Philippine Normal University

Name:

The National Center for Teacher Education

Taft Avenue, Manila

REPORT ON LOADS FOR FULL-TIME FACULTY

__________Trimester, SY 20__ - 20__

_________LIWANAG______MA. RUBY ANNE

________M.____________
Surname

CGSTER
CTD
___ FAL
___ FBeSS
___ FES
___ FSTeM
CFLeX & e-PNU
OSASS

First Name

M.I.

I. REGULAR LOAD
Load

No. of
Units

Course

T/NT/MD

College/
Faculty/Institute
Center/Unit/Office

Mode of
Delivery
(FFD/FLD)

Time/Day

Room

Enrollment

IKM
ITL

PNU-MN-2016-VPA-FM003

IPEHRDS
Center ____________
Unit
____________
Office ____________

Year/Section

Signature of Immediate Head

(Assoc Dean/Director/Head/ProgramCoordinator)
and UCMIMO

3
4

MD

Materials Development

Regular Official Time:

MTh
TF
Wed

Academic Advising/Conference:
Day ___________________
______
Time ___________________
Year & Section _____________

Sat

_______

Days

Teaching/Non-Teaching

Materials Development

Summary:
No. of T loads

______ x 7.5 =

No. of NT loads
No. of Mat Dev loads

______ x 12 = ______
______ x 2.5 = _______
TOTAL
=

II. EXTRA LOAD

Load

T/NT/MD

Course

No. of
Units

College/
Faculty/Institute
Center/Unit/Office

Mode of
Delivery
(FFD/FLD)

Time/Day

Course

No. of
Units

College/
Faculty/Institute
Center/Unit/Office

Mode of
Delivery
(FFD/FLD)

Time/Day

Room

Enrollment

Signature of Immediate Head

Year/Section

(Assoc Dean/Director/Head/Program Coordinator)

and UCMIMO

Year/Section

(Assoc Dean/Director/Head/Program Coordinator)

and UCMIMO

T
T

III. EMERGENCY EXTRA LOAD

Load

T/NT/MD

Room

Enrollment

Signature of Immediate Head

IV. OUTSIDE TEACHING LOAD

V. STUDY LOAD

Do you render any teaching service in other institutions? No _____

College/University

Yes ____ If yes, please provide information and attach Permit to Teach.

Subject/Course

VI. OTHER ACTIVITIES / ASSIGNMENT OUTSIDE THE UNIVERSITY

No. of Units

Days

Are you presently enrolled? No ______ Yes ______.

Time

College/University

If yes, please provide information and attach Permit to Study.

Subject/Course

No. of Units

Days

Time

(e.g. Consultancy Services, Administrative Supervision) Please attach contract or terms of reference.

College/University

I certify on my honor that the above entries are true and correct.

Signature: _________________________ Date: _____________

Nature of Activity

APPROVED:

No. of hrs. required/week

Days

Time

Associate Dean/Director/ Head

__________________________________________________

Dean(s)

__________________________________________________

VP for Academics/VPRPQA

__________________________________________________

President

________________________________________________________

This form should be submitted to the Deans Office within two weeks after the first day of regular classes. The signature of the Immediate Head
signifies approval of all the entries in the form.Changes in days, time, room and enrollment must be officially approved by the Immediate Head, Dean and Registrar.

Please see reverse side for guidelines. (Updated June 2016)

Reference Code: PNU-MN-2016-VPA-FM-003