WILFREDA D. BONGALOS, Ph. D.

, CESO V
Schools Division Superintendent
Schools Division of Negros Oriental
Capitol Area, Dumaguete City

THRU:
IENY A. SOCORRO
District Supervisor
Mabinay District IV
Mabinay Negros Oriental

Ma’am:

With great passion to impart my knowledge and experiences, I would like to apply for a
teaching position at Nabaliwan Elementary School of Mabinay District IV.

I am Jesamae E. Acaso, 23 years old, single, and a resident of Polog, Samac, Mabinay Negros
Oriental. I graduated Bachelor of Elementary Education at Negros College Inc., Tampocon II,
Ayungon Negros Oriental last March 24, 2017 and fortunately passed the Licensure
Examination for Teachers on September 2017. Currently, I am serving as an Extension Teacher
at Mabinay Central School, District III.
Believing that education is the best foundation, I hope to be a part of this world’s educators and
molders of young minds.

I am willing to come to your office for an interview at your most convenient time. You can reach
me via mobile number 0997-088-5793.
Herewith are my pertinent papers for your perusal.

Respectfully Yours,

JESAMAE E. ACASO
Teacher-1 Applicant
 DEPARTMENT OF EDUCATION
Region VII, Central Visayas
SCHOOLS DIVISION OF NEGROS ORIENTAL
Office of the Curriculum and Implementation Division

Name of Applicant: JESAMAE E.ACASO District: DISTRICT IV

Major: GENERAL EDUCATION (BEED)

No. Name of Document Remarks

1 Application Letter

2 CSC Form 212 (Revised 2005) in two copies with the latest 2x2 ID
picture

3 Certified Photocopy of authenticated PRC License

4 Certified Photocopy of authenticated Ratings in the LET/PBET

5 Certified copy of Transcript of Records

6 Copies of Service Records, Certificate of Employment,
Performance Rating and School Clearance (for those with teaching
experience).
NOTE: In case the said documents may not be available at the
time of the submission of the application letter, a JUSTIFICATION
stating the reasons why these are not yet available must also be
submitted.

7 Certificates of specialized training, if any (National Certificate (NC)

must be from TESDA)
8 Certified copy of the voters ID and/ or any proof of residency as
deemed acceptable by the School Screening Committee

9 NBI clearance
10 Omnibus Certification of authenticity and veracity of all
documents submitted and signed by the applicant

Checked by:
_________________________________
SIGNATURE OVER PRINTED NAME

NOTED:
__________________________________
SIGNATURE OVER PRINTED NAME OF PSDS

CONFORME:

________________________________________
SIGNATURE OVER PRINTED NAME OF APPLICANT
 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VII, Central Visayas
SCHOOLS DIVISION OF NEGROS ORIENTAL
Mabinay District IV

OMNIBUS CERTIFICATION OF AUTHENTICITY AND VERACITY OF DOCUMENTS

I, Jesamae E. Acaso of legal age, Filipino and residing at Polog, Samac, Mabinay, Negros
Oriental, Philippines, after having been duly sworn in accordance with the law, do hereby
depose and state that:
1. I am applying for Teacher I at Nabaliwan Elementary School, Nabaliwan , Samac,
Mabinay, Negros Oriental.
2. I have submitted the following documents:
2.1. Application Letter
2.2. CSC Form 212 (Revised 2005) in two copies with the latest 2x2 ID picture
2.3. Certified Photocopy of authenticated PRC License
2.4. Certified Photocopy of authenticated Ratings in the LET
2.5. Certified copy of Transcript of Records/GPA
2.6. Copies of Service Records and School Clearance / MOA
2.7. Certificates of specialized training TESDA)
2.8. Certified copy of the Voter’s Certification
2.9. NBI clearance

______________________________
(Signature over printed name)