Teacher
Resume:
PERSONAL DATA SHEET
Print legibly. Mark appropriate boxes with " " and use separate sheet if necessary. 1. CS ID No.
(to be filled up by CSC)
I. PERSONAL INFORMATION
2. SURNAME GUEVARRA
FIRST NAME MARYJANE
MIDDLE NAME DAWOG 3. NAME EXTENSION (e.g. Jr., Sr.) 4. DATE OF BIRTH (mm/dd/yyyy) 08 / 06 / 1991 16. RESIDENTIAL ADDRESS Prias Drive, Tumaga, Z.C., ZAMBOANGA CITY, ZAMBOANGA DEL SUR
5. PLACE OF BIRTH Cantilan, Surigao del Sur
6. SEX MALE FEMALE
7. CIVIL STATUS
Single Widowed
Married Separated
Annuled Others, specify
ZIP CODE 7000
17. TELEPHONE NO. none
18. PERMANENT ADDRESS Km. 5, Limbaga Road, Pasonanca, Z.C., ZAMBOANGA CITY, ZAMBOANGA DEL SUR
8. CITIZENDSHIP Filipino
9. HEIGHT (m) 5
10. WEIGHT (kg) 56 ZIP CODE 7000
11. BLOOD TYPE O+ 19. TELEPHONE NO. none
12. GSIS ID NO. None 20. EMAIL ADDRESS (if any) ******.********@*****.*** 13. PAGIBIG ID NO. 914*-****-**** 21. CELLPHONE NO. (if any) 090-***-***** 14. PHILHEALTH NO. 14-050******-*-**. AGENCY EMPLOYEE NO. none 15. SSS NO. 10-111****-*-**. TIN 454-667-614
II. FAMILY BACKGROUND
24. SPOUSE'S SURNAME 25. NAME OF CHILD (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy) FIRST NAME Xavier G. Marcos 08 / 28 / 2013
MIDDLE NAME Mikaela Zoe G. Marcos 06 / 22 / 2015
OCCUPATION
EMPLOYER/BUS. NAME
BUSINESS ADDRESS
TELEPHONE NO.
(Continue on separate sheet if necessary)
26. FATHER'S SURNAME Guevarra
FIRST NAME Eduardo
MIDDLE NAME Calinacion
27. MOTHER'S MAIDEN NAME
MOTHER'S SURNAME Rosalita Macuray Dawog
FIRST NAME Rosalita
MIDDLE NAME Dawog
III. EDUCATIONAL BACKGROUND
NAME OF SCHOOL
(Write in full)
DEGREE COURSE
(Write in full)
YEAR
GRADUATED
(if graduated)
HIGHEST
GRADE/
LEVEL/ UNITS
EARNED
(if not
graduated)
INCLUSIVE DATES OF
ATTENDANCE SCHOLARSHIP/ ACADEMIC
HONORS RECEIVED
LEVEL
From To
ELEMENTARY
Pasonanca Elementary
School
200*-****-** 2004-03 Second Honors
SECONDARY
Zamboanga City High
School- MAIN
200*-****-** 2009-04 none
VOCATIONAL/ TRADE
COURSE
COLLEGE
Western Mindanao State
University
Bachelor of
Secondary Education
201*-****-** 2013-03 none
GRADUATE STUDIES
IV. CIVIL SERVICE ELIGIBILITY
Unique Applicant Number
T15091426
GUEVARRA, MARYJANE DAWOG - T15091426 CS FORM 212 (Revised 2005), Page 1 of 3 29.
