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Office Service

Location:
Kauswagan, Cagayan de Oro, 9000, Philippines
Posted:
March 09, 2021

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Resume:

Print legibly. Tick appropriate boxes and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No. 2.

KATRINA JOY

TAMBOT

3.

16. CITIZENSHIP

4. PLACE OF BIRTH

5. SEX

17. RESIDENTIAL ADDRESS

8.

18. PERMANENT ADDRESS

12. PHILHEALTH NO.

13. SSS NO. 19. TELEPHONE NO.

20. MOBILE NO.

15. AGENCY EMPLOYEE NO. 21. E-MAIL ADDRESS (if any) II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME

FIRST NAME

MIDDLE NAME

OCCUPATION

EMPLOYER/BUSINESS NAME

BUSINESS ADDRESS

TELEPHONE NO.

24. FATHER'S SURNAME

FIRST NAME

MIDDLE NAME

25.

SURNAME

FIRST NAME

MIDDLE NAME

III. EDUCATIONAL BACKGROUND

From To

ELEMENTARY 6/8/1996 3/20/2001 2001

SECONDARY 6/5/2002 3/15/2005 2005

VOCATIONAL /

TRADE COURSE

COLLEGE 6/1/2005 4/9/2009 2009

GRADUATE STUDIES

CS FORM 212 (Revised 2017), Page 1 of 4

SIGNATURE

(Continue on separate sheet if necessary)

January 27, 2021

VICENTE

DELA CRUZ

DATE

HIGHEST LEVEL/

UNITS EARNED

(if not graduated)

GALVEZ

TAMBOT

JOSEFA

NAME EXTENSION (JR., SR)

BASIC EDUCATION/DEGREE/COURSE

(Write in full)

WARNING: Any misrepresentation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s against the person concerned.

LEVEL

NAME OF SCHOOL

(Write in full)

DON GREGORIO EVANGELISTA MEMORIAL

SCHOOL

ZAMBOANGA STATE COLLEGE OF MARINE

SCINECES AND TECHNOLOGY

WESTERN MINDANAO STATE UNIVERSITY

Barangay

ZAMBOANGA CITY ZAMBOANGA DEL SUR

City/Municipality Province

City/Municipality Province

GALVEZ DRIVE

ZIP CODE

955-1674

STA. MARIA

************@*****.***

23. NAME of CHILDREN (Write full name and list all) PERSONAL DATA SHEET

I. PERSONAL INFORMATION

(Do not fill up. For CSC use only)

SCHOLARSHIP/

ACADEMIC

HONORS

RECEIVED

DATE OF BIRTH (mm/dd/yyyy)

26. YEAR

GRADUATED

GALVEZ

35906

SURNAME

FIRST NAME

MIDDLE NAME

ZIP CODE

NAME EXTENSION (JR., SR)

14. TIN NO. 312147770

RTRYX JANN

SPIRIG

KEAN RANDALL SIOSE

1.57

9.

HEIGHT (m)

WEIGHT (kg)

BLOOD TYPE

GSIS ID NO.

PAG-IBIG ID NO.

ZAMBOANGA CITY

House/Block/Lot No. Street

Subdivision/Village Barangay

ZAMBOANGA CITY

100*******

READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM. Street

STA. MARIA

Subdivision/Village

10.

11.

B

NA

121*********

6

7.

CIVIL STATUS

DATE OF BIRTH

(mm/dd/yyyy)

NAME EXTENSION (JR., SR)

9/28/1988

BACHELOR OF SCIENCE IN NURSING

DUNGGON (Continue on separate sheet if necessary)

PERIOD OF ATTENDANCE

MOTHER'S MAIDEN NAME

991-2471

11/20/2013

010*********

095********

please indicate the details.

If holder of dual citizenship, Pls. indicate country: GALVEZ DRIVE

79

ZAMBOANGA DEL SUR

7000

SIOSE

EMT-TRANEE

ZAMBOANGA PUERICULTURE

LA PURISAMA STREET, Z.C

House/Block/Lot No.

7000

CS Form No. 212

Revised 2017

Filipino Dual Citizenship

Male Female

Single Married

Widowed

Other/s:

Separated

by birth by naturalization

27.

NUMBER

Date of

Validity

75.9 0618269 7/9/1905

(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet. 28.

