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[1] Last Name First Name Middle Name Extension [2] Sex [3] Birthdate [4] Age [5]Highest [6] Email
(Jr, Sr, II,etc.) (M/F) (MM/DD/YY) (by June Educational Address
Bachelor of
2019) Attainment
Science in
Elementary
Reglos Ermelita Santos N/A F 08/29/78 40 Education ermelita.reglos@deped.gov
Prepared by:
ERMELITA S. REGLOS
Signature Over Printed Name
Teacher I
Designation
April 8, 2019
Date of Submission
Republic of the Philippines
Department of Education
[7] Plantilla [8] Years in the [9] Designation [10] Years in the [11] Area of [12] Subject [13] Years [14] [15] Division [16] Region
Position Position Designated Specialization Taught in DepEd Office/School
ESP, English,
Position
OSEC-DECSB- Math, Filipino,AP,
TCH1-151344- Science, MTB,
2002 15 Teacher I 15 General Education MAPEH 15 Palauig Central Zambales III
Noted by:
Division Level Date Conducted Regional Level Date Conducted National Level Date Conducted
GEORGE P. ACUPAN
Signature Over Printed Name
_________________________
Date
ANNEX "A"
[1] Last Name First Name Middle Name Extension [2] Sex [3] Birthdate [4] Age [5]Highest [6] Email
(Jr, Sr, II,etc.) (M/F) (MM/DD/YY) (by June Educational Address
2019) Attainment
Prepared by:
ERMELITA S. REGLOS
Signature Over Printed Name
Teacher I
Designation
April 8, 2019
Date of Submission
Republic of the Philippines
Department of Education
[7] Plantilla [8] Years in the [9] Designation [10] Years in the [11] Area of [12] Subject [13] Years [14] [15] Division [16] Region
Position Position Designated Specialization Taught in DepEd Office/School
Position
Noted by:
Division Level Date Conducted Regional Level Date Conducted National Level Date Conducted
Approved by:
GEORGE P. ACUPAN
Signature Over Printed Name
Date
ANNEX "A"
[1] Last Name First Name Middle Name Extension [2] Sex [3] Birthdate [4] Age [5]Highest [6] Email
(Jr, Sr, II,etc.) (M/F) (MM/DD/YY) (by June Educational Address
2019) Attainment
Prepared by:
____________________________
Signature Over Printed Name
____________________________
Designation
____________________________
Date of Submission
Republic of the Philippines
Department of Education
[7] Plantilla [8] Years in the [9] Designation [10] Years in the [11] Area of [12] Subject [13] Years [14] [15] Division [16] Region
Position Position Designated Specialization Taught in DepEd Office/School
Position
Noted by:
____________________________
Signature Over Printed Name
____________________________
Date
[17] Title of L & D Program Attended
Division Level Date Conducted Regional Level Date Conducted National Level Date Conducted
Approved by:
_________________________
Signature Over Printed Name
_________________________
Date
ANNEX "A"
[1] Last Name First Name Middle Name Extension [2] Sex [3] Birthdate [4] Age [5]Highest [6] Email
(Jr, Sr, II,etc.) (M/F) (MM/DD/YY) (by June Educational Address
2019) Attainment
Prepared by:
____________________________
Signature Over Printed Name
____________________________
Designation
____________________________
Date of Submission
Republic of the Philippines
Department of Education
[7] Plantilla [8] Years in the [9] Designation [10] Years in the [11] Area of [12] Subject [13] Years [14] [15] Division [16] Region
Position Position Designated Specialization Taught in DepEd Office/School
Position
Noted by:
____________________________
Signature Over Printed Name
____________________________
Date
[17] Title of L & D Program Attended
Division Level Date Conducted Regional Level Date Conducted National Level Date Conducted
Approved by:
_________________________
Signature Over Printed Name
_________________________
Date
ANNEX "A"
[1] Last Name First Name Middle Name Extension [2] Sex [3] Birthdate [4] Age [5]Highest [6] Email
(Jr, Sr, II,etc.) (M/F) (MM/DD/YY) (by June Educational Address
2019) Attainment
Prepared by:
____________________________
Signature Over Printed Name
____________________________
Designation
____________________________
Date of Submission
Republic of the Philippines
Department of Education
[7] Plantilla [8] Years in the [9] Designation [10] Years in the [11] Area of [12] Subject [13] Years [14] [15] Division [16] Region
