APPLICATION FOR EMPLOYMENT

is an official document.
Picture Please
items. If an item is

Instructions: This form

answer all
not applicable to you, indicate NA or Not Applicable.
Please check ( ) the appropriate box whenever applicable.

(Passport size)

Position Applied For:

Have you taken BSP pre-employment

test before?
Yes
No

1.

SURNAME
MIDDLE NAME

FIRST NAME

VILLAFUERTE
AQUILINO
2. CIVIL STATUS

MARK AL

Single
Widower/Widow
5. DATE OF BIRTH
MAY 8, 1990

3. GENDER
Married
6. AGE
24

7. PLACE OF BIRTH
CAMARINES SUR

Secondary

Name and Address of

School/College/ University
St. Louise de Marillac School of Pili

4. CITIZENSHIP
FILIPINO

Separated

10. PERMANENT ADDRESS

ZONE 2, SALVACION BULA CAMARINES SUR
13.
EDUCATION

For female married applicant: write Maiden

Name

Male
Female
8. HEIGHT (Meters)
1.72

9. WEIGHT (Kilos)
62

11. E-MAIL ADDRESS

12. CONTACT NUMBER
Phil_ghaniz08@yahoo.c 09099479475
om
Inclusive
Course
Honors
Dates of
(If Undergraduate, indicate
Received
no. of units completed)
Attendance
June 2002-March
2006

Vocational
College

Naga College Foundation

June 2007-March
2011

Postgraduat
e
(Continue on separate sheet, if necessary)

14. CIVIL SERVICE

ELIGIBILITY/LICENSE
(specify if BOARD, BAR, etc.)

Ratin 15. SKILLS AND OTHER

QUALIFICATIONS
g

16. MEMBERSHIP IN
RELATED
ASSOCIATION,
HOBBIES, etc.

CSE Professional

80.92 Operating Canon Printer,

Surfing Net, Watching

Current News

Encoding, Sorting Files, MS

Office Knowledge

(Continue on separate sheet, if necessary)

17. SEMINAR/TRAINING ATTENDED
Title of Seminar/ Training
OJT - LBP -Pili

Inclusive Dates
April 2011 - May 2011

No. of
Hours
250

(Continue on separate sheet, if necessary)

18. EMPLOYMENT HISTORY

Inclusive dates
(Exact dates)

Position Title and

Status of Appointment
(specify if Permanent,
Probationary Temporary,
Casual, Contractual, etc.)

February 21, 2012

- March 31, 2014

Office Staff - Permanent

April 19, 2011 July 31, 2011

Teller 2 - Contractual

Monthly
Name and Address of
Company/Agency/Office
HRD(S) Pte., Ltd
CEZ II, Bacao, General Trias
Cavite
CAMSUR MULTI-PURPOSE
COOPERATIVE, Cadlan Pili,
Cam. Sur

HR Form No. 02-001 (AOM Form No.01-080) * Version: 4 * Updated: 30 August 2012

Basic
Salary

Allowanc
es

Reason for
Leaving

9000

150

NOT RELATED
TO MY COURSE

4500

na

Too Far from

home

Page 1 of 3

(Continue on separate sheet, if necessary)

19. Are you related to any official or employee in the

If yes, give name/s of relative/s and relationship/s

BSP:

a.) within the third degree of consanguinity (i.e.

mother/father, son/daughter, brother/sister,

nephew/niece, uncle/aunt, grandparent,

grandchild)?
Yes
No

If yes, give name/s of relative/s and relationship/s

b.) within the second degree of affinity (i.e. mother-in-

law/ father-in-law, son-in-law/daughter-in-law, brother

in-law/ sister-in-law)?

Yes

If yes, give name/s of relative/s and relationship/s

No

c.) other relative/s not specified in items a and b?

Yes

No

20. Do you have relative/s who was/were former

employee/s of the
Bangko Sentral ng Pilipinas?
Yes
No
21. Have you ever been a respondent for a preliminary
investigation
before the Prosecutors/ Fiscals Office or any law

enforcement
agency such as the police, PDEA, NBI, etc.?
Yes
No
22. Have you ever been charged of

a) an administrative case?

Yes

b) a criminal case?

No

No

Yes

If yes, give name/s, relationship, department and

date of retirement
If Yes, state nature of the offense complained of
Status:
On-going
Dismissed
If Yes, state nature of offense/crime
Status:
Ongoing
Acquitted

23. Have you ever been convicted of any administrative

offense
or crime?

Yes

Dismissed
If Yes, state nature of the offense/case and
penalty

No
If Yes, give reasons

24. Have you ever been retired, forced to resign or

dropped from
employment whether in the public or private sector ?
Yes

No
If "Yes", give details

25. Have you ever been a candidate in a national or

local election
(except Barangay election)?

Yes

No

26. Please check any ailment/s for which you have been treated or are presently undergoing treatment

hypertension
diabetes
acquired heart
disease

chronic pulmonary disease

malignancies/cancer
autoimmune disease

kidney disease

cardiovascular Accident
(CVA)

pulmonary
tuberculosis

neuro-psychiatric condition

hematologic condition
chronic liver disease
major congenital
anomaly/deformation
others: _____________________________
_____________________________

HR Form No. 02-001 (AOM Form No.01-080) * Version: 4 * Updated: 30 August 2012

Page 2 of 3

What is the minimum

salary
you are willing to
accept?
27.

28. FOR APPLICANTS TO A SECURITY GUARD POSITION ONLY

If considered, are you willing to be assigned/re-assigned to the Main/SPC/regional
offices/branches of the Bangko Sentral ng Pilipinas in the performance of your job?
Yes
No
Signature
__________________________________

16,000
29. REFERENCES (Persons not related by consanguinity or affinity to applicant)
Name
Address/ Telephone No.

1.

Yanee Arleen Benosa

San Jose Pili, Camarines

Sur/477-2113
2.
3.

Renacy M. Tuano___________________________

Tanza, Cavite/(046) 437-1188

Emma Ruth Estadilla

San Juan Pili, Camarines Sur/

(054) 477-3044
I declare that the answers given above are true and correct to the best of my knowledge
and belief. It is understood that any false representation I made above shall disqualify me from
employment in the BSP in which case, my appointment, if one is issued, shall be revoked; such
representation shall be a ground for an administrative case for DISHONESTY and/or CONDUCT
PREJUDICIAL TO THE BEST INTEREST OF THE SERVICE punishable under the disciplinary rules on
administrative cases both in Civil Service Commission and BSP.
I further waive my right to confidentiality of information pertaining to the BSP Watchlist
clearance
in
compliance
with
M.B. Resolution No. 1487.

Signature over Printed Name/ Date

Community Tax Certificate No.

03679499
Issued at
MTO-BULA CAM.SUR
Issued on
APRIL 14, 2014

HR Form No. 02-001 (AOM Form No.01-080) * Version: 4 * Updated: 30 August 2012

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