Professional Documents
Culture Documents
I. PERSONAL INFORMATION
2. SURNAME FIRST NAME MIDDLE NAME
MARATUDO, MAGSINGAL ILOCOS SUR 2730 N/A MARATUDO, MAGSINGAL ILOCOS SUR
ZIP CODE 19. TELEPHONE NO. 20. E-MAIL ADDRESS (if any) 21. CELLPHONE NO. (if any) 22. AGENCY EMPLOYEE NO. 23. TIN
8. CITIZENSHIP 9. HEIGHT (m) 10. WEIGHT (kg) 11. BLOOD TYPE 12. GSIS ID NO. 13. PAG-IBIG ID NO. 14. PHILHEALTH NO. 15. SSS NO.
FILIPINO 5'0 55 KGS. O LP-82010800265 N/A 05-000066845-9 N/A TABULOC FRANCIS TADENA DRIVING N/A N/A N/A
(Continue on separate sheet if necessary)
26. FATHER'S SURNAME FIRST NAME MIDDLE NAME 27. MOTHER'S MAIDEN NAME SURNAME FIRST NAME MIDDLE NAME
(if graduated)
ELEMENTARY
MAAS-ASIN ELEMENTARY SCHOOL BACSIL NATIONAL HIGH SCHOOL N/A UNIVERSITY OF NORTHERN PHILS VIGAN CITY, ILOCOS SUR
GRADUATE STUDIES
N/A
N/A
N/A
N/A
N/A
N/A
N/A
75.00%
08/25/2002
BAGUIO CITY
0789372
V. WORK EXPERIENCE (Include private employment. Start from your current work)
30. INCLUSIVE DATES (mm/dd/yyyy) From To POSITION TITLE (Write in full) DEPARTMENT / AGENCY / OFFICE / COMPANY (Write in full)
MONTHLY SALARY
SALARY GRADE & STEP INCREMENT (Format "00-0")
STATUS OF APPOINTMENT
DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION
18,922.00 17,318.00 15,900.00 14,483.00 12,328.00 11,207.00 10,933.00 9,939.00 9,939.00 11-2 11-2 10-2 10-2 10-1 10-1 10-1
N/A / / / /
N/A / / / / / / / /
N/A / / / /
N/A
N/A
K TO 12 FOR GRADE II DISTRICT TRAINING FOR ELEMENTARY TEACHERS IN ENGLISH LANGUAGE & READING ENHANCEMENT PROG DepED UNIFIED TEACHERS TRAINING IN ENGLISH, MATH & SCIENCE BEGINNING TEACHERS CORE VALUES FORMATION WORKSHOP ON UPGRADING THE ELEM TEACHERS PEDAGOGICAL CONTENT KNOWLEDE STRATEGIES BASIC TRAINING COURSE FOR TROOP LEADER OUTDOOR LEADERSHIP COURSE AGE LEVEL COURSE BASIC LEADERSHIP COURSE TEST STRATEGIES & TEST CONSTRUCTION
05/18/2012 08/20/2010 05/21/2007 04/26/2007 10/23/2006 10/29/2005 9/2-4/2005 08/26/2005 07/29/2005 04/19/2005
05/22/2013 08/21/2010 05/25/2007 04/28/2007 10/28/2006 10/31/2005 9/10-11/2005 08/28/2005 07/31/2005 04/19/2005
40HRS 16HRS 40HRS 24HRS 48HRS 24HRS 32HRS 24HRS 24HRS 8HRS
NARVACAN NAT'L HIGH SCHOOL DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION DEPARTMENT OF EDUCATION
N/A
36. a.
Are you related by consanguinity or affinity to any of the following : Within the third degree (for National Government Employees): appointing authority, recommending authority, chief of office/bureau/department or person who has immediate supervision over you in the Office, Bureau or Department where you will be appointed? Within the fourth degree (for Local Government Employees): appointing authority or recommending authority where you will be appointed?
YES NO If YES, give details: _____________________________________ _____________________________________ _____________________________________
b.
37
If YES, give details: ________________________________ ________________________________ YES NO If YES, give details: ________________________________ ________________________________ YES NO If YES, give details: ________________________________ ________________________________ YES NO
38.
Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation by any court or tribunal?
39.
Have you ever been separated from the service in any of the following modes: resignation, retirement, dropped from the rolls, dismissal, termination, end of term, finished contract, AWOL or phased out, in the public or private sector?
40.
Have you ever been a candidate in a national or local election (except Barangay election)?
Pursuant to: (a) Indigenous People's Act (RA 8371); (b) Magna Carta for Disabled Persons (RA 7277); and (c) Solo Parents Welfare Act of 2000 (RA 8972), please answer the following items: Are you a member of any indigenous group? Are you differently abled? Are you a solo parent? YES NO If YES, please specify: ____________________ YES NO If YES, please specify: ____________________ YES NO If YES, please specify: ____________________
a. b. c.
42. REFERENCES (Person not related by consanguinity or affinity to applicant / appointee) NAME ADDRESS TEL. NO.
ID picture taken within the last 6 months 3.5 cm. X 4.5 cm (passport size)
SAN CLEMENTE, MAGSINGAL I.SUR PANAY, MAGSINGAL I.SUR MARATUDO, MAGSINGAL I.SUR
I declare under oath that this Personal Data Sheet has been accomplished by me, and is a true, correct and complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the Philippines. I also authorize the agency head / authorized representative to verify / validate the contents stated herein. I trust that this information shall remain confidential. 23135160
COMMUNITY TAX CERTIFICATE NO.
PHOTO
MAGSINGAL, I. SUR
ISSUED AT SIGNATURE (Sign inside the box)
01/14/2014
ISSUED ON (mm/dd/yyyy) DATE ACCOMPLISHED RIGHT THUMBMARK