DepEd – DIVISION OF QUEZON

Sitio Fori, Brgy. Talipan, Pagbilao, Quezon QUALITY

ASSURED
COMPANY
Trunkline # (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321 ISO 9001

www.depedquezon.com.ph Registration Number:

“Creating Possibilities, Inspiring Innovations” QAC/R63/0216

SCORE SHEET FOR MASTER TEACHER I APPLICANTS

Applicant’s Name: School:

Present Position: Designation:
District: Position Applied For:

Required Qualification/Entry Requirements REMARKS

For Natural Vacancy Authenticated TOR: _______________
✓ BEEd / BSEd or its equivalent and at least 18 units for a Master’s
degree in Education (Authenticated TOR) PRC License: ___________________
✓ LET/PBET passers
Service Record: _________________
✓ Teacher III with at least 3 years’ experience, where no T-III is
available in school. Teacher II with 5 years’ experience may apply
Latest Appointment: ______________
(Service Record and Copy of Latest Appointment) Date of Last Promotion: ___________
✓ Very Satisfactory performance for the last Three (3) rating period
(on the current position) Performance Rating (3 VS) : ________
✓ At least 30 points in leadership and potential and has been a ________
demonstration teacher in the school/district/division level (see ________
attached Score Sheet)
No. of Demo Teaching: ____________
For Reclassification
Lesson Plan: ____________________
✓ Teacher III with at least 3 years’ experience
Certification of Demo Teaching signed
Note: No additional documents will be accepted after the scheduled
by the DS, SH and teachers: _______
date of submission to the Division Office.

LEADERSHIP, POTENTIAL AND ACCOMPLISHMENTS REMARKS / POINTS

(At least 25 points) COMMENTS EARNED

(20 pts maximum)

A. Introduced any of the following which has been adopted or
used by the school or district/division
1. Curriculum or instructional materials _______________
-Certification issued by proper authorities that the
curriculum/IMs were used by the school/district _______________
-Copy of curriculum/IMs introduced

Regional = 10 District = 6 Division = 8 School = 4

Sub-total

2. Effective teaching techniques or strategies _______________

a. Certification of the demonstration teaching made
corroborated by at least five (5) of the Teacher observers _______________
b. Certification that the teaching techniques or strategies
introduced were used by the school / district signed by _______________
School Head and District Supervisor
c. Copy of the Lesson Plan showing effective teaching
_______________
techniques or strategies duly approved by the School
Head
d. Program of Activities when demonstration teaching was
made signed by proper authorities

No. of Demonstration: School District Division Regional National

3 or more demonstration 3 pts 6 pts 8 pts 10 pts 12 pts
2 demonstration 2 pts 4 pts 6 pts 8 pts 10 pts
1 demonstration 1 pt 2 pts 4 pts 6 pts 8 pts
Sub-total
DEPEDQUEZON-TM-ASD-04-016-003
Email address: [email protected]
Comments: Txt HELEN – 09178902327 (Smart/Sun/TalknTxt) 2327 (Globe and TM)

This form is a property of SCHOOLS DIVISION OFFICE - QUEZON PROVINCE. Therefore, unauthorized use is strictly prohibited unless otherwise
permitted by the Schools Division Superintendent.
 DepEd – DIVISION OF QUEZON
Sitio Fori, Brgy. Talipan, Pagbilao, Quezon QUALITY
ASSURED
COMPANY
Trunkline # (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321 ISO 9001

www.depedquezon.com.ph Registration Number:

“Creating Possibilities, Inspiring Innovations” QAC/R63/0216

3. Simplification of work as in reporting system, record

keeping etc. or procedures that resulted in cost
reduction
a. Certification for Simplification of Work that resulted _______________
to cost reduction, corroborated by five (5) teachers
b. Letter request to the SDS to adopt the originally _______________
made material for the Simplification of Work
c. Brief description of work/ reporting system/record _______________
keeping or procedure that resulted in cost reduction.
d. Work Plan for the implementation _______________
e. School memorandum
f. Accomplishment Report (Narrative and Pictorial) _______________

