary)
Table 14 (District Data Bulletin) for Elementary/List of Teachers Per Subject Area
16 of Specialization for Secondary duly signed by immediate head, certified correct
by Planning Officer and approved by SDS
17 School Form (SF) 7
Attested
__________________________________________
School Head/Administrative Officer II
OMNIBUS SWORN STATEMENT
CERTIFICATION OF AUTHENTICITY AND VERACITY
I hereby certify that all information above are true and correct, and of my personal knowledge and belief, and the documents submitted
herewith are original and/or certified true copies thereof.
DATA PRIVACY CONSENT
I hereby grant the Department of Education the right to collect and process my personal information as stated above, for purposes relevant
to the recruitment, selection, and placement of personnel of the Department and for purposes of compliance with the laws, rules, and
regulations being implemented by the Civil Service Commission.
0
Name and Signature of Applicant
Subscribed and sworn to before me this _______ day of _____, year ________.

Person Administering Oath

In consonance with Republic Act No. 8792 or the "Electronic Commerce Act of 2000", (electronic documents shall have the legal effect,
validity or enforceability as any other document or legal writing and a) (where the law requires a document to be in writing, that requirement
is met by an electronic document if the said electronic document maintains its integrity and reliability and can be authenticated so as to be
usable for subsequent reference.

Capitol Compound Amas, Kidapawan City

[email protected]
Smart: 09616315330 / 09519806756
Globe: 09668270675 / 09271917810 Page 1 of 1
ERF-HT & PRIN

Republic of the Philippines

Department of Education
REGION XII
SCHOOLS DIVISION OFFICE OF COTABATO

CHECKLIST OF REQUIREMENTS
Name of Applicant: Application Code:
Position Applied For: Ethnicity:
Office of the Position Applied For: Person with Disabilty: Yes ( ) No ( )
Contact Number: Solo Parent: Yes ( ) No ( )
Religion:

Status of Verification (To be filled-out by the

Submission HRMO/HR Office/sub-committee)
Basic Documentary Requirement (to be filled-out by the Status of
applicant; Check if Submission Remarks
submitted) (Check if complied)
Checklist of Requirements and Omnibus Sworn Statement on the Certification on
1 the Authenticity and Veracity (CAV) of the documents submitted and Data Privacy
attached form of School Records (Annex C)
2 Endorsement from the Division Office
Comparative Assessment of School Head Applicants duly signed by the Division
3 HRMPSB

4 Letter of Intent addressed to the Head of Office

5 Duly Accomplished ERF
6 Duly accomplished PDS (CS Form212, Revised2017) with Work Experience sheet
7 Photocopy of valid and updated PRC License/ID
Photocopy of scholastic/academic records such as but not limited to Transcript of
8 Record (TOR), Diploma and Special Order, including completion of graduate and
postgraduate units/degrees (Masteral and Doctoral)
Omnibus Certification of Authenticity and Veracity of School Records (HEIs, LUCs
9
and SUCs by Division HRMO)
10 Photocopy of Certificate(s) of Training
Other Documents as may be required by the HRMPSB for comparative
11 assessment, including but not limited to (means of verification):
a. Outstanding Accomplishments, Application of Education and Application of Learning and
Development
b. reckoned
Photocopy of from the date
the Performance Ratingof obtained
last issuance
fromofthe
appointment
relevant work experience, if
Performance Rating is not relevant to the position to be filled
12 Photocopy of updated and duly signed Service Record
13 Photocopy of latest appointment
Photocopy of Performance Rating in the last rating period(s) covering one-year
14 performance in the current/latest position

15 Actual Duties and Responsibilities

16 School Form 7 – School Personnel Assignment List of Basic Profile
List of teachers under his/her supervision with item number duly certified by the
17
Schools Division Superintendent
18 Justification letter for Reclassification of position
NEAP Certification as to the result of NQESH/Principal’s test or a similar
19 standardized examination nationally administered by DepEd
• For HT positions (if any)
• For higher school principal positions –NQESH/Principal’s test or similar standardized
examination nationally administered by DepEd or a result from the written examination
developed by the HRMPSB

Certificate of Completion/Participation/Attendance to DepEd/NEAP-recognized

20 and other relevant educational leadership trainings aligned to the PPSSH
domains
Attested
__________________________________________
HRMO
OMNIBUS SWORN STATEMENT
CERTIFICATION OF AUTHENTICITY AND VERACITY
I hereby certify that all information above are true and correct, and of my personal knowledge and belief, and the documents submitted
herewith are original and/or certified true copies thereof.
DATA PRIVACY CONSENT
I hereby grant the Department of Education the right to collect and process my personal information as stated above, for purposes relevant
to the recruitment, selection, and placement of personnel of the Department and for purposes of compliance with the laws, rules, and
regulations being implemented by the Civil Service Commission.
0
Name and Signature of Applicant
Subscribed and sworn to before me this _______ day of _____, year ________.

Person Administering Oath

In consonance with Republic Act No. 8792 or the "Electronic Commerce Act of 2000", (electronic documents shall have the legal effect,
validity or enforceability as any other document or legal writing and a) (where the law requires a document to be in writing, that requirement
is met by an electronic document if the said electronic document maintains its integrity and reliability and can be authenticated so as to be
usable for subsequent reference.

Capitol Compound Amas, Kidapawan City

[email protected]
Smart: 09616315330 / 09519806756
Globe: 09668270675 / 09271917810 Page 1 of 1