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  • 8/12/2019 Search for Outstanding Criteria

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    GUIDELINES FOR THE 2009-2010 NOPSSCEA SEARCH FOR THE

    MOST OUTSTANDING SCHOOL ADMINISTRATOR, TEACHERS,

    ACADEMIC NON-TEACHING PERSONNEL,

    NON-TEACHING PERSONNEL

    AND STUDENTS

    RATIONALE

    NOPSSCEA conducts the Search for outstanding performance of school administrators, teachers,

    academic non-teaching personnel, non-teaching personnel and students. This search is aimed

    toards recogni!ing the e"emplar# performance, outstanding competence, and accomplishments of

    mem$ers of the academic communit# ho manifest profound commitment and remar%a$le

    dedication to their specific duties and responsi$ilities in their field of or%.

    &oreo'er, through this search, NOPSSCEA strongl# $elie'es that $# gi'ing due recognition to the

    e"emplar# competence, outstanding performance and accomplishments of the mem$ers of the

    academic communities in Negros Occidental, man# other academicians, personnel and studentsma# $e strongl# moti'ated to achie'e e"cellence in their rolesof strengthening and uplifting the

    educational ser'ices of schools in the pro'ince, in particular, and of the countr#, in general.

    The Search is underta%en $# NOPSSCEA and is hoped to $e supported $# school heads of pri'ate

    elementar#, secondar# and tertiar# institutions of NOPSSCEA mem$er schools in the pro'ince.

    WHO ARE QUALIFIED TO APPLY

    I. SCHOOL ADMINISTRATORS

    Gener! Re"#$re%en&'(1. School administrators ho are (ilipino citi!ens ith full time appointment as President,

    )ice-President, School *irector, Principal, Asst. Principal, *eans, Program *irector, +ead

    Teachers, ith at least 1 teachers under hisher super'ision/, ho ha'e $een acti'e in

    administration and super'ision for the last fi'e #ears and not less than to #ears as

    administratorsuper'isor of the school she is presentl# connected ith inclusi'e of lea'es

    not e"ceeding to #ears, pro'ided the nominee is not on lea'e, and actuall# ith

    administrati'e super'isor# roles at the time of nomination/.

    +oe'er, the nominee must NOT ha'e $een on lea'e for more than three #ears immediatel#

    prior to nomination.

    2. (or either pre-elementar#, elementar#, secondar# and tertiar# categories, the $asic

    educational re0uirement is at least a masters degree. *egree holders in la and medicine

    are considered to possess a masters degree.

    There ill $e onl# )neinner for all positions in this categor#.

    WHO ARE NOT QUALIFIED

    1. Pre'ious aardees and pre'ious nominees ho ha'e $een finalists tice and semi-finalists

    thrice regardless of the #ears the# oined/.2. School administrators ho ha'e $een sanctioned for 'iolation of administrati'e policies,

    rules and regulations.

    3

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    WHO CAN NOMINATE

    A mem$er of the 4oard of Trustees of the school, Presidents of collegesuni'ersities, *eans,

    Principals, +ead Teachers or school heads, are the onl# ones authori!ed to nominate school

    administrators to the Search.

    GENERAL CRITERIA FOR E*ALUATION

    1. Per')n! Q#!$&$e' n+ Cr&er

    5.1 &odel of moralit# and integrit# $oth in pu$lic and pri'ate life has demonstrated

    honest#, lo'e of countr#, humilit#, perse'erance, diligence, courtes#, generosit#,

    %indness, and humane concern for his constituents/

    5.2 6ood human relations in the school and in the communit#

    2. A+%$n$'&r&$e C)%/e&ene n+ Ee&$ene''

    2.1 *emonstrated competence, dedication, and commitment in administration and

    super'ision, as e'idenced $# the high performance e'aluation

    2.2 Programs and proects hich ere used, practiced and implemented for the

    impro'ement of their respecti'e schools in the last #ears

    2.3 5nno'ati'e administrati'e outputssuper'isor# approachesstrategiespractices in the

    last #ears

    2.7 Educational attainment and professional ad'ancement

    3. Pr)e''$)n! n+ C)%%#n$& In)!e%en&

    3.1 &em$ership in professional organi!ations related to administration 8 super'ision

