TEMPLATE FOR TEACHERS AND THEIR MENTORS

Pursuant to the implementation of DepEd Order 43, s. 2017 entitled “Teacher Induction Program Policy”, the Human Resource Development Division shall be establishing a databank of teachers in
the region. This is to make available a more current reference in the development of its Learning & Development Programs as well as come up with a more accurate entry in the implementation of
the Teacher Induction Program.

Please supply the information needed. Rest assured that all requested information will be used only for the conduct of the aforementioned activities and related concerns and shall be treated with
utmost confidentiality pursuant to RA 10173 otherwise known as the Data Privacy Act of 2012.

Finished Module for SY 2018- 2019 (Please select all that apply)
No. Name of Teacher Position of Teacher School Name of Mentor Position of the Mentor Module l Module 2 Module 3 Module 4 Module 5 Module 6
1 Cacho, Jerome C. Teacher 1 Binabalian NHS Marian C. Cacho Head Teacher III √ √ √ √ √ √
2 Del Rosario, Arlene C. Teacher 1 Binabalian NHS Marian C. Cacho Head Teacher III √ √ √ √ √ √
3 Caaya, Sheryl O. Teacher 1 Binabalian NHS Marian C. Cacho Head Teacher III √ √ √ √ √ √
4 Conzaga, Marie Cris C. Teacher 1 Binabalian NHS Marian C. Cacho Head Teacher III √ √ √ √ √ √
5 Quisay, Mariz C. Teacher 1 Binabalian NHS Marian C. Cacho Head Teacher III √ √ √ √ √ √
 TEMPLATE FOR TEACHERS WHO HAVE NOT ATTENDED THE REGIONAL ORIENTATION ON TEACHER INDUCTION PROGRAM
Pursuant to the implementation of DepEd Order 43, s. 2017 entitled “Teacher Induction Program Policy”, the Human Resource Development Division shall be establishing a databank of teachers in the region. This is to make available a more
current reference in the development of its Learning & Development Programs as well as come up with a more accurate entry in the implementation of the Teacher Induction Program.

Please supply the information needed. Rest assured that all requested information will be used only for the conduct of the aforementioned activities and related concerns and shall be treated with utmost confidentiality pursuant to RA 10173
otherwise known as the Data Privacy Act of 2012.

No. Name of Teacher Position of Teacher School Specialization Subject Taught

1 Guarin, Khayzle Zaira C. Teacher 1 San Roque Elementary School None English, Math, Science, Filipino, EsP, Araling Panlipunan, Mapeh, EPP