Regional Level = 20 District Level = 12 Sub-total

Division Level = 16 School Level = 8

4. Worthwhile Income Generating Project (IGP) for pupils

given due recognition by the higher officials of the
_______________
division
a. Certification for being the proponent of an IGP for
_______________
two (2) consecutive schools’ years as corroborated
by five (5) Teachers _______________
b. Letter request to the SDS conduct an IGP
c. IGP Proposal _______________
d. Accomplishment Report (Pictorial and Narrative)
e. Financial Statement _______________
No. of Years School District Division Regional
1-2 years 2 pts 4 pts 6 pts 8 pts _______________
3-4 years 4 pts 6 pts 8 pts 10 pts
5-6 years 6 pts 8 pts 10 pts 12 pts
7 years above 10 pts 14 pts 17 pts 20 pts Sub-total

B. Served as subject coordinator or grade chairman for at least

one (1) year or as adviser of school publication or any
special organization like dramatic club, glee club, science
club, etc. and discharged such assignments satisfactory for
at least (2) years provided such assignments or services are _______________
in addition to, and not considered part of the regular teaching
load. _______________
a. As subject coordinator
1. Certification for serving as a subject coordinator for _______________
two (2) years corroborated by five (5) teachers
2. Designation through school memorandum
3. Accomplishment Report (Narrative and Pictorial)

No. of Years School District Division Regional

1-2 years 1 pt 2 pts 3 pts 4 pts
3-4 years 2 pts 3 pts 4 pts 5 pts
5 years above 3 pts 4 pts 5 pts 6 pts
Sub-total

DEPEDQUEZON-TM-ASD-04-016-003
Email address: [email protected]
Comments: Txt HELEN – 09178902327 (Smart/Sun/TalknTxt) 2327 (Globe and TM)

This form is a property of SCHOOLS DIVISION OFFICE - QUEZON PROVINCE. Therefore, unauthorized use is strictly prohibited unless otherwise
permitted by the Schools Division Superintendent.
 DepEd – DIVISION OF QUEZON
Sitio Fori, Brgy. Talipan, Pagbilao, Quezon QUALITY
ASSURED
COMPANY
Trunkline # (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321 ISO 9001

www.depedquezon.com.ph Registration Number:

“Creating Possibilities, Inspiring Innovations” QAC/R63/0216

b. As Grade/Year level Chairman/Leader

1. Certification for serving as Grade/Year Level
Chairman, corroborated by 5 teachers
2. Designation through School Memorandum _______________
3. Accomplishment Report (Narrative and Pictorial)
_______________
No. of Years School District Division Regional
1-2 years 1 pt 2 pts 3 pts 4 pts Sub-total
3-4 years 2 pts 3 pts 4 pts 5 pts
5 years above 3 pts 4 pts 5 pts 6 pts
C. Served as chairman of a special committee, such as
curriculum study committee to prepare instructional
materials; and or committee to prepare school program, and
discharged work with utmost efficiency.
1. Certification for serving as Chairman of a Special
Committee for IMs, corroborated by 5 teachers _______________
2. Designation through School Memorandum
3. Copy of curriculum/ IMs prepared/Programs _______________
4. Accomplishment Report (Narrative and Pictorial)
Sub-total
No. of Times School District Division Regional
Chairman: Member Chairman: Member Chairman: Member Chairman: Member
1-4 1 0.5 2 1 4 2 6 3
5-7 2 1 3 2 6 4 9 6
8-10 3 2 4 3 8 6 12 9
D. Initiated or headed or participated in an educational
research activity duly approved by educational authorities
either for improvement of instructions, for community
development, or for teacher welfare.
1. For Action Researches
a. Letter request to SDS to conduct Action Research _______________
b. Approved Research Proposal
c. Research Report _______________
d. Accomplishment Report (including brief report on
the implications of such research for the _______________
improvement of instruction, community
development or teacher welfare) Sub-total
Chairman: 12 pts Member: 7 pts
(For group claims, divided by no. of members)
E. Coordinator for community project or activity or of a program
of another agency or coordinator of a rural service
improvement activity in a community such as feeding,
nutrition, agro-industrial fairs, etc. for the last three (3) years
or projects not credited in the last promotion.
1. Certification as the Coordinator of the Community
Project for at least two (2) years _______________
2. Designation as Coordinator of a Community Project in
the form of a Memorandum signed by DepEd officials _______________
and other agencies involved in the community project.
3. Project Proposal _______________
4. Accomplishment Report (Narrative and Pictorial)
Sub-total
No. of Times School District Division Regional
Chairman: Member Chairman: Member Chairman: Member Chairman: Member
1-4 1 0.5 2 1 4 2 6 3
5-7 2 1 3 2 6 4 9 6
8-10 3 2 4 3 8 6 12 9

