Republic of the Philippines

Department of Education
REGION II –CAGAYAN VALLEY
Division of Cagayan
District/School: _Alcala Rural School
EQUIVALENT RECORD FORM
Name:___MAXIMO_______MARY ANN______ B._____________Date of Birth: DECEMBER 31, 1990
(Surname) (Given) (M.I.)
Employee No: __5347154______________________Authorized Position Title:_____________________
Item No: OSEC-DECSB-TCH2 1200 70-2016 P.D. No._____Authorized Salary:___22, 149______
I Educational Attainment and Civil Service Eligibility
Civil Service
Title, Degree or Highest Attained Name of Institution Year Examination Rating Date
Received
MaEd (Academic CSU-
requirement completed) ANDREWS 2017 LET 77 Sept. 2011

II. Service Record ATTACHED DULY CERTIFIED SERVICE RECORD

III. Equivalent Units
A. Total No. of years teaching (Public only) ____3________ ____________ __________
B. Degree to degree equivalent (present degrees) _____BSED___
C. Areas Equivalent School Year No. of Units Descriptions

1. Professional Study MaEd_ FILIPINIO ____33____ Academic

Requirement completed
2. Teaching Experience
a. Public school _____3___________________ ___________
b. Private school _____5_______ _____________ ___________
3. Adm. Supervisory Experience ____________ _____________ ___________
a. Public school ____________ _____________ ___________
b. Private school ____________ _____________ ___________
4. Others (seminars, workshop, etc.) _____see attachment_______ _____________
TOTAL ____________ _____________ ___________
LATEST EFFICIENCY RATING: __4.8_(Outstanding)_

RECOMMENDING APPROVAL:
_________________________ _________________________
DANTE C. ADVIENTO, Ph.D. Teacher’s Signature
Secondary School Principal II
NOTE: Teachers do no write below
IV. Division Action Date Range Salary Ranged Scheduled Remarks
Classification Processed Assignment Salary

Recommending Approval: Certified Correct:

DENIZON P. DOMINGO RICHARD G. AGUDO

OIC- Schools Division Superintendent Administrative Officer IV

V. DEPED Regional Office Action

Classification: __________________________ Range ___________________________
Date of approval/processed ______________ Post Audited Range ___________________________
(for future reference) ___________________________
______________________________________ __________________________________
Regional Director Evaluator

PROPER ACTION ________________________