Republic of the Philippines

Department of Education
REGION IV-B MIMAROPA
DIVISION OF ORIENTAL MINDORO
Sta. Isabel, Calapan City

SENIOR HIGH SCHOOL TEACHER – APPLICANTS

Name: _____________________________________________________ Sex: ___________ Age: ___________
Surname First Name Middle Initial
Home Address: ______________________________________________ Birthday: _______________________
(mm/dd/yyyy)
Contact Number: _________________________________ Email Add: _________________________________
Course/Degree: ____________________________________________ Major: __________________________
Graduate Studies: _____________________________________ Units Specialization: ____________________
 Kindly indicate your preferred strand in front of your folder.
 If you are an old applicant who prefer to use your score in the previous RQA please submit a hand written letter containing
your intention to use your points from the previous ranking and your preferred track.
MANDATORY REQUIREMENTS
Letter of intent (in hand writing) indicating:
a. Statement of purpose/expression of
1
b. Subject group where you intend to teach
c. Preferred school
2 CSC Form 212 (Personal Data Sheet) 2 Copies with the latest 2x2 ID pictures
Certified photocopy of TOR with at least 15 units of specialization in relevant
strand/specialized subject w/ computed GENERAL WEIGHTED AVERAGE (GWA) from the
3
school/Registrar’s Office / Certified Photocopy of Certified Photocopy of Master’s Degree
TOR/Units earned Certified Photocopy of Doctors Degree TOR/Units earned (if available)
4 Certified Photocopy of Employment Certificates
5 Certified Photocopy of Certificates of relevant trainings, if any.
6 Certified Photocopy of Recognitions/Awards/Certificates for Outstanding Accomplishments
Certified Photocopy of Diploma on Bachelor’s Degree/Proof of graduation from Technical
7
Vocational Course
8 For TVL Applicants Only: Certified photocopy of NC II/NC III/NC IV (valid and migrated)
9 Certified copy of Voter’s ID and or / any proof of residency
10 NBI Clearance
Omnibus certification of authenticity and veracity of all documents submitted, signed by the
11
applicant.
ADDITIONAL REQUIREMENTS
1
2 Certified photocopy of ratings obtained in LET/PBET (if available)
ADDITIONAL REQUIREMENTS FOR TVL
1
ADDITIONAL REQUIREMENTS FOR ARTS AND DESIGN AND SPORTS TRACK
Certified photocopy of Certification of Proficiency/Recognition from organized & relevant
1
association/organization/guild
ADDITIONAL REQUIREMENTS FOR HEI/TVI FACULTY/OFW
Certified photocopy of Certification of Status of Employment/Service Record from
1
HEI/TVI/OFW Proof of Employment
ADDITIONAL REQUIREMENTS FOR PART-TIME POSITIONS
Written approval from head of unit if currently employed by the national government of the
1
local government unit
Reference: DO 3, s 2016 & DO 32, s2016, DO 51, s2017
Note: Please attach Label (tabbing) on the right side of each requirement for easy access and evaluation.

Submitted by:

__________________________________________
Signature Teacher-Applicant

HR FORM 4-A
 Republic of the Philippines
Department of Education
REGION IV-B MIMAROPA
DIVISION OF ORIENTAL MINDORO
Sta. Isabel, Calapan City

ELEMENTARY AND JUNIOR HIGH SCHOOL TEACHER – APPLICANTS

Name: _____________________________________________________ Sex: ___________ Age: ___________
Surname First Name Middle Initial
Home Address: ______________________________________________ Birthday: _______________________
(mm/dd/yyyy)
Contact Number: _________________________________ Email Add: _________________________________
Course/Degree: ____________________________________________ Major: __________________________
Graduate Studies: _____________________________________ Units Specialization: ____________________
 If you are an old applicant who prefer to use your score in the previous RQA please submit a hand written letter containing
your intention to use your points from the previous ranking.
 Please arrange your pertinent papers as follows:

MANDATORY REQUIREMENTS
Letter of intent (in hand writing) indicating:
1 a. Statement of purpose/expression of
b. Preferred school
2 CSC Form 212 (Personal Data Sheet) 2 Copies with the latest 2x2 ID pictures
Certified photocopy of TOR w/ computed GENERAL WEIGHTED AVERAGE (GWA) from the
3 school/Registrar’s Office / Certified Photocopy of Certified Photocopy of Master’s Degree
TOR/Units earned Certified Photocopy of Doctors Degree TOR/Units earned (if available)
Copies of service record, performance rating, and school clearance for those with teaching
4 experience. If unavailable, the applicant must submit a justification citing the reason/s for
unavailability.
5 Certified Photocopy of PRC Professional identification card
Certified photocopy of ratings obtained in Licensure Examination for Teachers
6
(LET)/Professional Board Examination for Teachers (PBET)
7 Certified Photocopy of certificates of specialized trainings
Certified copy of Voter’s ID and or / any proof of residency as deemed accepted by the school
8
screening committee.
9 NBI Clearance
Omnibus certification of authenticity and veracity of all documents submitted, signed by the
10
applicant.

Reference: DO 7, s 2015 & DO 22, s2015

Note: Please attach Label (tabbing) on the right side of each requirement for easy access and evaluation.

Submitted by:

__________________________________________
Signature Teacher-Applicant

HR FORM 3-A