DEPEDQUEZON-TM-ASD-04-016-003
Email address: [email protected]
Comments: Txt HELEN – 09178902327 (Smart/Sun/TalknTxt) 2327 (Globe and TM)

This form is a property of SCHOOLS DIVISION OFFICE - QUEZON PROVINCE. Therefore, unauthorized use is strictly prohibited unless otherwise
permitted by the Schools Division Superintendent.
 DepEd – DIVISION OF QUEZON
Sitio Fori, Brgy. Talipan, Pagbilao, Quezon QUALITY
ASSURED
COMPANY
Trunkline # (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321 ISO 9001

www.depedquezon.com.ph Registration Number:

“Creating Possibilities, Inspiring Innovations” QAC/R63/0216

F. Organized / Managed an in-service activity or other similar

activities at least on the school level (at least two days
INSET)
1. Certification for organizing and managing In-Service _______________
Training/Seminar-Workshops
2. Approved Training Designs and Program of Activities _______________
3. Accomplishment Report (Narrative and Pictorial)
_______________
No. of Times School District Division
Chairman: Member Chairman: Member Chairman: Member
1-4
5-7
2
4
1
2
4
6
2
4
6
9
3
6
Sub-total
8-10 6 3 8 6 12 9
G. Credited with meritorious achievements such as:
1. Trainer or coach of contestants who received prizes,
commendations, or any form of recognition:
a. Certification as trainer/coach/coordinator issued by
authorities concerned
b. Certificate of Recognition awarded/received signed _______________
by proper school officials.
c. Award/commendation/citation given to winning _______________
pupil/ group contestants trained, coached and
signed by proper school officials. _______________
d. Program of Activities of the Contests/ Competition/
Quiz. Sub-total
National Winner –10 points Regional Winner –5 points Division Winner –3 points
District Winner –2 points School Winner –1 point
2. Awards received as member/coordinator of Boy
Scout/Girl Scout/Red Cross activities:
a. Certificate of Recognition as coordinator of Boy/Girl _______________
Scout/Red Cross activities signed by proper
authorities _______________
National Winner –10 points Regional Winner –5 points Division Winner –3 points
District Winner –2 points School Winner –1 point _______________

Note: Gold, Silver, Bronze for GSP – Division Level Sub-total

USA, Tamaraw for BSP – National Level
H. Authorship
Ten (10) points for a book and one (1) point each for each
article provided they are on education. _______________
1. Copy of the articles published
2. Certification from the publisher _______________
3. Copy of the Certificate of Copyright Registration for
authorship of a book _______________
4. Copy of the published book/article/s
Sole authorship –10 points Co-authorship –5 points Article –1 point per article
Sub-total
GRAND TOTAL

Note: No credit or points for any incomplete requirements.

____________________________
Signature of Applicant

DEPEDQUEZON-TM-ASD-04-016-003
Email address: [email protected]
Comments: Txt HELEN – 09178902327 (Smart/Sun/TalknTxt) 2327 (Globe and TM)

This form is a property of SCHOOLS DIVISION OFFICE - QUEZON PROVINCE. Therefore, unauthorized use is strictly prohibited unless otherwise
permitted by the Schools Division Superintendent.
 DepEd – DIVISION OF QUEZON
Sitio Fori, Brgy. Talipan, Pagbilao, Quezon QUALITY
ASSURED
COMPANY
Trunkline # (042) 784-0366, (042) 784-0164, (042) 784-0391, (042) 784-0321 ISO 9001

www.depedquezon.com.ph Registration Number:

“Creating Possibilities, Inspiring Innovations” QAC/R63/0216

COMMENTS/RECOMMENDATIONS:

REVIEWED AND EVALUATED BY:

DIVISION SELECTION COMMITTEE

______________________ ______________________ ______________________

______________________ ______________________ ______________________
______________________ ______________________ ______________________
______________________ ______________________ ______________________

APPROVED BY:

________________________________
Schools Division Superintendent

DEPEDQUEZON-TM-ASD-04-016-003
Email address: [email protected]
Comments: Txt HELEN – 09178902327 (Smart/Sun/TalknTxt) 2327 (Globe and TM)

This form is a property of SCHOOLS DIVISION OFFICE - QUEZON PROVINCE. Therefore, unauthorized use is strictly prohibited unless otherwise
permitted by the Schools Division Superintendent.