PERSONAL DATA SHEET
1. CS ID No.
Print legibly. Mark appropriate boxes with " " and use separate sheet if necessary. (to be
I. PERSONAL INFORMATION
CALMA
2. SURNAME
MYLA
FIRST NAME
NAVARRO 3. NAME EXTENSION (e.g. Jr., Sr.)
MIDDLE NAME
16. RESIDENTIAL ADDRESS
05/27/1975
4. DATE OF BIRTH (mm/dd/yyyy)
641 ROXAS STREET, DAU, MABALA
ANGELES CITY
5. PLACE OF BIRTH
PAMPANGA
Male Female
6. SEX
Widowed
Single
7. CIVIL STATUS
2010
ZIP CODE
Married Separated
NONE
17. TELEPHONE NO.
Others, specify
Annulled 18. PERMANENT ADDRESS
641 ROXAS STREET, DAU, MABALA
FILIPINO
8. CITIZENSHIP
PAMPANGA
155 cm.
9. HEIGHT (cm)
53 kg. 2010
10. WEIGHT (kg) ZIP CODE
B NONE
11. BLOOD TYPE 19. TELEPHONE NO.
*********@*****.***
12. GSIS ID NO. 20. E-MAIL ADDRESS (if any)
109*-****-**** 091*-*******/ 090*-*******
13. PAG-IBIG ID NO. 21. CELLPHONE NO. (if any)
19-090549525-2 4162391
14. PHILHEALTH NO. 22. AGENCY EMPLOYEE NO.
225-119-461
02-1425013-8
15. SSS NO. 23. TIN
II. FAMILY BACKGROUND
N/A
24. SPOUSE'S SURNAME 25. NAME OF CHILD (Write full name and list all) DATE OF BIRTH
N/A JARRAH GILLAND C. PARAS 09/30/
FIRST NAME
N/A NONE NON
MIDDLE NAME
N/A NONE NON
OCCUPATION
N/A NONE NON
EMPLOYER/BUS. NAME
N/A NONE NON
BUSINESS ADDRESS
N/A NONE NON
TELEPHONE NO.
NONE NON
(Continue on separate sheet if necessary)
NONE 05/09/
CALMA
26. FATHER'S SURNAME
ROMEO NONE NON
FIRST NAME
DUNGCA NONE NON
MIDDLE NAME
27. MOTHER'S MAIDEN NAME
NAVARRO NONE 06/02/
SURNAME
ERLINDA NONE NON
FIRST NAME
SANCHEZ
MIDDLE NAME (Continue on separate sheet if necessary)
YEAR
GRADUATED
III. EDUCATIONAL BACKGROUND
HIGHEST GRADE/ INCLUSIVE DATES OF
28. NAME OF SCHOOL DEGREE COURSE LEVEL/ ATTENDANCE
LEVEL (Write in UNITS EARNED
(Write in full) full) (if not From To
graduated)
DAU CENTRAL (if
6TH GRADE 198*-****-****
graduated) GRADUATED
ELEMENTARY
ELEMENTARY SCHOOL
HOLY ANGEL UNIVERSITY 4TH YEAR 199*-****-****
GRADUATED
SECONDARY /
VOCATIONAL
NONE NONE NONE NONE NONE NONE
COLLEGE
TRADE COURSE BSBA-
ANGELES UNIVERSITY MANAGEMENT &
GRADUATED
ENTREPRENEURS
FOUNDATION HIP
GRADUATE STUDIES
NONE NONE NONE NONE NONE NONE
(Continue on separate sheet if necessary)
DATA SHEET
(to be filled up by CSC)
NONE
641 ROXAS STREET, DAU, MABALACAT,
PAMPANGA
2010
NONE
641 ROXAS STREET, DAU, MABALACAT,
PAMPANGA
2010
NONE
*********@*****.***
4162391
225-119-461
DATE OF BIRTH (mm/dd/yyyy)
09/30/2009
NONE
NONE
NONE
NONE
NONE
NONE
05/09/1951
NONE
NONE
06/02/1954
NONE
(Continue on separate sheet if necessary)
SCHOLARSHIP/
ACADEMIC HONORS
RECEIVED
NONE
NONE
NONE
NONE
NONE
rate sheet if necessary)
Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
LICENSE (if applicable)
29. DATE OF
CAREER SERVICE/ RA 1080 (BOARD/ BAR)
RATING EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
UNDER SPECIAL LAWS/ CES/ CSEE DATE OF
NUMBER
CONFERMENT
RELEASE
CAREER SERVICE JANUARY 24,
82.46% MALOLOS, BULACAN
10/17/1993
SUBPROFESSIONAL 1994
(Continue on separate sheet if necessary)
V. WORK EXPERIENCE (Include private employment. Start from your current work) GOV'T
SERVICE
SALARY
POSITION TITLE
INCLUSIVE DATES
30. DEPARTMENT / AGENCY / OFFICE / GRADE &
MONTHLY STATUS OF
(mm/dd/yyyy) STEP
COMPANY
(Write in SALARY APPOINTMENT
INCREMENT
(Write in full) (Format "00-
full)
From To 0")
(Yes / No)
PERMA
ADMINISTRATIVE DIVISION OF CITY SCHOOLS,
03/01/15 SG 6 YES
PRESENT P 13, 378
NENT
AIDE VI ANGELES CITY
IN-CHARGE OF CONTRA
ANGELES CITY NATIONAL
08/01/10 02/28/15 P 8, 000 NONE YES
RECORDS HIGH SCHOOL CTUAL
(Continue on separate sheet if necessary)
CS FORM 212 (Revised 2005), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGA
INCLUSIVE DATES
31. NAME & ADDRESS OF ORGANIZATION NUMBER OF
POSITION / NATURE OF WORK
(Write in full) HOURS
(mm/dd/yyyy)
From To
NONE NONE NONE NONE NONE
(Continue on separate sheet if necessary)
