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RECLASSIFICATION to MASTER TEACHER POSITION
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<<INDICATE as APPLICABLE: "ELEMENTARY EDUCATION," "KINDERGARTEN," OR "JUNIOR HIGH SCHOOL">>
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CHECKLIST OF REQUIREMENTS (for REGION X Office)
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Name of Applicant:_______________________________________
Application Code:
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Bachelor's Degree:________________________________________
MT Position Applied For Reclassification:
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Master's/Doctorate Degree: _________________________________
_____________________________________
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Current Position Title:______________________________________
Subject Area taught (Junior HS only):
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Plantilla: ________________________________________________
_____________________________________
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School Assignment:________________________________________
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District: _________________________________________________
Contact Number: ________________________
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Basic Documentary RequirementRequired CopiesStatus of Submission
(To be filled-out by the applicant;
Check if submitted)		Verification
(To be filled-out by the AO/Screening Committee)
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Status of Submission
(Check if complied)		Remarks
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1.Letter of Intent addressed to the SDS (specifying the MT position being applied for reclassification with District for Elementary or with Subject Area & School Plantilla for Junior HS) 1 - Original
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2.Checklist of Requirements and Omnibus Sworn Statement (Annex C2)2 - Original & Notarized
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3.Updated and duly accomplished CS Form No. 212, Revised 2017: Personal Data Sheet (PDS) and Work Experience Sheet, if applicable1 - Original & Notarized
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4.Transcript of Records1 - Original or Authenticated copy (originally signed as authenticated by issuing school) per level
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 a. College / Bachelor's Degree
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 b. Master's Degree
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5.Certified, Authenticated and Validated (CAV) Certificate for Master’s Degree (for MA Degree Graduate only) 1 - Original or Authenticated copy, originally signed as authenticated by issuing school (public) or CHED (private school)
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6.Performance Rating for the last 3 consecutive years, complete set per year1 - Original or Authenticated copy (originally signed as authenticated by Division AO-V) per year
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7.Latest Service Record signed by Division AO-V (applicable to both Elementary and Junior High School)1 - Original or Authenticated copy (originally signed as authenticated by Division AO-V)
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8.Updated/Renewed PRC license (not to expire within 12 months) 1 - Authenticated copy, originally signed as authenticated by PRC
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9.Latest Approved Appointment (attested by CSC)1 - Authenticated copy, originally signed as authenticated by HRMO/ AO IV-Personnel
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10.Certificates showing Leadership, Potential and Accomplishments 1 - Original or Authenticated copy (originally signed as authenticated by issuing office)
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12.1 Introduced Curriculum or Instructional Materials/ Effective teaching techniques or strategies/Simplification of Work / Income-Generating Projects
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12.2 Served as Subject Coordinator/Grade Chairman/Adviser of school publication or special school organization
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12.3 Served as Special Committee Chairman
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12.4 Initiated/Headed an Educational Research
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12.5 Coordinator of a Community Project or Rural Service Improvement activity
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12.6 Managed an In-Service Activity
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12.7 Meritorious Achievements as Trainor or Coach or Boy Scout/Girl Scout Coordinator
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12.8 Authorship
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11.Documents/Certificates on Demonstration Teaching1 - Original or Authenticated copy (originally signed as authenticated by issuing office)
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12.Other documents as may be required for assessment of documents
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Attested:
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<<Name of HRMO / AO IV - Personnel>>
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HRMO / Administrative Officer IV - Personnel
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OMNIBUS SWORN STATEMENT
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CERTIFICATION OF AUTHENTICITY AND VERACITY
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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.
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DATA PRIVACY CONSENT
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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.
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Name and Signature of Applicant
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Subscribed and sworn to before me this ______ day of ________________, year ________.
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Person Administering Oath
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In consonance with Republic Act No. 8792 or the "Electronic Commerce Act of 2000", (e)lectronic documents shall have the legal effect, validity or enforceability as any other document or legal writing and a) (w)here 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.
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