    3.2 Participation in communit# and ci'ic mo'ements

    3.3 Professionalcommunit# ser'ice aards

    3.7 Participation in training programs

    SPECIFIC CRITERIA

    1. Per')n! Q#!$&$e' n+ Cr&er . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

    2. A+%$n$'&r&$e n+ Mn3er$! C)%/e&ene n+ Ee&$ene'' . . . 40

    Performance E'aluation . . . . . . . . . . . . . . . . . . . . . . . . . 9:

    5mmediate Superior . . . . . . . . . 29:

    Constituents . . . . . . . . . . . . . . . 1:

    PupilsStudents . . . . . . . . . . . . . 1:

    Creati'it#5nno'ati'eness as Administrator in

    ;esearchProgramsProects . . . . . . . . . . . . . . . . . . . . 9:

    5. In)!e%en& $n C)%%#n$& W)r6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

    Outreach Acti'ities . . . . . . . . . . . . . . . . . . . . . . . . . . . . :

    Positions

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    II. TEACHERS

    Gener! Re"#$re%en&'(

    1. Teachers ho are (ilipino citi!ens ithfull time appointmentas teacher of pre-elementar#,

    elementar#, secondar#, and tertiar# le'els, ho ha'e $een acti'e in teaching for the last 19

    #ears and not less than to #ears from the school she is presentl# connected inclusi'e of

    lea'es not e"ceeding to #ears, pro'ided the nominee is not on lea'e, and actuall# teachingat the time of nomination/.

    +oe'er, the nominee must NOT ha'e $een on lea'e for more than to #ears immediatel#

    prior to nomination.

    2 (or either pre-elementar#, elementar#, and secondar# categories, the $asic educational

    re0uirement is at least a $achelor>s degree? for the tertiar# le'el it should $e at least a

    masters degree. *egree holders in la and medicine are considered to possess a masters

    degree.

    There ill $e onl# )ne 8$nner for e !ee! in the pre-elementar#, elementar#, secondar# and

    tertiar# le'els.

    WHO ARE NOT QUALIFIED

    1. Pre'ious aardees and pre'ious nominees ho ha'e $een finalists tice and semi-finalists

    thrice regardless of the #ears the# oined/.

    2. Teachers ho ha'e $een sanctioned for 'iolation of administrati'e policies, rules and

    regulations.

    WHO CAN NOMINATE9

    The PresidentSchool +ead, *ean, Principal, and +ead Teacher are the onl# ones authori!ed to

    nominate teachers to the Search.

    GENERAL CRITERIA FOR E*ALUATION

    1. Per')n! Q#!$&$e' n+ Cr&er

    1.1 The nominee should $e a model of moralit# and integrit# $oth in pu$lic and pri'ate life

    has demonstrated honest#, lo'e of countr#, humilit#, perse'erance, diligence, good faith,

    courtes#, %indness, solicitude and respect for childrenstudents and other mem$ers of theacademic communit#/

    1.2 &anifest good human relations in the school and in the communit#

    2 In'&r#&$)n! C)%/e&ene n+ Te$n3 Ee&$ene''

    2.1 *emonstrated competence, dedication, and commitment to the teaching profession, as

    e'idenced $# the high performance e'aluation $# immediate superior, peer and students

    2.2 Produced and used 5nstructional materials for the impro'ement of teaching

    2.3 =tili!ed inno'ati'e teaching approachesstrategiespractices in the last 19 #ears

    2.7 +as produced research outputsinstructional materials outputs in the last 19 #ears

    2. Acti'el# participated in co-curricular acti'ities in the last 19 #ears 2.@ =pgraded educational attainment and professional ad'ancement

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    5. Pr)e''$)n! n+ C)%%#n$& In)!e%en&

    3.1 &em$ership in professional organi!ations related to hisher field of speciali!ation

    3.2 Participation in communit# and ci'ic mo'ements

    3.3 Professionalcommunit# ser'ice aards

    3.7 Participation in training programs

    SPECIFIC CRITERIA

    1. Per')n! Q#!$&$e' n+ Cr&er. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

    2. In'&r#&$)n! C)%/e&ene : Te$n3 Ee&$ene'' . . . . . . . . . . . . . 40

    2.1 Performance E'aluation . . . . . . . . . . . . . . . . . . . . 9:

    2.1.1 5mmediate Superior 29:

