Annex 1 JDVP TVL Application Form 01212020
Annex 1 JDVP TVL Application Form 01212020
Annex 1 JDVP TVL Application Form 01212020
Region:
Division:
School Name:
School Address:
(Number/Block/Street)
(Subdivision/Village/Brgy.)
City or Municipality:
Province:
Contact Number/s:
Email:
TESDA Accreditation
Number
No. of Kilometers to the
nearest and accessible
Public DepEd SHS:
TVL
Specializations/Trainin
g Offered
Attach the following documents:
1. For private SHS/non-DepEd public SHS, certified true copy of the Provisional Permit to offer SHS-TVL issued by
DepEd;
2. For private TVI, certified true copy of TESDA accreditation;
3. For both, Board Resolution indicating the intention to participate and to comply with SHS-TVL Curriculum
Learning Standards, including absorptive capacity of 25 learners per class, Pedagogical Requirements, and Policies
on Assessment and Rating System based on DepEd Order No. 8, s. 2015; and
4. For both, attestation that there is a maximum four-kilometer distance between the listed qualified DepEd public
SHS and the applicant partner.
ATTESTATION
I certify that my answers are true and complete to the best of my knowledge.
I am aware that the information supplied in this document shall be retained by DepEd on a database and shall be
processed in compliance with the Data Protection Act of 2012.
I consent that the information herein may be used for reports both internally and to the Department of Education.
_______________________________________ ________________________________
School Head/ Date Signed
Authorized Representative
(Signature over Printed Name)