Professional Documents
Culture Documents
WARNING: Any misrepresentation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s
CS Form
READ THE No. 212 GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.
ATTACHED
Revised
Print 2017
legibly. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No.
I. PERSONAL INFORMATION
2. SURNAME BALILING
SURNAME VIOLA
FIRST NAME EMELIANA
MIDDLE NAME RENDAL (Continue on separate
PHILIPPINE PHARMACEUTICAL
COMPUTER HARDWARE SERVICING 2014 2014
TECHNOLOGY SCHOOL (TESDA)
SIGNATURE DATE
AL DATA SHEET
nce Sheet shall cause the filing of administrative/criminal case/s against the person concerned.
N/A
Street
LOCUBAN
Barangay
ZAMBOANGA DEL SUR
Province
7015
N/A
Street
LOCUBAN
Barangay
ZAMBOANGA DEL SUR
Province
7015
N/A
09122937613
ebaliling72@gmail.com/tarrayjay26@gmail.com
23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
SCHOLARSHIP/
HIGHEST LEVEL/ YEAR
ACADEMIC
UNITS EARNED GRADUATED
HONORS
(if not graduated)
RECEIVED
SCHOLARSHIP/
HIGHEST LEVEL/ YEAR
ACADEMIC
UNITS EARNED GRADUATED
HONORS
(if not graduated)
RECEIVED
4/17/2018
V. WORK EXPERIENCE
(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet.
From To
District Level In- Service Training for Secondary School Level 10/23/2018 10/27/2018 48 SUPERVISORY DE
MASS TRAINING FOR 2ND YEAR TEACHERS (UBD) 5/23/2011 5/26/2011 24 SUPERVISORY D
MASS TRAINING FOR 1ST YEAR TEACHERS (UBD) 6/3/2010 6/6/2010 24 SUPERVISORY
Singing N/A
cooking
Writing Poem/Tula/Balak
N/A
SIGNATURE DATE
LE / VOLUNTARY ORGANIZATION/S
Treasurer
Member
President
N/A
CONDUCTED/ SPONSORED BY
(Write in full)
DEPARTMENT OF EDUCATION
DEPARTMENT OF EDUCATION
DEPARTMENT OF EDUCATION
DEPARTMENT OF EDUCATION
REGION IX ZAMBOANGA PENINSULA
TESDA ZAMBOANGA DEL SUR
DEPARTMENT OF EDUCATION
DEPARTMENT OF EDUCATION
DEPARTMENT OF EDUCATION
PROVENCIAL GOV.PROGRAM
DEPARTMENT OF EDUCATION
DEPARTMENT OF EDUCATION
N/A
04/17/2018
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
YES ✘ NO
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:
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated ab
TORNITO M. GUMINTAD
Person Administering Oath
✘ NO
✘ NO
If YES, give details (country):
✘ NO
✘ NO
✘ NO
Computer generated
or photocopied picture
is not acceptable
PHOTO
Right Thumbmark