CAREER SERVICE/ RA 1080 (BOARD/ BAR)
UNDER SPECIAL LAWS/ CES/ CSEE
RATING
DATE OF
EXAMINATION /
CONFERMENT
PLACE OF EXAMINATION / CONFERMENT
LICENSE (if applicable)
NUMBER
DATE OF
RELEASE
CS PROFESSIONAL 81.42% 04 / 06 / 2014 Zamboanga City High School-MAIN 340881 05/19/2014 LET (LICENSURE EXAMINATION FOR TEACHER) 79% 01 / 26 / 2014 Don Pablo Lorenzo Memorial High School 1305145 V. WORK EXPERIENCE
30. INCLUSIVE DATES
(mm/dd/yyyy)
POSITION TITLE (Write in full)
DEPARTMENT / AGENCY / OFFICE /
COMPANY (Write in full)
MONTHLY
SALARY
SALARY
GRADE &
STEP
INCREMENT
(Format "00-0")
STATUS OF
APPOINTMENT
GOV'T SERVICE
(Yes / No)
From To
05/06/2014 04/15/2015 Secondary English Teacher
Immaculate Conception
Archdiocesan School
8,000 0 - 1 Contractual No
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S 31.
NAME & ADDRESS OF ORGANIZATION
(Write in full)
INCLUSIVE DATES
(mm/dd/yyyy) NUMBER OF
HOURS
POSITION / NATURE OF WORK
From To
VII. TRAINING PROGRAMS (Start from the most recent training.) 32.
TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES
(Write in full)
INCLUSIVE DATES OF
ATTENDANCE
(mm/dd/yyyy)
NUMBER OF
HOURS
CONDUCTED/ SPONSORED BY
(Write in full)
From To
K to 12 Learning Outcome-based Assessment 05 / 22 / 2014 05 / 24 / 2014 24 Diwa Learning Systems Inc. Classroom Management with Bullying 05 / 12 / 2014 05 / 12 / 2014 8 Phoenix Publishing House Genyo e-learning Training for Teaching Education 05 / 02 / 2014 05 / 04 / 2014 24 Diwa Learning Systems Inc. Job Enabling English Proficiency Program 06 / 01 / 2010 04 / 01 / 2012 VIII. OTHER INFORMATION
33.
SPECIAL SKILLS / HOBBIES:
34. NON-ACADEMIC DISTINCTIONS / RECOGNITION:
(Write in full)
35. MEMBERSHIP IN ASSOCIATION / ORGANIZATION
(Write in full)
Painting 1st placer On the spot painting contest. Member of GURU Publication Stage Decorating Journalism Awardee Adviser
Moderator
GUEVARRA, MARYJANE DAWOG - T15091426 CS FORM 212 (Revised 2005), Page 2 of 3 36. Are you related by consanguinity or affinity to any of the following : a. 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?
YES NO
If YES, give details:
b. Within the fourth degree (for Local Government Employees): appointing authority or recommending authority where you will be appointed? YES NO
If YES, give details:
37. a. Have you ever been formally charged?
YES NO
If YES, give details:
b. Have you ever been guilty of any administrative offense? YES NO
If YES, give details:
38. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation by any court or tribunal?
YES NO
If YES, give details:
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?
YES NO
If YES, give details:
40. Have you ever been a candidate in a national or local election (except Barangay election)? YES NO
If YES, give details:
41. 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 differently abled?
YES NO
If YES, please specify:
c. Are you a solo parent?
YES NO
If YES, please specify:
42. REFERENCES (Person not related by consanguinity or affinity to applicant / appointee) NAME ADDRESS TEL. NO.
PHOTO
X
Mrs. Celina Gamao Carmen Valley,Abong-Abong,
Zamboanga City
Mrs. Carolyn Salcedo Tetuan, Zamboanga City 092-***-***** Ms. Entizar A. Ibrahim Lustre Drive, Sta. Catalina, Z.C. 091-***-***** 43. 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.
01707842
COMMUNITY TAX CERTIFICATE NO.
Pasonanca, Z.C.
ISSUED AT
2015-10-01
ISSUED ON (mm/dd/yyyy)
SIGNATURE (Sign inside the box)
10 / 21 / 2015
DATE ACCOMPLISHED
RIGHT THUMBMARK
GUEVARRA, MARYJANE DAWOG - T15091426 CS FORM 212 (Revised 2005), Page 3 of 3
Contact this candidate