Republic of the Philippines

DEPARTMENT OF EDUCATION
Region III
SCHOOLS DIVISION OFFICE
City of San Jose del Monte
website: www.depedcsjdm.webs.com / e-mail: sanjosedelmonte.city@deped.gov.ph / telefax: (044) 815-2815

APPLICATION FOR PERMIT TO TEACH

Date

Name of Teacher:

Applicant’s Assignment:
School:
District:

School where the applicant plans to teach:

School:
Place:

Last Performance Rating:

LIST OF SUBJECTS TO TEACH

[ ] 1ST Semester [ ] 2ND Semester [ ] Trimester [ ] Summer SY 20___ - 20 ___

SUBJECT/S UNITS DAY TIME

Certified Correct:

Signature of Teacher University Dean

Recommending Approval:

School Head

Approved:

GERMELINA H. PASCUAL
Schools Division Superintendent

“ Commitment Driven Performance by our Leaders, Character-Based Instruction for our Learners”