Instructor'S Load: Señora Diana Conquillo

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Republic of the Philippines

NORTHWEST SAMAR STATE UNIVERSITY


Main Campus, Calbayog Ciity

INSTRUCTOR'S LOAD

School Year: 2016-17


Semester : 1st
NAME : SEÑORA DIANA CONQUILLO Home Address :
Surname First name Middle Name

Educational Qualification : Baccalaureate : Major :


Master's Degree : Major :
Doctoral Degree : Major :

Administrative Designation / Special Assignment:


Years of teaching experience: Public School : Private School:
SUBJECTS
TIME MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
7:00 - 7:30
7:30 - 8:00
8:00 - 8:30
8:30 - 9:00
9:00 - 9:30
9:30 - 10:00
10:00-10:30
10:30-11:00
11:00-11:30
11:30-12:00
12:00-12:30
NOON BREAK
12:30- 1:00
1:00 - 1:30 PE 4
1:30 - 2:00 CET 14
2:00 - 2:30 BSIT-FT 2A
2:30 - 3:00 PE 4 -DO-
3:00 - 3:30 CET 14
3:30 - 4:00 ENGG 2A(CE)
4:00 - 4:30 -DO-
4:30 - 5:00 PE 4
5:00 - 5:30 CET 14
5:30 - 6:00 ENGG 2D(ECE)
6:00 - 6:30 -DO-
6:30 - 7:00
7:00 - 7:30
7:30 - 8:00
8:00 - 8:30
8:30 - 9:00
Lec Lab
SUBJECT SECTION DESCRIPTION HOURS HOURS
PE 4 ENGG 2A(CE) Recreational Activities 2
PE 4 ENGG 2D(ECE) Recreational Activities 2
PE 4 BSIT-FT 2A Recreational Activities 2
TOTAL: 6 0
Form No. 004 Republic of the Philippines Prepare in 8 copies
Prepare in 8 copies
1. Personnel Officer
1. Personnel Officer
Revised November 2009 NORTHWEST SAMAR STATE UNIVERSITY 2. Accounting Section
2. Accounting Section
Main Campus, Calbayog Ciity 3. COA Resident 3.
Auditor
COA Resident Auditor
4. VP, Academic 4.
Affairs
VP, Academic Affairs
5. Dean Concerned5. Dean Concerned
TEACHING LOAD FORM 6. Instructor Concerned
6. Instructor Concerned
7. Registrar 7. Registrar
Undergraduate Graduate 8. Cashier 8. Cashier
School Year: 2016-17
Semester : 1st Regular Overload Part -time
NAME : Home Address :
Surname First name Middle Name

Educational Qualification : Baccalaureate : Major : Minor:


Master's Degree : Major :
Doctoral Degree : Major :

Administrative Designation / Special Assignment:


Years of teaching experience: Public School : Private School: Total :
SUBJECTS Dept/Subj No. of Contact
TIME MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Yr & Sec. Stud. Hours
7:00 - 7:30
7:30 - 8:00
8:00 - 8:30
8:30 - 9:00
9:00 - 9:30
9:30 - 10:00
10:00-10:30
10:30-11:00
11:00-11:30
11:30-12:00
12:00-12:30
NOON BREAK
12:30- 1:00
1:00 - 1:30
1:30 - 2:00
2:00 - 2:30
2:30 - 3:00
3:00 - 3:30
3:30 - 4:00
4:00 - 4:30
4:30 - 5:00
5:00 - 5:30
5:30 - 6:00
6:00 - 6:30
6:30 - 7:00
7:00 - 7:30
7:30 - 8:00
8:00 - 8:30
8:30 - 9:00
Indicate inside subject block: Student Contact # of
1. Course Code Lecture : CERTIFIED TRUE AND CORRECT: Hours (Undergrad)uate )
2. Room Number Laboratory/Shop : Lecture :
3. Overload Other Assignments: Laboratory :
4. Research, Extension & Consultation Non-teaching Hours : Student Contact # of
5. Designated Work Research: 3 Signature Over Printed Name Hours (Graduate)
6. DPTL Code : Extension: 3 Lecture :

