Professional Documents
Culture Documents
212
Revised 2017
I. PERSONAL INFORMATION
2. SURNAME Mangelen
NAME EXTENSION (JR., S
FIRST NAME Salehk
15. AGENCY EMPLOYEE NO. 97-0310 21. E-MAIL ADDRESS (if any) sbmangelen@yahoo.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME Compania 23. NAME of CHILDREN (Write full name and list all)
NAME EXTENSION (JR., SR) Nurlailah Nisa C. Mangelen
FIRST NAME Bai Norly
Yusuf Azhar C. Mangelen
MIDDLE NAME Bila
Shairah Aliah C. Mangelen
OCCUPATION Secondary School Teacher
Izdihar C. Mangelen
EMPLOYER/BUSINESS NAME Department of Education
Ayishah C. Mangelen
BUSINESS ADDRESS Sinsuat Avenue, Cotabato City
Husniyyah C. Mangelen
TELEPHONE NO. N/A
SURNAME Benito
SECONDARY Cotabato City National High School High School 1978 1982
VOCATIONAL /
TRADE
COURSE
COLLEGE Notre Dame University Bachelor of Science in Civil Engineering 1982 1987
GRADUATE STUDIES Notre Dame University Master in Public Administration 1998 2010
Dual Citizenship
by birth by naturalization
Pls. indicate country:
Narra Street
Street
Rosary Heights XI
Barangay
Maguindanao
Province
9600
Narra Street
Street
Rosary Heights XI
Barangay
Maguindanao
Province
9600
(064)552-1638
0926-7031230
sbmangelen@yahoo.com
6/1/2000
12/4/2001
01/23/2003
08/19/2004
09/16/2006
7/10/2008
SCHOLARSHIP/
YEAR ACADEMIC
GRADUATED HONORS
RECEIVED
1978 N/A
1982 N/A
1996 N/A
1987 N/A
2010 N/A
1/6/1993 05/31/1996 Instructor/Trainor Sultan Kudarat Islamic Academy P3,900.00 N/A Contractual
Date of
Validity
N/A
GOV'T
SERVICE
(Y/
N)
Y
ate sheet if necessary)
Quality Management Standard Manual Calibration Session 03/13/2017 03/13/2017 Managerial Technical Education
8
15th Human Resource and Skills Development Conference 9/8/2016 11/8/2016 Supervisory Technical Educatio
24
1st Bruni Indonesia Malaysia Philippines-Eest Asian Growth Association Technical
07/19/2016 07/19/2016 Managerial Technical Educa
Vocational Education Training Forum 8
Technical Vocational Education Training Monitoring Workshop 06/21/2016 06/23/2016 Technical Technical Educati
24
4th National Technical Vocational Education Training Congress 12/11/2016 12/11/2015 Supervisory Technical Voca
8
1st National Quality Technival Vocational Education Training Forum 9/9/2015 9/9/2015 Managerial Technical Educa
8
Technical Educat
14th Human Resource and Skills Development Conference 3/9/2015 5/9/2015 Supervisory Mindanao
24
13th Human Resource and Skills Development Conference 08/26/2014 08/28/2014 Supervisory Mindanao
24
3rd International & National Technical Educational Skills Development Congress 10/17/2014 10/17/2014 Supervisory Technical Voca
8
1st Bruni Indonesia Malaysia Philippines-Eest Asian Growth Association Technical Technical Educat
10/22/2014 10/22/2014 Managerial Mindanao
Vocational Education Training Forum 8
Training Program on the Development of Training Plan 9/9/2013 12/9/2013 24 Technical Technical Educati
International Standard Organization Capability Training Program 12/8/2013 08/16/2013 40 Technical Technical Education S
Provincial Tech
Driving N/A
Computer Operation
N/A
te sheet if necessary)
GRAMS ATTENDED
(5) years for Division Chief/Executive/Managerial positions)
CONDUCTED/ SPONSORED BY
(Write in full)
te sheet if necessary)
MEMBERSHIP IN ASSOCIATION/ORGANIZATION
(Write in full)
te sheet if necessary)
35. a. Have you ever been found guilty of any administrative offense? YES NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? YES NO
If YES, give details:
________________________________
Date Filed:
________________________________
Status of Case/s:
36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation NO
YES
by any court or tribunal?
If YES, give details:
________________________________
________________________________
37. Have you ever been separated from the service in any of the following modes: resignation, YES NO
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or phased If YES, give details:
out (abolition) in the public or private sector? ________________________________
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except YES NO
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last YES NO
election to promote/actively campaign for a national or local candidate? If YES, give details:
39. Have you acquired the status of an immigrant or permanent resident of another country?
YES NO
If YES, give details (country):
40. 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:
a. Are you a member of any indigenous group? YES NO
If YES, please specify:
b. Are you a person with disability? YES NO
If YES, please specify ID No:
c. Are you a solo parent? YES NO
If YES, please specify ID No:
Datu Ismael V. Mastura Sultan Kudarat, Maguindanao N/A With full and handwritten
name tag and signature over
Don Eduardo Sero Street, Cotabato printed name
Doctor Eduardo Rabago City
N/A
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
is not acceptable
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the
Philippines. I authorize the agency head / authorized representative to verify/validate the contents stated herein. I
agree that any misrepresentation made in this document and its attachments shall cause the filing of PHOTO
administrative/criminal case/s against me.
Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)
PLEASE INDICATE ID Number and Date of Issuance
Government Issued ID: 97-0310
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.