VII. TRAINING PROGRAMS (Start from the most recent training.)
INCLUSIVE DATES OF
ATTENDANCE
32.
TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES NUMBER OF CONDUCTED/ SPONSORED BY
(mm/dd/yyyy)
(Write in full) HOURS (Write in full)
From To
06/08/2016 06/10/2016 24 HRS. DEPED ANGELES CITY
DIVISION PRE-OPENING CONFERENCE
GENDER AND DEVELOPMENT CAPACITY BUILDING FOR DIVISION OF
04/27/2016 04/29/2016 24 HRS. DEPED ANGELES CITY
ANGELES CITY PERSONNEL
GENDER AND DEVELOPMENT TRAINING FOR DIVISION PERSONNEL
07/30/2015 07/31/2015 16 HRS. DEPED ANGELES CITY
OF ANGELES CITY
INDUCTION PROGRAM ON THE IMPLEMENTATION OF THE
03/18/2015 03/20/2015 24 HRS. DEPED ANGELES CITY
RATIONALIZATION PROGRAM
GUNG HO! A PERFORMANCE IMPROVEMENT AND TEAM-BASED
06/13/2012 06/15/2012 24 HRS. DEPED ANGELES CITY
COMPETENCE ENHANCEMENT PROGRAM
(Continue on separate sheet if necessary)
VIII. OTHER INFORMATION
MEMBERSHIP IN
ASSOCIATION/ORGANIZATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION:
33. SPECIAL SKILLS / HOBBIES: 34.
(Write in full)
(Write in
full)
COMPUTER LITERATE NONE NONE
SINGING
BIKING
(Continue on separate sheet if necessary)
CS FORM 212 (Revised 2005), Page 3 of 4
36. Are you related by consanguinity or affinity to any of the following :
a. Within the third degree (for National Government Employees): YES NO
appointing authority, recommending authority, chief of If YES, give details:
office/bureau/department or person who has immediate supervision over you
in the Office, Bureau or Department where you will be appointed?
b. Within the fourth degree (for Local Government Employees): YES NO
appointing authority or recommending authority where If YES, give details:
you will be appointed?
37 a. Have you ever been formally charged? YES NO
If YES, give details:
YES NO
b. Have you ever been guilty of any administrative offense?
If YES, give details:
38. Have you ever been convicted of any crime or violation of any law, decree, YES NO
ordinance or regulation by any court or tribunal? If YES, give details:
39. Have you ever been separated from the service in any of the following modes: YES NO
resignation, retirement, dropped from the rolls, dismissal, termination, end of
term, finished contract, AWOL or phased out, in the public or private sector? If YES, give details:
RESIGNATION
40. Have you ever been a candidate in a national or local election (except YES NO
Barangay election)?
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: SINGLE MOTHER
42. REFERENCES (Person not related by consanguinity or affinity to applicant / appointee)
NAME ADDRESS TEL. NO.
MRS. ESTRELITA D. LECAROS 092*-*******
SAPANGBATO, ANGELES CITY
ID picture taken within
the last 6 months
ATTY. ARVIN SULLER 091*-*******
VILLA ANGELA SUBD., ANGELES CITY 3.5 cm. X 4.5 cm
(passport size)
Computer generated
43. I declare under oath that this Personal Data Sheet has been accomplished by me, and is a or xerox copy of picture
true, correct and complete statement pursuant to the provisions of pertinent laws, rules and is not acceptable
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. PHOTO
09812156
COMMUNITY TAX CERTIFICATE NO.
ANGELES CITY
ISSUED AT SIGNATURE (Sign inside the box)
02/03/2016 07/25/2016
ISSUED ON (mm/dd/yyyy) DATE ACCOMPLISHED RIGHT THUMBMARK
CS FORM 212 (Revised 2005), Page 4 of 4