Checklist For Appointment To Teacher I 3

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Republika ng Pilipinas

Kagawaran ng Edukasyon
Rehiyon V
TANGGAPAN NG MGA PAARALANG PANSANGAY NG CAMARINES SUR

DOCUMENTARY REQUIREMENTS FOR APPOINTMENT TO TEACHER I


(FOR NEWLY HIRED & RE-EMPLOYMENT STATUS)

NAME :______________________________________________________________________
STATUS : Permanent SG : 11 DISTRICT ASSIGNMENT:_______________________________

SET A (CSC FILE) FORMS/DOCUMENTS NO. OF


COPIES
1. CS Form 212 (Revised 2017) (Personal Data Sheet) Original copy (duly notarized) with
attached latest passport size picture with name tag and signature, white background (can 3
be encoded or hand-written, please use black ink pen)
2. Work Experience Sheet 3
3. Certificate of Good Standing (original or authenticated by PRC ) 2
4. PRC License(authenticated by PRC) 2
5. CS Form No. 1 (Position Description Form ) 2
6. CS Form No. 32 (Oath of Office) Original copy with Documentary Stamp (Write your First 2
Name, Complete Residential Address and Position Title - Hand written)
7. CS Form No. 4 (Certificate of Assumption to Duty)1st paragraph(Write your FN,MN,LN, Position 2
Title, Name of School Assignment)Hand Written,2 nd paragraph(Write your FN,MN, LN and your Position Title),
3rdparagraph -leave it blank
8. Transcript of Records (original or authenticated by the School/University) 2
9. Marriage Contract/Certificate issued by the PSA (for married employees) -Original copy 2
10. Certificate of Live Birth (issued by the PSA) Original copy 2
11. Statement of Assets, Liabilities and Net Worth (duly notarized) - Original copy 2
12. CSC Publication of Vacant Item 1

NO. OF
SET B (201 FILE – DIVISION OFFICE) FORMS/DOCUMENTS COPIES
1. CS Form 212 (Revised 2017) (Personal Data Sheet) Original Copy 1
2. Work Experience Sheet 1
3. Certificate of Good Standing (photocopy ) 1
4. PRC License(authenticated by PRC/photocopy) 1
5. CS Form No. 1 (Position Description Form ) 1
6. CS Form No. 32 (Oath of Office) 1
7. CS Form No. 4 (Certificate of Assumption to Duty) 1
8. Marriage Contract/Certificate issued by the PSA (for married employees) photocopy 1
9. Certificate of Live Birth issued by the PSA (for unmarried employees) photocopy 1
10. CS Form 211 (Revised 2018) - Medical Certificate , please attach the photocopy of the
following results: 1
a. Blood Test d. Drug Test
b. Urinalysis e. Psychological Test
c. Chest X-Ray f. Neuro-Psychiatric Examination (original)
11. NBI Clearance 1
12. Statement of Assets, Liabilities and Net Worth (duly notarized) 1
13. Transcript of Records (original or authenticated by the School/University) 1
14. Approved Clearance from former Office/School (Government or Private) 1
NOTE:
• ALL PHOTOCOPIED DOCUMENTS SHOULD BE AUTHENTICATED BY THE SCHOOL/ UNIVERSITY/ OFFICE
ISSUING THE DOCUMENTS.
• ALL DOCUMENTS FOR SET A AND SET B MUST BE PLACED INTACT IN ONE LONG-SIZED BROWN TAGBOARD
FOLDER.

VALIDATED AND PROCESSED:

JEZALENE JOY D. ALBEZA/EDEN B. MACANDOG


Validators

REVIEWED:

MARIA DIVINA H. CALLEJA


Administrative Officer IV

Adres: Freedom Sports Complex, San Jose, Pili, Camarines Sur


Email: [email protected]
Website: www.depedcamsur.com
Telepono Bilang: (telefax) 8713340
Republika ng Pilipinas
Kagawaran ng Edukasyon
Rehiyon V
TANGGAPAN NG MGA PAARALANG PANSANGAY NG CAMARINES SUR

Adres: Freedom Sports Complex, San Jose, Pili, Camarines Sur


Email: [email protected]
Website: www.depedcamsur.com
Telepono Bilang: (telefax) 8713340

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