    2.1.2 Peers 1:

    2.1.3 PupilsStudents 1:

    2.2 Creati'it#5nno'ati'eness in Teaching in

    ;esearch5nstructional &aterials Outputs . . . . . .. . . 9:

    5. In)!e%en& $n C)%%#n$& W)r6 . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

    3.1 Outreach Acti'ities

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    III. ACADEMIC NON-TEACHING PERSONNEL

    Gener! Re"#$re%en&'(

    Nominees shall $e Academic Non-Teaching Personnel ho are (ilipino citi!ens ith full time

    appointment as academic non-teaching personnel ho ha'e $een acti'e in hisher or% as

    Bi$rarian, 6uidance Counselor, ;esearch Coordinator, ;egistrar, Ba$orator# 5n Charge for the last

    19 #ears ith not less than to #ears from the school she is presentl# connected inclusi'e of

    lea'es not e"ceeding to #ears, pro'ided the nominee is not on lea'e, and actuall# in the non-

    teaching nature of or% at the time of nomination/.

    +oe'er, the nominee must NOT ha'e $een on lea'e for more than to #ears immediatel# prior to

    nomination.

    She must $e at least a $achelor>s degree holder.

    There ill $e onl# )ne inner for all positions in this categor#.

    WHO ARE NOT QUALIFIED9

    1. Pre'ious aardees and pre'ious nominees ho ha'e $een finalists tice and semi-

    finalists thrice regardless of the #ears the# oined/.

    2. Personnel ho ha'e $een sanctioned for 'iolation of administrati'e policies, rules and

    regulations.

    WHO CAN NOMINATE9

    The PresidentSchool +ead, *ean, Principal, +ead Teacher or an# immediate superior are the onl#ones authori!ed to nominate academic non-teaching personnel to the Search.

    GENERAL CRITERIA FOR E*ALUATION

    1. Per')n! Q#!$&$e' n+ Cr&er

    1.1 The nominee should $e a model of moralit# and integrit# $oth in pu$lic and pri'ate life

    has demonstrated honest#, lo'e of countr#, humilit#, perse'erance, diligence, courtes#,

    %indness, solicitude and respect for mem$ers and clients of the academic communit#

    hom she ser'es/

    1.2 &anifests good human relations in the school and in the communit#

    2. S6$!!' n+ W)r6 Ee&$ene'' : E$$en

    2.1 *emonstrated competence, dedication, commitment and effecti'eness in hisher field

    of or%, as e'idenced $# the high performance e'aluation $# immediate super'isor

    and peers

    3. Pr)e''$)n! n+ C)%%#n$& In)!e%en&

    3.1 Participation in training programs

    3.2 &em$ership in professional organi!ations related to field of or%

    3. 3 Participation in communit# and ci'ic mo'ements

    D

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    SPECIFIC CRITERIA

    1. Per')n! Q#!$&$e' n+ Cr&er. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

    2. S6$!!' n+ W)r6 Ee&$ene'' : E$$en . . . . . . . . . . . . . . . . . . . . . 40

    2.1 Performance E'aluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . @9:

    2.1.1 5mmediate Superior 29:

    2.1.2 Peers 29:

    2.1.3 Clients randoml# chosen/ 29:

    2.2 Creati'it#5nno'ati'eness in area of or% . . . . . . . . . . . . . . .79:

    5. In)!e%en& $n C)%%#n$& W)r6 . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

    3.1 Outreach Acti'ities

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    I*. NON-TEACHING PERSONNEL

    Gener! Re"#$re%en&'(

    Non Teaching Personnel ho are (ilipino citi!ens ith full time appointment as non-teaching

    personnel, ho ha'e $een acti'e in hisher or% either as personnel assigned in accounting and

    records offices, secretaries, health personnel and other support staff for the last 19 #ears ith not

    less than to #ears from the school she is presentl# connected.inclusi'e of lea'es not e"ceeding

    to #ears, pro'ided the nominee is not on lea'e, and actuall# in the non-teaching nature of or%

    at the time of nomination/.

    +oe'er ,the nominee must NOT ha'e $een on lea'e for more than to #ears immediatel# prior

    to nomination.

    She must $e at least a $achelor>s degree holder.

    There ill $e onl# )neinner for all positions in this categor#.

