EPISCOPAL DIOCESE OF SOUTHERN PHILIPPINES

BRENT HOSPITAL AND COLLEGES INCORPORATED

P.O. Box 33, Zamboanga City, 7000 Philippines

PERSONNEL DATA SHEET

(For Ranking and Permanency Evaluation)

Name of Employee: Employee Status: PERMANENT/REGULAR

As of (from date of Appointment) Years in Service:
Address: Civil Status:

I. HIGHEST EDUCATIONAL QUALIFICATION

Degree Obtained Major Specification Year Obtained POINTS
_______
_______
_______

II. LICENSURE / ELIGIBILITY EXAMINATION TAKEN

Name of Examination Date Taken Rating POINTS

III. ADDITIONAL RELEVANT CREDITS EARNED

Course/Institution Units Earned POINTS
1. Towards a Higher Degree
2. Same Level of Degree

IV. WORK EXPERIENCES

A. Teaching Experiences / Positions
Position/Institution Inclusive Date POINTS
1. Primary School
2. Secondary School
3. Tertiary School
4. Post Graduate School

B. Non-Teaching Experiences / Positions

Position/Institution Inclusive Date POINTS
1. Administrative
2. Non-Administrative
3. Other Designations
4. Professional Experiences

V. PROFESSIONAL / COMPETENCIES DEVELOPMENT ACTIVITIES/AWARDS HONORS

1. SEMINARS, CONFERENCES, WORKSHOPS, TRAININGS (JAN. 2015-FEB 2018)

Type Nature of Participation Sponsoring Inclusive Date POINTS
Seminar/Workshop Participant/speaker/organizer Institution
Training

2. INVENTIONS, DISCOVERIES

3. CREATIVE WORKS, INNOVATION

4. PUBLICATIONS, BOOKS, ARTICLES, RESEARCH

5. SCHOLARSHIP
Program Sponsoring Institution Inclusive Dates POINTS

6. AWARDS / HONORS RECEIVED

Nature of Awards/Honor Received Awarding Institution Date Received POINTS
 7. MEMBERSHIP IN PROFESSIONAL ORGANIZATIONS
Name of Organization Nature of Membership (Position Held) Inclusive Date POINTS

8. PARTICIPATION IN INSTITUTIONAL COMMITTEES

Name of Committees Nature of Work (Position Held) Inclusive Date POINTS

9. PARTICIPATION IN COMMUNITY SERVICES

Name of Community Nature of Participation Inclusive Date POINTS

10. EFFICIENCY
a. Performance Evaluation
1. Superior
2. Students
b. Peers Evaluation
c. Self Evaluation

Submitted by:

Signature over printed name of employee