Republic of the Philippines

Northwest Samar State University

Website: http//www.nwssu.edu.ph Email: main@nwssu.edu.ph
Telefax: (055) 2093657

TEACHING LOAD FORM

ACA – QF – 05
Revision No.: 00
Undergraduate Graduate
:Effectivity
School Year: 2019-2020 February 4, 2019
Semester: 1st Regular Overload Part-Time Petition

NAME: MAGBUTAY REXOR HERNANDEZ HOME ADDRESS: BRGY. PAYAHAN, CALBAYOG CITY
Surname First Name Middle Name
Educational Qualification: Baccalaureate Degree: Bachelor of Secondary Education Major: English Minor: NA
Note: Masters Degree: Master of Arts in Education (CAR) Major: English
Indicate 6 digit code Doctoral Degree: NA Major:
Administrative Designation/Special Assignment: Office of QA - Accreditation Focal Person
Years of teaching experience: NA Public School: NA Private School: NA Total NA
SUBJECTS Dept./Sub. No. of Contact Total
Contac
Time Monday Tuesday Wednesday Thursday Friday Saturday Yr & Sec. Students Hours Hrs.
7:00 CAS
8:00 CMEC 1
8:00 BSCRIM 1A 40 3 120
9:00 BSCRIM 1B 40 3 120
9:00 CMEC 1 CMEC 1 GE 5
10:00 EXTENSION AB 303 EXTENSION AB 303 BSCD 1 40 3 120
10:00 BSCRIM 1B BSCRIM 1B COEd
RESEARCH
11:00 LIT 1 LIT 1 LIT 1
11:00 BTVTED 2 40 3 120
12:00 BTVTED 2 BTVTED 2 BTLED 2 40 3 120
12:00
LUNCH BREAK
1:00
1:00 GE 5 GE 5
DESIGNATED DESIGNATED
2:00 AB 302 AB 302 DESIGNATED
WORK WORK
2:00 BSCD 1 BSCD 1 WORK
3:00 CMEC 1 GE ELEC LIT 2 CMEC 1 GE ELEC LIT 2
3:00 AB 304 AB 302 AB 304 AB 302
4:00 BSCRIM 1A BSCD 2A BSCRIM 1A BSCD 2A
4:00 LIT 1 LIT 1
5:00 AB 302 AB 302
5:00 * BTLED 2 * BTLED 2
6:00
6:00
7:00
7:00
8:00
8:00
9:00

Indicate inside subject block: Number of Hours/Week Student Contact # 60

1. Course Code Lecture: 15 Hours (Undergrad)
2. Room Number Laboratory/Shop: 0 Lecture:
3. * Overload Other Assignments/ Laboratory:
4. # Petition Designated Work: 6 CERTIFIED TRUE AND CORRECT: Student Contact #
5. Research, Extension & Consultation Non-teaching Hours: 10 Hours (Graduate)
6. DPTL Code: 140403 Research: 3 Lecture:
Effectivity: AUGUST 12, 2019 Extension: 3 REXOR H. MAGBUTAY Laboratory:
 Consultation: 3 Signature Over Printed Name
TOTAL: 40 No. of Preparations: 3
RECOMMENDING APPROVAL:

Dean: ARMANDO A. ALVIOLA, Ph.D. Dean: FE C. MONTECALVO, Ed.D.

Date: Date:

MARCIANO B. APILADO, Ed.D

Vice President for Academic Affairs
Date:

Prepare in 8 copies APPROVED:

1 Personnel Officer
2 Accounting Section BENJAMIN L. PECAYO. Ed.D.
3 COA Resident Auditor University President
4 VP, Academic Affairs
5 Dean Concerned
6 Instructor Concerned
7 Registrar
8 Cashier
he Philippines
r State University
ph Email: main@nwssu.edu.ph
55) 2093657

ACA – QF – 05
Revision No.: 00
:Effectivity
February 4, 2019

BRGY. PAYAHAN, CALBAYOG CITY

NA
English

itation Focal Person

NA
Total
Contact
Hrs.
CAS
CMEC 1
120
120
GE 5
120
COEd
LIT 1
120
120

600
3
 Republic of the Philippines
Northwest Samar State University
Website: http//www.nwssu.edu.ph Email: main@nwssu.edu.ph
Telefax: (055) 2093657

TEACHING LOAD FORM

ACA – QF – 05
Revision No.: 00
Undergraduate Graduate
:Effectivity
School Year: 2019-2020 February 4, 2019
Semester: 1st Regular Overload Part-Time Petition

NAME: MAGBUTAY REXOR HERNANDEZ HOME ADDRESS: BRGY. PAYAHAN, CALBAYOG CITY
Surname First Name Middle Name
Educational Qualification: Baccalaureate Degree: Bachelor of Secondary Education Major: English Minor: NA
Note: Masters Degree: Master of Arts in Education (CAR) Major: English
Indicate 6 digit code Doctoral Degree: NA Major:
Administrative Designation/Special Assignment: Office of QA - Accreditation Focal Person
Years of teaching experience: NA Public School: NA Private School: NA Total NA
SUBJECTS Dept./Sub. No. of Contact Total
Contac
Time Monday Tuesday Wednesday Thursday Friday Saturday Yr & Sec. Students Hours Hrs.
7:00 CAS
8:00 CMEC 1
8:00 BSCRIM 1A 40 3 120
9:00 BSCRIM 1B 40 3 120
9:00
10:00
10:00
11:00
11:00
12:00
12:00
LUNCH BREAK
1:00
1:00
2:00
2:00
3:00
3:00
4:00
4:00
5:00
5:00 * *
6:00
6:00
7:00
7:00
8:00
8:00
9:00

Indicate inside subject block: Number of Hours/Week Student Contact # 24

1. Course Code Lecture: 3 Hours (Undergrad)
2. Room Number Laboratory/Shop: Lecture:
3. * Overload Other Assignments/ Laboratory:
4. # Petition Designated Work: CERTIFIED TRUE AND CORRECT: Student Contact #
5. Research, Extension & Consultation Non-teaching Hours: Hours (Graduate)
6. DPTL Code: 140403 Research: Lecture:
Effectivity: AUGUST 12, 2019 Extension: REXOR H. MAGBUTAY Laboratory:
 Consultation: Signature Over Printed Name
TOTAL: 3 No. of Preparations: 3
RECOMMENDING APPROVAL:

Dean: ARMANDO A. ALVIOLA, Ph.D.

Date:

MARCIANO B. APILADO, Ed.D

Vice President for Academic Affairs
Date:

Prepare in 8 copies APPROVED:

1 Personnel Officer
2 Accounting Section BENJAMIN L. PECAYO. Ed.D.
3 COA Resident Auditor University President
4 VP, Academic Affairs
5 Dean Concerned
6 Instructor Concerned
7 Registrar
8 Cashier
he Philippines
r State University
ph Email: main@nwssu.edu.ph
55) 2093657

ACA – QF – 05
Revision No.: 00
:Effectivity
February 4, 2019

BRGY. PAYAHAN, CALBAYOG CITY

NA
English

itation Focal Person

NA
Total
Contact
Hrs.
CAS
CMEC 1
120
120

240
3