    WHO ARE NOT QUALIFIED9

    1. Pre'ious aardees and pre'ious nominees ho ha'e $een finalists tice and semi-finalists

    thrice regardless of the #ears the# oined/.

    2. Personnel ho ha'e $een sanctioned for 'iolation of administrati'e policies, rules and

    regulations.

    WHO CAN NOMINATE9

    The PresidentSchool +ead, *ean, Principal, +ead Teacher or an# immediate superior are the onl#

    ones authori!ed to nominate non teaching personnel to the Search.

    GENERAL CRITERIA FOR E*ALUATION9

    1. Per')n! Q#!$&$e' n+ Cr&er

    1.1 The nominee should $e a model of moralit# and integrit# $oth in pu$lic and pri'ate life

    has demonstrated honest#, lo'e of countr#, humilit#, perse'erance, diligence, courtes#,

    %indness, solicitude and respect for mem$ers and clients of the academic communit#

    hom she ser'es/

    1.2 &anifested good human relations in the school and in the communit#

    2. S6$!!' n+ W)r6 Ee&$ene'' : E$$en

    2.1 *emonstrated competence, dedication, commitment and effecti'eness in hisher field

    of or%, as e'idenced $# the high performance e'aluation $# immediate super'isor and

    peers

    3. Pr)e''$)n! n+ C)%%#n$& In)!e%en&

    3.1 Participation in training programs

    3.2 &em$ership in professional organi!ations related to field of or%

    3.3 Participation in communit# and ci'ic mo'ements

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    SPECIFIC CRITERIA

    1. Per')n! Q#!$&$e' n+ Cr&er . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

    2. S6$!!' n+ W)r6 Ee&$ene'' : E$$en . . . . . . . . . . . . . . . . . . . . . ;0

    2.1 Performance E'aluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . @9:

    2.1.1 5mmediate Superior 29:

    2.1.2 Peers 29:

    2.1.3 Clients randoml# chosen/ 29:

    2.2 Creati'it#5nno'ati'eness in area of or% . . . . . . . . . . . . . 79:

    5. In)!e%en& $n C)%%#n$& W)r6 . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

    3.1 Outreach Acti'ities

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    *. STUDENTS

    Gener! Re"#$re%en&'(

    Nominees shall $e at least third #ear high school for the secondar# le'el and 3 rd #ear in the

    curriculum of the course enrolled in for the tertiar# le'el ith at least 5 units load for to

    consecuti'e semesters of the current school #ear or during the calendar #ear of nomination and not

    less than to #ears residence in the school she is presentl# connected ith, immediatel# prior to

    nomination.

    There ill $e )ne 8$nner for the to le'els, secondar# and tertiar#, in this categor#.

    WHO ARE NOT QUALIFIED9

    Pre'ious aardees and pre'ious nominees ho ha'e $een finalists semi-finalists tice.

    WHO CAN NOMINATE9

    The Presidents of collegesuni'ersities *eans, Principals, +ead Teachers or school heads are the

    onl# ones authori!ed to nominate students to the Search.

    GENERAL CRITERIA FOR E*ALUATION

    1. Per')n! Q#!$&$e' n+ Cr&er

    1.1 &odel of moralit# and integrit# $oth in pu$lic and pri'ate life has demonstrated

    honest#, lo'e of countr#, humilit#, perse'erance, diligence in hisher or%, courtes#,

    generosit#, %indness, and humane concern for others/

    1.2 6ood human relations in the school and in the communit#

    2. Le+er'$/ Q#!$&$e'

    2.1 *emonstrated competence, dedication, and commitment as a student leader , as e'idenced

    $# the high performance e'aluation

    2.2 Programs and proects hich ere initiated, practiced and implemented for the

    impro'ement of their respecti'e schools in the last to #ears

    5. In)!e%en& $n C)%%#n$&, C$$, Re!$3$)#', G)ern%en&

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    Te NOPSSCEA E+#&$)n! T'6 F)re

    NOPSSCEA Office

    2( ;m 29@, Sunstar 4ldg.

    +ilado Street, 4acolod Cit#

    *ear &esdamesSirs

    After re'ieing the rules and criteria for the Search for the NOPSSCEA &ost Outstanding School

    Administrator, Teachers, Academic Non-Teaching Personnel, Non-Teaching Personnel, Students, 5

    here$# nominate

    Name of Nominee GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

    Categor# GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

    Be'el GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

    5 here$# certif# that, to the $est of m# %noledge, the information contained in this nomination

    form and the accompan#ing supporting documents are true and correct.

