ERF Form

Republic of the Philippines

DEPARTMENT OF EDUCATION
Region I
DIVISION OF ILOCOS SUR
Bantay, Ilocos Sur
NAME: ________________________________________________________ Date of Birth: _______________________ Sex: ____________
Surname
Given
M.I.
Employee No. ___________________________________________________ Authorized Position Title: ______________________________
Item No. _______________________________________ G.A.A. No. ___________________ Authorized Position Title: _________________
I. Educational Attainment & Civil Service Eligibility:
__________________________________________________________________________________________________________________
Titles, Degrees or Highest
Grade Attained

Name of Institution

Year Received

CS Exam

Rating

Date

II. Service Records: Attached Duly Certified Service Record

III. Equivalent Units:
A. Total Number of Years Teaching
(Public Only) ___________________________ Equiv. __________________________
B. Degree to Degree Equivalent
(Present Degree) ________________________ Equiv. __________________________
C. Areas of Equivalents
School Year
No. of Units
Description
1. Professional Study
2. Teaching Experience
a. Public School
b. Private School
3. Adm. Supervisory Experience
a. Public School
b. Private School
4. Others (Seminars, Workshop, etc.)

TOTAL
LATEST EFFICIENCY RATING: ________________________

________________________________
Teachers Signature

CERTIFIED AND VERIFIED CORRECT:

CONCESA T. RUMIAS, Ed. D.
District Supervisor
Note: Teachers Do Not Write Below
IV. DIVISION ACTION:
CLASSIFICATION
Date Processed

Grade Assignment

Salary Grade

Scheduled Salary

REMARKS

RECOMMENDING APPROVAL:
MARINO S. BAYTEC, Ed. D., CSEE
Schools Division Superintendent

SOLEDAD B. DUMBRIQUE
Administrative Officer V

V. DepEd REGIONAL OFFICE ACTION:

Classification ____________________________________________ Grade ___________________________________
Post-Audited at Grade ______________________________________________________________________________
(For Future Reference)
Date approved/processed: _________________________________________
___________________________________
Evaluator

______________________________________
Regional Director