Republic of the Philippines

Date: _____________________
Ref: ______________________
Remarks:

Department of Foreign Affairs

P a s a y

C i t y

Qualified for testing

Photo

Not Qualified
Inactive
Remarks: _______________
________________________

____________________
APPLICATION FORM

* Note: Please print clearly in ink. Use additional sheets if necessary.

POSITION APPLIED FOR:

PERSONAL BACKGROUND
Surname

First Name

Middle

Name

NAME:
CIVIL STATUS
MARRIED

SINGLE

SEPARATED

WIDOWED

SEX:

MALE

CITIZENSHIP:

FEMALE

ANNULLED

DIVORCED

IF MARRIED, WRITE MAIDEN NAME:

DATE OF BIRTH:
HEIGHT:
RELIGION:
TEL NO. (RES.):
PRESENT ADDRESS:
PROVINCIAL ADDRESS:

NAME OF SPOUSE:
PLACE OF BIRTH:
WEIGHT:
E-MAIL ADDRESS:
CEL NO:

Surname

PROVINCE:

First Name

Middle Name

NAME OF FATHER:
CITIZENSHIP:

OCCUPATION:
Maiden Name

First Name

Middle Name

NAME OF MOTHER:
CITIZENSHIP:

OCCUPATION:

EDUCATIONAL ATTAINMENT
Name of
School/College/University

Inclusive
Dates

Course/ Degree
Earned
& Honors Received (if Any)

ELEMENTARY
SECONDARY
VOCATIONAL
COLLEGE
POST
GRADUATE

CIVIL SERVICE ELIGIBILITY/GOVERNMENT EXAMS PASSED

TITLE OF EXAM

DATE OF EXAM

PLACE OF EXAM

RATING

EMPLOYMENT RECORDS
INCLUSIVE
DATES

POSITION

NAME OF EMPLOYER/
ADDRESS

CAUSE OF SEPARATION

RECORD OF AWARDS/ COMMENDATIONS/ TRAININGS/SEMINARS

ATTENDED/ SCHOLARSHIP GRANTS

MEMBERSHIP IN SCHOOL/ PROFESSIONAL ORGANIZATION(S)

(LOCAL/INTERNATIONAL)
ORGANIZATION

POSITION

INCLUSIVE DATES

LITERARY ACCOMPLISHMENTS
TYPE OF PUBLICATION

TITLE

DATE PUBLISHED

KNOWLEDGE OF FOREIGN LANGUAGE (STATE PROFICIENCY FAIR, GOOD,

EXCELLENT)
LANGUAGE

READING

SPEAKING

WRITING

TRAVELS ABROAD
INCLUSIVE DATES

COUNTRIES

PURPOSE

SPECIALIZATION/SKILLS

Typing

Driving Office Machine Operations

Programming
Desktop Publishing

Computer Knowledge

GIVE OTHER SKILLS ASIDE FROM THE ONES MENTIONED:

WHAT COMPUTER SOFTWARE PROGRAMS ARE YOU FAMILIAR WITH?
WHY DO YOU SEEK A POSITION IN THE DEPARTMENT?
HAVE YOU EVER TAKEN THE EMPLOYMENT EXAMINATION OF THE DEPARTMENT? Yes (If yes,
when?_________) No
IF OFFERED APPOINTMENT, WHAT MINIMUM SALARY ARE YOU WILLING TO ACCEPT?
ARE YOU WILLING TO ACCEPT CASUAL/CONTRACTUAL APPOINTMENT?
Yes
No
HOW SOON CAN YOU START?

IDENTIFICATION OF RELATIVES IN GOVERNMENT SERVICE

DO YOU HAVE ANY RELATIVE (EITHER BY CONSANGUINITY OR AFFINITY) WORKING IN THE
DEPARTMENT OF FOREIGN AFFAIRS? Yes No
IF YES, STATE THE NAME OF RELATIVE(S) AND RELATIONSHIP(S)
ARE YOU RELATED WITHIN THE 3RD DEGREE OF AFFINITY OR CONSANGUINITY TO THE
APPOINTING/ RECOMMENDING AUTHORITY OR TO THE PERSON WHO HAS DIRECT SUPERVISION
OVER YOU IN THE OFFICE, BUREAU OR DEPARTMENT YOU ARE APPOINTED TO?
Yes
No
IF YES, GIVE PARTICULARS:

OTHER PERTINENT INFORMATION

HAVE YOU EVER BEEN DISMISSED OR FORCED TO RESIGN FROM ANY EMPLOYMENT FOR REASON
OTHER THAN LACK OF FUNDS?
Yes
No
IF YES, GIVE PARTICULARS:
HAVE YOU EVER BEEN CONVICTED FOR VIOLATING ANY LAW, DECREE, ORDINANCE OR
REGULATIONS BY ANY COURT, BODY OR TRIBUNAL? Yes
No
IF YES, GIVE PARTICULARS:
HAVE YOU EVER BEEN CONVICTED OR FOUND GUILTY OF AN ADMINISTRATIVE OFFENSE?
Yes No
IF YES, GIVE PARTICULARS:
DO YOU HAVE ANY PENDING ADMINISTRATIVE / CRIMINAL CASE?
Yes No
IF YOU HAVE ANY, GIVE PARTICULARS:

CHARACTER AND CREDIT REFERENCES (GIVE 3 PERSONS WHO KNOW YOU

PERSONALLY)
NAME

ADDRESS

NUMBER

OCCUPATION

I hereby certify that the answers given above are true and correct to the best of my
knowledge and based on authentic records. Any wrong or withheld information herein
will make my application in the Department null and void.

ACCOMPLISHED

SIGNATURE OF PERSON ACCOMPLISHING THIS FORM

COMMUNITY TAX CERTIFICATE NUMBER:
PLACE OF ISSUE
DATE OF ISSUE:

DATE