PERSONAL DATA SHEET bieiegby. wack apropine be] wif and use sepa sen acess be ed up CS) [LPERSONAL INFORMATION. 2 sue waRceLino este |SHeRWN wwecuswe MENDEZ wweereisouies 1.8) [WA 7. DATE OF ORTH NYA) Ca PLACE OF RTH (Quezon crTy 15643. FAIARDO'ST SAMPALOC, MANILA 6 Sex wae Oo Fenae TomcsTas | Sage Ca Weoved 2 cous 108 CaWarred 2 Separaed 7 Teron Ne WA a a Ohers, spciy ee. ones fi FeRwaren ARESS 7 CmENSHP FILIPINO, 1964 J, FAJARDO ST, SAMPALOC, MANILA 0 HECHT (n) 1a 2. WEST) % 2 Cone 1008 b cespra fc es conn baa i: FAN BACKGROUND, enon wid rm 7 (nr Te 7 wasn ReORGUEZ (no a ry it eoucaronat BACKGROUND fe ec soon, czoee comms | van [ers | rons © | Saar (re a) weeintiy—|iegaaaraa] UNTSEARNED [— oe) eee ‘zcomm | rawowuacsavsarmcnscroo. | secovoasy | isn | casuaee | me | ims vooaTOWA TATE Wk wa [ona | wa [wa | wa | wa Pasta[v. CL SERVICE ELIGIBILITY cesnsezven mn oven ey unen recurs cesesce | axrno fovumutou| ruccoreuumaren! com vomsen [ECE "a moms Na wa | ma \Z-WORK EXPERENCE [hole private englovment Sa Hom your cuenta] ‘enh copa SRN facta tte] ene 201 caonees| PeinsTrucToR ST-COLLETA no ronx20ne er02007 caswier wanes No oxonon0 cetaonon. WAITER ‘CENTURY PARK HOTEL no romeo a SOUTHERN FRIED CHICKEN no osou0x3 resent] FAMILY ORIVER WARCELINO FAMILY No ran on pas he ney FTN ET|Vi. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC /NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATIONIS INCLUSNE DAT at NAME & ACORESS OF ORGANZATION SWE OMTE humeer oF - (vi in tat) (nmidyyyy) HOURS. | POSTION NATURE OF WORK From Te TAU GAMA PHI- LEALTAD CHAPTER. [957 PRESET | NA MEMBER, ‘anne on separate sheet necessary Vil_ TRAINING PROGRAMS (Start from the most recent training.) | 52, _TITLEOF SEMINARICONFERENCEIORKSHOPISHORT ATTENDANCE Inumeer oF] coNoUCTEDY SPONSORED ay COURSES (vi na) ited HouRS (ui in ta) From NIA NIA NA NIA NIA [Continve on separate sheet necessary) NON ACADEMIC DSTINCTIONS | RECOGNITION: MEMBERSH a SPECIAL SKILLS HOBBES 4 Neneh 35. ASSOCIATONIORGANZATION (ui in i infu BASKETBALL NONE wa [Continue on separate sheet necessary) (CS FORM 212 (Revised 2008) Page doh[fm Are you relaea by consanguniy oF tiny b any ofthe blowing 2. Win eft degre (br Natonal Government mpayees) ores gino agpcnng autor, recommending autory, chet ofoerureauseparmentr person ho. | 'YES gv ces nas media sierison ovr you He Oe, Bureau or Departrent where you wi be appoined? . Win te ourh degree (br Local Government Employees) ves gfno appoining auforiy or recommending autriy where you willbe appointed? HIYES, gve deta: {a7 a Have you ever been formally charged? ves (NO HIYES, gve deta: . Have you ever been guily of any adminisratve ofense? Gres no HIYES, gve details: [f= Have you ever been canviced ofany cre or volaton ofany lav, decree, ordnance or | CYES NO regulation by any courtar ibunal? TIYES, gve details is, Have you ever been separated fom fe service in any offhe folowing modes: esignaton, ves (No retrement, dropped tom he ols, dsissal,erminaton, end oer, nished contact AWOL or phased out inthe pubic or private seco? IIYES, gve deta: fished fe conractin all ny previous wars and | have been given proper and honorable released tom dy. aa, Have you ever been a canddai ha natonal or al econ (excepiBarangay eeaion)? | EVES aANO IVES, give detais: a Pursuant: (a) Indigenous People's Act(RA S371); (b) Magna Carta br Disabled Persons (RA 7277); and (c) Sola Parents Wellare Actof 2000 (RA 8972), please answer he lowing items: Are you a member of any indigenous group? yes gNo IIYES, please speci ». Are you diferenty abled? Ges sno IIYES, please speci «Are you a solo parent? Dyes sANo IVES, please speci 22, REFERENCES (Person notrelated tb you by consanguiniy or afriy © appicant/ appoint) NAME ADDRESS TEL NO) ‘CHRISTIAN MONTEMAYOR WONDREADEZ st. saMPaLoc Manna | 0939-2340570 a MA. RUBY ANNE LIWANAG MALOLOS, BULACAN o1s-8825424 Beem xe ‘pepon RICHARD ESPIRITU SAMPALOG MANILA 0905-3936529 [1 dedare under oah farhis Personal Dat Sheothas been aozonpiched by ne, and wa We, cavestand ont conplee seiement pursuant the provisions of pertnentaus, rues and reglatons of fe Repub of he ‘Sat acer Phippines. | abo auhorze he agency head / auhoried repesentaive vert valéae he conten’ seed herein | tus that his information shal remain confident PTO 14906055 ‘COMMUNITY TAX CERTIGATE NO. Manila TSSUEDAT 'SJGNATURE (Sign inside the box) ‘outere018 osrzerz014 TESUED ON (mmissiyyyy) DATE ACCONPLSFED RIGHT THUMEMARK (CSFORM 212 Revised 2005) Page 4014