Annex C

CHECKLIST OF REQUIREMENTS FOR SENIOR HIGH SCHOOL APPLICANT

Name of Applicant: _____________________________ Date of Submission: ______________

Track/Strand Applied For: ___________________________
School: _________________________________________
Contact Number: _______________________________
Religion: _______________________________________
Ethnicity: ______________________________________
Person with Disability: Yes ( ) No ( )
Solo Parent: Yes ( ) No ( )

Status of VERIFICATION
Submission (To be filled-out by the
(To be filled- HRMO/HR Office/sub-
Basic Documentary Requirement out by the committees)
applicant; Status of Remarks
Check if Submiss
submitted) ion
(Check if
complied)
MANDATORY REQUIREMENTS
a. Letter of intent addressed to the Head of Office:
 Statement of purpose/expression of interest
 Subject group he/she intends to teach
 Preferred schools, if any
b. Duly accomplished Personal Data Sheet (CS Form 212, revised 2017) which can be
downloaded at www.csc.gov.ph with the attachment to CS Form 212 Work Experience
Sheet and 1 Passport size ID picture
c. Certified photocopy of certificates of relevant specialized trainings, if any
d. Photocopy of Certificate of Employment, Contract of Service, or duly signed Service
Record, whichever is/are applicable
e. National Bureau of Investigation (NBI) clearance
f. Checklist of Requirements and Omnibus Sworn Statement on the Certification on the
Authenticity and Veracity (CAV) of the documents submitted and Data Privacy Consent
Form
ADDITIONAL REQUIREMENTS
g. Certified photocopy of Diploma on Bachelor’s Degree
h. Photocopy of scholastic/academic record such as but not limited to Certification on the
Authenticity and Veracity (CAV) Transcript of Records (TOR), General Weighted Average
(GWA) and Diploma/certification on CAR, including completion of graduate and post-
graduate units/degrees, if available
i. Certified photocopy of Professional Regulation Commission (PRC) professional ID
card/certificate of registration/license.
j. Certified photocopy of ratings obtained in the Licensure Examination for teachers
(LET)/Professional Board examination for Teachers (PBET)
k. Written approval from his/her head of unit if he/she is currently employed by the
national government or the local government unit.
ADDITIONAL REQUIREMENTS FOR TVL TEACHERAPPLICANTS
l. Technical Education and Skills Development Authority (TESDA) National Certificate (NC)
of at least one level higher than course to be taught in subject to be taught (e.g. NC-III in
SMAW to teach SMAW-NC-II) or same level if there is no NC level higher. Exceptions are
given to applicants for courses with no National Certificates (e.g. Handicraft courses)
m. Certified photocopy of Trainers Methodology Certificate (TMC), if available
ADDITIONAL REQUIREMENT FOR HEI/TVI FACULTY
n. Certified photocopy of Certification of Status of Employment/Service Record from
HEI/TVI
OTHER DOCUMENTS AS MAY BE REQUIRED FOR COMPARATIVE ASSESSMENT:
k. Means of Verification (MOVs) showing: a) Outstanding Employee Award/s; b) approved
innovative work plan, research and development projects; c) publication/authorship; d)
Consultation/Resource Speaker in Trainings/Seminars/Workshops/ Symposia;
e) Certificates of relevant trainings attended (must be relevant to the position being
applied)/Certificates of Recognition/Commendation (if any) not used during the last
promotion and earned within five (5) years reckoned from the issuance of this
memorandum

Attested:

___________________________________________________________________
Human Resource Management Officer/Sub Committees

OMNIBUS SWORN STATEMENT

CERTIFICATION OF AUTHENTICITY AND VERACITY

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.

DATA PRIVACY CONSENT

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.

_______________________________________
Name and Signature of Applicant

Subscribed and sworn to before me this ____ day of ________________, year ________.

Person Administering Oath

In consonance with Republic Act No. 8792 or the “Electronic Commerce Act of 2000”, electronic 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.