Annex C
CHECKLIST OF REQUIREMENTS
NAME OF APPLICAT: ABIOL, ROBERT KANE OMISOL
POSITION APPLIED FOR: TEACHER I (ELEMENTARY)
LEARNING AREA: ELEMENTARY
OLD/NEW: New Applicant (SY 2024-2025)
OFFICE: SCHOOLS DIVISION OF CAGAYAN DE ORO
CONTACT NO: 09816378380
RELIGION: ROMAN CATHOLIC
ETHNICITY: Cebuano PERSON WITH DISABILITY: No SOLO PARENT: No
APPLICATION CODE: _____________________________________
STATUS OF VERIFICATION
SUBMISSION (To be filled-out by the HRMO/HR
(To be filled- Office/sub-committee)
BASIC DOCUMENTARY REQUIREMENT
out by the STATUS OF
applicant; SUBMISSION REMARKS
Check if (Check if
A. Letter of intent addressed to the Head of Office: submitted) complied HRMO)
ROY ANGELO E. GAZO, SCHOOLS DIVISION SUPERINTENDENT
B. Duly accomplished Personal Data Sheet (PDS)
(CS Form No. 212, Revised 2017) and; Work
Experience Sheet, if applicable
C. Photocopy of valid and updated PRC License/ID,
D. Photocopy of Certificate of Eligibility/Report of Rating,
E. Photocopy of scholastic/academic record such as but not limited to
Transcript of Records (TOR) and Diploma,
including completion of graduate and post-graduate units/degrees,
F. Photocopy of Certificate/s of Training,
G. Photocopy of Certificate of Employment, Contract of Service, or duly
signed Service Record, whichever is/are applicable
H. Checklist of Requirements and Omnibus Sworn Statement on the
Certification on the Authenticity and Veracity (CAV) of the documents
submitted and Data Privacy Consent Form
OMNIBUS SWORN STATEMENT
CERTIFICATION OF AUTHENTICITY AND VERACITY
I hereby certify that all information above are true and correct, and of my personal knowledge and belief, and the documents
submitted herewith are original and/or certified true copies thereof.
DATA PRIVACY CONSENT
I hereby grant the Department of Education the right to collect and process my personal information as stated above, for
purposes relevant to the recruitment, selection, and placement of personnel of the Department and for purposes of compliance
with the laws, rules, and regulations being implemented by the Civil Service Commission.
Name and Signature of Applicant
Subscribed and sworn to before me this day of , year .
In consonance with Republic Act No. 8792 or the "Electronic Commerce Act of 2000 ", (e)lectronic documents shall have the legal effect, validity or enforceability as
any other document or legal writing and a) (w)here the law requires a document to be in writing, that requirement is met by an electronic document if the said
electronic document maintains its integrity and reliability and can be authenticated so as to be usable for subsequent reference.
INDIVIDUAL EVALUATION SHEET FOR IER
(EDUCATION, TRAINING, EXPERIENCE & ELIGIBILITY)
NAME OF APPLICANT: ABIOL, ROBERT KANE OMISOL
APPLICATION CODE: CDO2024-TCH1-
POSITION APPLIED FOR: TEACHER I (ELEMENTARY)
LEARNING AREA: ELEMENTARY
OLD/NEW: New Applicant (SY 2024-2025)
EDUCATION: (perTranscriptofRecords(TOR))
▪ BACHELOR’S DEGREE: BACHELOR OF ELEMENTARY EDUCATION MAJOR IN GENERAL EDUCATION
▪ POST-GRADUATE: MASTERS IN MANAGEMENT MAJOR IN EDUCATIONAL MANAGEMENT (ONGOING)
TRAINING: (RELEVANTtrainingsattendedinthelastfiveyears)
NO. DETAILS HOURS
1 24 HOURS - INSET ( 2024 3-DAY IN-SERVICE TRAINING
FOR TEACHERS)
2 16 HOURS - GAD (2024 2-DAY GENDER AND
DEVELOPMENT TRAINING AND SEMINAR)
3 15 HOURS - ( 2020 IN-SERVICE TRAINING FOR JUNIOR
HIGH SCHOOL TEACHERS ENSURING ENDURING
STUDENT LEARNING OUTCOMES WITH ONLINE
DISTANCE LEARNING AND TEACHING OF K-12
STANDARDS IN THE TIME OF COVID-19)
4 8 HOURS - (LEARNING MANAGEMENT SYSTEM )
5 24 HOURS - (DESIGNING, ASSESSING AND
FACILITATING LEARNING OF THE K-12 STANDARDS
WITH 21ST CENTURY PEDAGOGIES)
6 24 HOURS - (IMPROVING JUNIOR HIGH SCHOOL
TEACHERS PEDAGOGICAL CONTENT KNOWLEDGE ON
ARTICULATED COMPETENCIES - PEAC SUMMER
INSET FOR JUNIOR HIGH TEACHERS )
7 NATIONAL CERTIFICATE II IN HOUSEKEEPING
8
TOTAL HOURS
EXPERIENCE: (RELEVANTTEACHINGexperience)
NO. DETAILS MONTHS AND YEARS
1 1 YEAR - ST. MATTHEW MONTESSORI SCHOOL
2 4 YEARS - CHRISTIAN HORIZON SCHOOL
3 2 YEARS - ST. CATHERINE ACADEMY
4 6 MONTHS - SUBSTITUTE TEACHER - DONA JUANA ACTUB
LLUCH MEMORIAL CENTRAL SCHOOL
5
6
7
8
TOTAL EXPERIENCE
ELIGIBILITY: (PBET/LET/LEPT)Licensure Examination for Teachers (LET) RATINGS: 78.6
_______________________________ Applicant’s
Name & Signature
I certify to the correctness of the documents evaluated:
