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Department of Education

Region III

HARDSHIP POST FORM

School : Pilien Primary School Division : Tarlac


Barangay : Sta. Juliana , Capas , Tarlac Region : III
District : Capas West EDP Code : ______

For the month of : January to December 2017

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1. DESCRIPTION OF TRAVEL FROM MUNICIPAL POBLACION TO SCHOOL

A. Total distance from Poblacion to school 43 kilometers

B. First Leg Distance : 40 kilometers

From 20 km. To 23 km.


Mode of Transportation : Dirt Bike, Carton Cart, Jeep 4x4.
C. Frequency of trips per month :
D. Total Time ( 1 way ) in hours / minutes : 5 hours
E. Average fare ( 1 way ) : P 1500.00

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2. NAME OF TEACHER POSITION BASIC SALARY GRADE LEVEL CLASS SIZE


ELVIN M. TULIO ESHT - III 30,044.00 N/A N/A

_____________________________
Name and Signature of School Head

Prepared by: Verified by: Certified by:

DR. LOIDA L. ZAMORA HON. REYNALDO L. CATACUTAN DR. ESTRELITA S. CUNANAN


District Supervisor Municipal Mayor OIC – Schools Division
Superintendent

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