Consultation: 3 Laboratory :

Total : 0.0 Number of Preparations :


RECOMMENDING APPROVAL:

Dean, Dean, Dean, Dean,


Date : _____________________ Date : _____________________ Date : _____________________ Date : ______________
.
FE D. MONTECALVO, Ed. D. BENJAMIN L. PECAYO,, Ed. D. MARIETTA L. ESPINA, Ph. D.
Vice President for Academic Affairs Vice President for Administration Vice President for Research and Extension

Approved :
AVELINA N. BERGADO, Ed. D.
SUC President
Prepare in 8 copies
1. Personnel Officer
2. Accounting Section
3. COA Resident Auditor
4. VP, Academic Affairs
5. Dean Concerned
6. Instructor Concerned
7. Registrar
8. Cashier

Tot Cont
Hours
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0 0 0

0.0
0.0

Dean,
Date : ______________

MARIETTA L. ESPINA, Ph. D.


Vice President for Research and Extension

Ed. D.
Form No. 004 Republic of the Philippines Prepare in 8 copies
1. Personnel Officer
Revised November 2009 NORTHWEST SAMAR STATE UNIVERSITY 2. Accounting Section
Main Campus, Calbayog Ciity 3. COA Resident Auditor
4. VP, Academic Affairs
5. Dean Concerned
TEACHING LOAD FORM 6. Instructor Concerned
7. Registrar
Undergraduate Graduate 8. Cashier
School Year: 2016-17
Semester : 1st Regular Overload Part -time
NAME : Home Address :
Surname First name Middle Name

Educational Qualification : Baccalaureate : Major : Minor:


Master's Degree : Major :
Doctoral Degree : Major :

Administrative Designation / Special Assignment:


Years of teaching experience: Public School : Private School: Total :
SUBJECTS Dept/Subj No. of Contact
TIME MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY Yr & Sec. Stud. Hours
7:00 - 7:30
7:30 - 8:00
8:00 - 8:30
8:30 - 9:00
9:00 - 9:30
9:30 - 10:00
10:00-10:30
10:30-11:00
11:00-11:30
11:30-12:00
12:00-12:30
NOON BREAK
12:30- 1:00
1:00 - 1:30
1:30 - 2:00
2:00 - 2:30
2:30 - 3:00
3:00 - 3:30
3:30 - 4:00
4:00 - 4:30
4:30 - 5:00
5:00 - 5:30
5:30 - 6:00
6:00 - 6:30
6:30 - 7:00
7:00 - 7:30
7:30 - 8:00
8:00 - 8:30
8:30 - 9:00
Indicate inside subject block: Student Contact # of
1. Course Code Lecture : CERTIFIED TRUE AND CORRECT: Hours (Undergrad)uate )
2. Room Number Laboratory/Shop : Lecture :
3. Overload Other Assignments: Laboratory :
4. Research, Extension & Consultation Non-teaching Hours : Student Contact # of
5. Designated Work Research: 3 Signature Over Printed Name Hours (Graduate)
6. DPTL Code : Extension: 3 Lecture :

Consultation: 3 Laboratory :

Total : 0.0 Number of Preparations :


RECOMMENDING APPROVAL:

Dean, Dean, Dean, Dean,


Date : _____________________ Date : _____________________ Date : _____________________ Date : ______________
.
FE D. MONTECALVO, Ed. D. BENJAMIN L. PECAYO,, Ed. D. MARIETTA L. ESPINA, Ph. D.
Vice President for Academic Affairs Vice President for Administration Vice President for Research and Extension

Approved :
AVELINA N. BERGADO, Ed. D.
SUC President
epare in 8 copies
Personnel Officer
Accounting Section
COA Resident Auditor
VP, Academic Affairs
Dean Concerned
Instructor Concerned
Registrar
Cashier

Tot Cont
Hours
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0.0 0 0

0.0
0.0

Dean,
______________

ESPINA, Ph. D.
earch and Extension

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