    5f selected, the Nominee ill $e sent $# the School to the 'enue chosen $# NOPSSCEA for the

    final inter'ie $# the 4oard of Hudges. The Nominee ill $e alloed to attend the Aarding

    Ceremonies hich ill $e held on 2 Hanuar# 299 or on an# date scheduled $# NOPSSCEA.

    The Nominee and the undersigned understand that the decision of the 4oard of Hudges is final and

    that e agree to a$ide $# it.

    Nominating School GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

    Name of School +ead GGGGGGGGGGGGGGGGGGGGGGGGGGGGGG Position GGGGGGGGGGGGGGGGGGGGGGG

    Address GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

    Name of Nominator GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG Position GGGGGGGGGGGGGGGGGGGGGGG

    Signature of NominatorGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG *ate Signed GGGGGGGGGGGGGGG

    NOMINEES INFORMATION SHEET

    Surname GGGGGGGGGGGGGGGGGGGG 6i'en Name GGGGGGGGGGGGGG &iddle NameGGGGGGGGGGGGGGG

    13

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    *ate of 4irth GGGGGGGGGGGGGGGGGGGGGGGGGGG 6ender &ale GGGGG (emale GGGG

    Ci'il Status Single GGGG &arried GGGG Fidoed GGGG Others. Please specif# GGGGGGGGGGGGGGGGG

    +ome Address GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

    Tell No. ;es./ GGGGGGGGGGGGG Office GGGGGGGGGGGG Email address GGGGGGGGGGGGGGGGGGGGGGG

    Name of School GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG AddressGGGGGGGGGGGGGGGGGGGGGGGGGGG

    Fe$site of SchoolGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG Tel. No. GGGGGGGGGGGG

    (a" No. GGGGGGGGGGG

    Position +eld GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG *epartment GGGGGGGGGGGGGGGGGGGGGGGGG

    No. of #ears 8 months in this position in this schoolGGGG #ears GGGG months

    &onth 8 Iear started GGGGGGGGGGGGGGGGGGGGGG

    E"perience in other schoolsoffices

    SchoolGGGGGGGGGGGGGGGGGGGG Position GGGGGGGGGGGGGGGGGGGPeriod co'eredGGGGGGGGGGGGG

    School GGGGGGGGGGGGGGGGGGGGG Position GGGGGGGGGGGGGGGGGGGPeriod co'eredGGGGGGGGGGGGG

    School GGGGGGGGGGGGGGGGGGGGG Position GGGGGGGGGGGGGGGGGGGPeriod co'eredGGGGGGGGGGGGG

    Educational

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    Yer

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    2. CO-CURRICULAR ACTI*ITIES

    Yer

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    3. COMMUNITY IN*OL*EMENT : CI*IC ACTI*ITIES

    Yer

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    GGGGGGGGGGGG GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG GGGGGGGGGGGGGGGGGGG

    7. PERSONAL SILLS

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    5 here$# certif# that 5 ha'e personall# %non GGGGGGGGGGGGGGGGGGGGGGGGGGGGGG, Nominee for

    the GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG Categor# for at least to 2/ #ears and to the $est of

    m# %noledge, heshe is a person of e"cellent moral character ith no pending

    administrati'eci'ilcriminal case or criminal con'iction.

    FOR NOMINATOR( Summari!e ithin the space pro'ided the reasons h# #ou $elie'e that

    #our nominee should $e chosen as the NOPSSCEA' O#&'&n+$n3

    BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB.

    Specif# Categor#/

    Name of Nominator GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

    ProfessionOccupation GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG+ome Address GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

    Compan#Office GGGGGGGGGGGGGGGGGGGGGGGG Position +eld GGGGGGGGGGGGGGGGGGGGGGGGGGGG

    Address GGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG

    Tel. No. GGGGGGGGGGG &o$ile No. GGGGGGGGGGGGG Email address GGGGGGGGGGGGGGGGGGGGGG

    SignatureGGGGGGGGGGGGGGGGGGGGGGGGGGGGGG *ate Signed GGGGGGGGGGGGGGGGG

    1@