Position Position Designated Specialization Taught in DepEd Office/School
Position
Noted by:
____________________________
Signature Over Printed Name
____________________________
Date
[17] Title of L & D Program Attended
Division Level Date Conducted Regional Level Date Conducted National Level Date Conducted
Approved by:
_________________________
Signature Over Printed Name
_________________________
Date
ANNEX "A"
[1] Last Name First Name Middle Name Extension [2] Sex [3] Birthdate [4] Age [5]Highest [6] Email
(Jr, Sr, II,etc.) (M/F) (MM/DD/YY) (by June Educational Address
2019) Attainment
Prepared by:
____________________________
Signature Over Printed Name
____________________________
Designation
____________________________
Date of Submission
Republic of the Philippines
Department of Education
[7] Plantilla [8] Years in the [9] Designation [10] Years in the [11] Area of [12] Subject [13] Years [14] [15] Division [16] Region
Position Position Designated Specialization Taught in DepEd Office/School
Position
Noted by:
____________________________
Signature Over Printed Name
____________________________
Date
[17] Title of L & D Program Attended
Division Level Date Conducted Regional Level Date Conducted National Level Date Conducted
Approved by:
_________________________
Signature Over Printed Name
_________________________
Date
ANNEX "A"
[1] Last Name First Name Middle Name Extension [2] Sex [3] Birthdate [4] Age [5]Highest [6] Email
(Jr, Sr, II,etc.) (M/F) (MM/DD/YY) (by June Educational Address
2019) Attainment
Prepared by:
____________________________
Signature Over Printed Name
____________________________
Designation
____________________________
Date of Submission
Republic of the Philippines
Department of Education
[7] Plantilla [8] Years in the [9] Designation [10] Years in the [11] Area of [12] Subject [13] Years [14] [15] Division [16] Region
Position Position Designated Specialization Taught in DepEd Office/School
Position
Noted by:
____________________________
Signature Over Printed Name
____________________________
Date
[17] Title of L & D Program Attended
Division Level Date Conducted Regional Level Date Conducted National Level Date Conducted
Approved by:
_________________________
Signature Over Printed Name
_________________________
Date
ANNEX "A"
[1] Last Name First Name Middle Name Extension [2] Sex [3] Birthdate [4] Age [5]Highest [6] Email
(Jr, Sr, II,etc.) (M/F) (MM/DD/YY) (by June Educational Address
2019) Attainment
Prepared by:
____________________________
Signature Over Printed Name
____________________________
Designation
____________________________
Date of Submission
Republic of the Philippines
Department of Education
[7] Plantilla [8] Years in the [9] Designation [10] Years in the [11] Area of [12] Subject [13] Years [14] [15] Division [16] Region
Position Position Designated Specialization Taught in DepEd Office/School
Position
Noted by:
____________________________
Signature Over Printed Name
____________________________
Date
[17] Title of L & D Program Attended
Division Level Date Conducted Regional Level Date Conducted National Level Date Conducted
Approved by:
_________________________
Signature Over Printed Name
_________________________
Date
ANNEX "A"
[1] Last Name First Name Middle Name Extension [2] Sex [3] Birthdate [4] Age [5]Highest [6] Email
(Jr, Sr, II,etc.) (M/F) (MM/DD/YY) (by June Educational Address
2019) Attainment
Prepared by:
____________________________
Signature Over Printed Name
____________________________
Designation
____________________________
Date of Submission
Republic of the Philippines
Department of Education
[7] Plantilla [8] Years in the [9] Designation [10] Years in the [11] Area of [12] Subject [13] Years [14] [15] Division [16] Region
Position Position Designated Specialization Taught in DepEd Office/School
Position
Noted by:
____________________________
Signature Over Printed Name
____________________________
Date
[17] Title of L & D Program Attended
Division Level Date Conducted Regional Level Date Conducted National Level Date Conducted
Approved by:
_________________________
Signature Over Printed Name
_________________________
Date