Republic of the Philippines

BC-CSC Form No. 1

1. NAME OF EMPLOYEE

2. DEPARTMENT, CORPORATION OR AGENCY

LOCAL GOVERNMENT

_____________________________________________
_
(Family Name)
(Middle Name)

(Given Name)

3. BUREAU OR OFFICE

4. DEPT./BRANCH/DIVISION

5. WORK STATION/PLACE OF WORK

School/District

6. Pres. Appro. __________________

b. Prev.
Act/Board Res. Blg. ____________
Approp.
Ord. NO. _________________
Act.
__________
Item No. _________________
Bd. Res.
_______
Ord. No.
_________________
Item No.
________________

7. SALARY
B. OTHER COMPENSATION
Authorized ___________________
Actual _______________________

8. OFFICIAL DESIGNATION OF POSITION

9. Working OR PROPOSED TITLE

10.CPCB CLASSIFICATION OF THIS POSITION

11.OCCUPATIONAL GROUP TITLE

12.FOR LOCAL GOVERNMENT POSITION,

CHECK GOVERNMENT UNIT 7 UNITS
CLASS
MUNICIPALITY
CITY
PROVINCE
1st
2nd
3rd
4th
5th
th
th
6
7

13.STATEMENT OF DUTIES AND

RESPONSIBILITIES Sheets.

If more spaces is needed, please attach

additional

Percent Working Time

Duties

14.POSITION TITLE OF IMMEDIATE

SUPERVISOR

15.POSITION TITLE OF NEXT HIGHER

SUPERVISOR

16.NAMES, TITLES AND ITEM NOS. OF THOSE YOU DIRECTLY SUPERVISE (If only seven (7),
list only by their item number and titles)
17.MACHINES, EQUIPMENTS, TOOLS, etc. used regularly in performance of work.

18.CONTACTS

19. WORKING CONDITION

Occasional
Frequent
Normal Working Condition
Gen. Public
(
)
(
)
(
)
Other Agencies
(
)
(
)
(
)
Supervisors
(
)
(
)
weather
(
)
Management
(
)
(
)
__________________
Others (Specify) ________________________

Field of Work
Field Trips
Exposed to varied
Others (Specify)

20.I CERTIFY THAT the above answers are accurate and complete
__________________
___________________________
Date
Signature of Employee
-----------------------------------------------------------------------------------------------------------------------------------------------------TO BE FILLED UP BY IMMEDIATESUPERVISOR
21. Describe briefly the general function of the Unit or Section
22. Describe briefly the general function of position
23. a. Indicate the required qualification by years and kind of education considered in filling
up a vacancy for this position. (Keep the position in mind rather than the qualifications of
the present incumbent. This item should be filled up for all positions, other than teaching)
Education:

____________________________________________

Experience:

____________________________________________

Training:

____________________________________________

23. b. Licensor certificates required to do this work, if any.

RA 1080 (Teacher)
24. I HEREBY CERTIFY that the above answers are accurate and complete.
__________________
Date

REBECCA B.

NAMOC
Secondary School
Principal I

25. APPROVED:
__________________
Date

CORA T. ASA,

Ph.D.
Schools Division
Superintendent