To

1/20/2021 12000.00 REGULAR N

8/15/2016 100000.00 REGULAR N

3/12/2013 180000.00 REGULAR N

12/9/2013 16000.00 PROBI N

DATE

CS FORM 212 (Revised 2017), Page 2 of 4

CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER

SPECIAL LAWS/ CES/ CSEE

BARANGAY ELIGIBILITY / DRIVER'S LICENSE

DATE OF

EXAMINATION /

CONFERMENT

PLACE OF EXAMINATION / CONFERMENT

LICENSE (if applicable)

RATING

(If Applicable)

IV. CIVIL SERVICE ELIGIBILITY

GOV'T

SERVICE

(Y/ N)

ZAMBOANGA CITY

SALARY/ JOB/ PAY

GRADE (if

applicable)& STEP

(Format "00-0")/

From INCREMENT

POSITION TITLE

(Write in full/Do not abbreviate)

NURSING LICENSURE EXAMINATION 11/29-30/2009

DEPARTMENT / AGENCY / OFFICE / COMPANY

(Write in full/Do not abbreviate)

MONTHLY

SALARY

OPERATING ROOM/FINANCE DEPARTMENT/CIUDAD

MEDICAL ZAMBOANGA

INCLUSIVE DATES

(mm/dd/yyyy)

1/9/2017

(Continue on separate sheet if necessary)

V. WORK EXPERIENCE

OPERATING ROOM INVENTORY

ASSOCIATE

8/6/2012

11/17/2015 STORE HEAD/ BRANCH SUPERVISOR CECILE'S PHARMACY/STA. MARIA CUSTOMER SERVICE REPRESENTATIVE SITEL PHILIPPINES/MANDALUYONG CITY STATUS OF

APPOINTMENT

SIGNATURE

MEDICAL REPRESENTATIVE NATRAPHARM-PATRIOT GROUP INC

(Continue on separate sheet if necessary)

7/6/2012

January 27, 2021

From To

From To

31. SPECIAL SKILLS and HOBBIES 32. 33.

CS FORM 212 (Revised 2017), Page 3 of 4

DATE January 27, 2021

(Continue on separate sheet if necessary)

WRITING

MS OFFICE PROFICEINT

NON-ACADEMIC DISTINCTIONS / RECOGNITION

(Write in full)

BASIC EDITING AND PROOFREADING

MEMBERSHIP IN ASSOCIATION/ORGANIZATION

(Write in full)

NUMBER OF HOURS

SIGNATURE

INTRA-SCHOOL WRITING COMPETITION

VIII. OTHER INFORMATION

TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS

(Write in full)

Type of LD

( Managerial/

Supervisory/

Technical/etc)

29. NAME & ADDRESS OF ORGANIZATION

(Write in full)

(Continue on separate sheet if necessary)

POSITION / NATURE OF WORK

INCLUSIVE DATES

(mm/dd/yyyy)

VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S CONDUCTED/ SPONSORED BY

(Write in full)

INCLUSIVE DATES OF

ATTENDANCE

(mm/dd/yyyy)

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED NUMBER OF HOURS

30.

RESIGNATION

a.

If YES, please specify:

b.

If YES, please specify ID No:

c.

If YES, please specify ID No:

REFERENCES (Person not related by consanguinity or affinity to applicant /appointee) ADDRESS

STA. CATALINA, Z.C

CANELAR, Z.C.

STA. MARIA, Z.C.

SSS UMID ID

CS FORM 212 (Revised 2017), Page 4 of 4

Person Administering Oath

SUBSCRIBED AND SWORN to before me this, affiant exhibiting his/her validly issued government ID as indicated above. Date Accomplished Right Thumbmark

Date/Place of Issuance: MAY 2018/ZAMBOANGA CITY

Government Issued ID:

ID/License/Passport No.:

Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.) PLEASE INDICATE ID Number and Date of Issuance

0111-648906-7

Signature (Sign inside the box)

January 27, 2021

PHOTO

997-***-****

NAME TEL. NO.

42.

905-***-****

MARITHEL TEVES

GENALYN PANGILINAN 997*******

JUNAS RABANES

I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and 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 administrative/criminal case/s against me.

41.

38.

If YES, give details:

If YES, give details:

Date Filed:

Status of Case/s:

b. Have you been criminally charged before any court? If YES, give details:

If YES, give details:

If YES, give details:

Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation by any court or tribunal?

a. Have you ever been a candidate in a national or local election held within the last year (except Barangay election)?

b. Have you resigned from the government service during the three (3)-month period before the last election to promote/actively campaign for a national or local candidate? If YES, give details (country):

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 or phased out (abolition) in the public or private sector?

35.

If YES, give details:

a. Have you ever been found guilty of any administrative offense? b. within the fourth degree (for Local Government Unit - Career Employees)? 36.

37.

Are you a person with disability?

Are you a solo parent?

40.

Have you acquired the status of an immigrant or permanent resident of another country? 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: Are you a member of any indigenous group?

39.

If YES, give details:

34. Are you related by consanguinity or affinity to the appointing or recommending authority, or to the chief of bureau or office or to the person who has immediate supervision over you in the Office, a. within the third degree?

Bureau or Department where you will be apppointed, ID picture taken within

the last 6 months

4.5 cm. X 3.5 cm

(passport size)

Computer generated

or photocopied picture

is not acceptable

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES

YES

YES

NO

NO

NO

YES NO

YES NO



Contact this candidate