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    Faculty Workload Form A: Central Luzon State University

    Uploaded by

    Allaiza Mei Reyes Lazaro
    This document is a faculty workload form for Marc Allaine Lazaro from Central Luzon State University for the first semester of the 2019-2020 school year. It provides his personal details like name, contact information, degrees obtained, and discipline classification. It requires signatures from the faculty member, department chair, dean, and human resources to certify the workload details.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Faculty Workload Form A: Central Luzon State University

    Uploaded by

    Allaiza Mei Reyes Lazaro
    49 views1 page
    This document is a faculty workload form for Marc Allaine Lazaro from Central Luzon State University for the first semester of the 2019-2020 school year. It provides his personal details like name, contact information, degrees obtained, and discipline classification. It requires signatures from the faculty member, department chair, dean, and human resources to certify the workload details.

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    FORM A workload

    Original Title

    FORM-A

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    This document is a faculty workload form for Marc Allaine Lazaro from Central Luzon State University for the first semester of the 2019-2020 school year. It provides his personal details like name, contact information, degrees obtained, and discipline classification. It requires signatures from the faculty member, department chair, dean, and human resources to certify the workload details.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    49 views1 page

    Faculty Workload Form A: Central Luzon State University

    Uploaded by

    Allaiza Mei Reyes Lazaro
    This document is a faculty workload form for Marc Allaine Lazaro from Central Luzon State University for the first semester of the 2019-2020 school year. It provides his personal details like name, contact information, degrees obtained, and discipline classification. It requires signatures from the faculty member, department chair, dean, and human resources to certify the workload details.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 1

    Republic of the Philippines

    CENTRAL LUZON STATE UNIVERSITY


    3120 Science City of Muñoz, Nueva Ecija

    FACULTY WORKLOAD
    Form A

    Semester: 1st Semester School Year: 2019-2020


    College/Unit: CED Department: USHS

    Printed name of Faculty Member:


    LAZARO MARC ALLAINE R.
    Family Given Name M.I.

    E-mail Address: [email protected] Contact Number: 09359225579


    Date of Birth (mm/dd/yyyy): 10/03/1999 Gender [(1) Male; (2) Female]: 1
    Generic Faculty Rank: Part Time Instructor Own Plantilla (PS) Item [Yes/No]: No
    In active duty during the entire semester? [Yes/No]: Yes
    On leave with pay? Type of Leave: N/A
    Period [indicate date (mm/dd/yyyy)]: N/A
    On leave without pay? Type of Leave: N/A
    Period [indicate date (mm/dd/yyyy)]: N/A
    Academic Degrees Obtained:
    Date Completed Wrote Thesis as
    Where Obtained
    Degree Title/ Major* (mm/dd/yyyy)[OR
    (School/Address)
    Part of the Degree
    Status] (Yes/No)
    BS Education Major in CLSU, Science
    Baccalaureate 6/28/2019 Yes
    Social Studies City of Muñoz
    Master’s (2)
    Doctoral (2)
    *Status: (1) Still being pursued / (2) Not yet started; Please do not indicate “1” if you are (a) NOT enrolled, (b) on
    official LOA, or (c) on residency.

    Discipline Classification of Primary Teaching Load**:


    First Specific Discipline where most teaching is done: 463902
    Second Specific Discipline where most teaching is done:

    **Please refer to 6-digit discipline codes by CHED from the CLSU website: http://clsu.edu.ph/downloads/Faculty%20and
    %20Staff/Faculty%20Files/Discipline%20Codes/index.php

    DATA PRIVACY NOTICE: CLSU is committed to ensure that the data privacy rights of its employees, students, clients and
    stakeholders are upheld and protected. By signing this form, you give permission to CLSU to store and process your personal data in
    adherence to the principles of transparency, legitimate purpose, and proportionality as required by RA 10173 or the Data Privacy Act of
    2012.

    Prepared by: Certified correct:

    MARC ALLAINE R. LAZARO MERCEDITA M. REYES, PhD REGIDOR G. GABOY, PhD


    Faculty Member Department Chair Dean
    Date: _____________ Date: _____________ Date: _____________

    Department Chair Dean


    Date: _____________ Date: _____________

    Copies for: (1) OVPAA; (2) College/Department; (3) HRMO; (4) Faculty; (5) Faculty Overload In-Charge

    ACA.XXX.YYY.F.013 (Revision No. 1; July 26, 2018)

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