ANNEX B – Curriculum Vitae

Republic of the PhilippinesOFFICE OF THE PRESIDENT

COMMISSION ON HIGHER EDUCATION

INSTITUTIONAL QUALITY ASSURANCE THROUGHMONITORING AND EVALUATION (IQuAME)

1. Name of Candidate/Nominee ______________________________________________________(Family) (First Name) (Middle Initial)

2. Employment/Name of Institution and Address _______________________________________________________________________________________________________________________

3. Present Job Position/Job Assignment ________________________________________________4. Status of Employment/Job Engagement ______________________________________________5. Contact Details:

5.1. Telephone number (Office) ____________________ 5.2. Fax No. _______________5.3. Mobile Number _______________________________________________________5.4. Email Address ________________________________________________________

6. Education Background/Training:

6.1. Highest Educational Attainment __________________________________________6.2. Field of Specialization _________________________________________________6.3. School/Institution where the Degree was Earned _____________________________6.4. Address of the Institution _______________________________________________6.5. Year When the Degree was Earned _______________________________________6.6. Other Specialized Training/Certification Received Related to or similar to IQuAME

Assessment, please indicate:6.6.1.1. Name /Title of Training _______________________________________6.6.1.2. Training or Organizing Body ___________________________________6.6.1.3. Duration/Date of Training:

a. Date of Training ___________________________________________b. Number of days ___________________________________________

7. Experience/Involvement as Assessor/Evaluator/Accreditor in the last 3 years (you are requested to answer only the items applicable to you)

2 X 2

Latest ID picture

Curriculum Vitae (CV) of the Candidate / Nominee for CHED IQuAME Assessor

7.1. As Team Leader/Head

7.1.1. Local/Regionala. Type of Engagement / Involvement

b. Date of Involvement

c. Name of Evaluating Accrediting Body/Group

* attached photocopies of certifications (attendance or participation)

7.1.2. Internationala. Type of Engagement / Involvement

b. Date of Involvement

c. Name of Evaluating Accrediting Body/Group

* attached photocopies of certifications (attendance or participation)

7.2. As Member

7.2.1. Local/Regionala. Type of Engagement / Involvement

b. Date of Involvement

c. Name of Evaluating Accrediting Body/Group

* attached photocopies of certifications (attendance or participation)

7.2.2. Internationala. Type of Engagement / Involvement

b. Date of Involvement

c. Name of Evaluating Accrediting Body/Group

* attached photocopies of certifications (attendance or participation)

8. Experience as faculty member of higher education institution in the last 3 years (you are requested to answer only the items applicable to you)

8.1. Subjects Taught:

8.2. Name of Institution

8.3. Students (ex. undergraduate level, graduate level, etc., pls. Indicate)

8.4. Date (semester, School year)

* attached certification from school or other related documents9. In a separate sheet (maximum of two-page) describe the evaluation / accreditation / assessment /

quality audit work done including names and possible contact details of the head of the institution(s) attached photocopies of certifications (attendance or participation) (s) who can certify/vouch your work.

10. Other type of academic involvement, please indicate (ex. as panel member, consultant, Technical Working Committee Member, Editor, Reviewer, Technical Expert etc.) please indicate the activities/type of involvement)

a. Type and Scope of Involvement

b. Activities / Terms of Reference (briefly describe)

c. Date of Involvement

d. Status (ex. Contract ends)

*necessary documents may be attached

11. Significant Accomplishments Made Related to Evaluation / Accreditation / Quality Audit / Assessment Work during the last three (3) years such as but not limited to the following:

11.1. Awards/Incentives Receiveda. Awards Received b. Award Giving Body c. Purpose of the Award e. Date

*Sample program, photocopies of Certificate of Recognition and pictures (scanned copies) must be attached

12. References (with permission) at least three (3)a. Complete Name b. Company /School

Affiliationc. Company / School Address

d. Contact Details

*with recommendation letters in a signed-sealed envelopes attached.

This is to certify that the information given in this CV is true and correct.

________________________________Name and Signature of the NomineeDate of Submission ________________

Submit the CV together with the required documents including a medical certificate taken within the last six (6) months and a 2 X 2 picture on or before April 30, 2010 to your respective CHED Regional Office Director: