Professional Documents
Culture Documents
PDS 2017
PDS 2017
212
Revised 2017
I. PERSONAL INFORMATION
2. SURNAME CALORA
N/A
FIRST NAME JOCELYN
Other/s:
Subdivision/Village Ba
BALANGIGA EASTER
7. HEIGHT (m) 151
City/Municipality Pr
8. WEIGHT (kg) 48 ZIP CODE 6812
15. AGENCY EMPLOYEE NO. NONE 21. E-MAIL ADDRESS (if any) calorajocelyn@yahoo.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME NONE 23. NAME of CHILDREN (Write full name and list all)
NAME EXTENSION (JR., SR) NONE
FIRST NAME
MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
SURNAME LABAYDAN
NONE
TRADE
COURSE BACHELOR OF SCIENCE IN INDUSTRIAL
COLLEGE EASTERN VISAYAS STATE UNIVERSITY EDUCATION MAJOR IN DRAFTING N/A
TECHNOLOGY
SIGNATURE DATE
CS FORM
L DATA SHEET
erience Sheet shall cause the filing of administrative/criminal case/s against the person
N/A
Dual Citizenship
by naturalization
DR.DURAN
Street
06
Barangay
EASTERN SAMAR
Province
6812
DR.DURAN
Street
06
Barangay
Province
NONE
09359426975
calorajocelyn@yahoo.com
SCHOLARSHIP/
YEAR
ACADEMIC
GRADUATED
HONORS
RECEIVED
2003 N/A
2007 N/A
2014 N/A
JOB
9/17/2015 1/29/2016 OFFICE WORK (SECRETARY) GIPORLOS NATIONAL TRADE SCHOOL 4000.00 0-0
CONTRACT
(Continue on separate sheet if necessary)
SIGNATURE DATE
LICENSE (if applicable)
Date of
Validity
6/2/2016
eet if necessary)
GOV'T SERVICE
(Y/ N)
YES
eet if necessary)
NONE
LISTEN MUSIC
DECORATING
READING
SIGNATURE DATE
/ PEOPLE / VOLUNTARY ORGANIZATION/S
CONDUCTED/ SPONSORED BY
(Write in full)
AUTOGRAFIX
eparate sheet if necessary)
MEMBERSHIP IN ASSOCIATION/ORGANIZATION
(Write
in full)
NONE
b. within the fourth degree (for Local Government Unit - Career Employees)? YES
If YES, give details:
________________________________
35. a. Have you ever been found guilty of any administrative offense? YES NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? YES NO
If YES, give details:
________________________________
Date Filed:
________________________________
Status of Case/s:
36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation
YES NO
by any court or tribunal?
If YES, give details:
________________________________
________________________________
37. Have you ever been separated from the service in any of the following modes: resignation, YES NO
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract or phased If YES, give details:
out (abolition) in the public or private sector? ________________________________
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except YES NO
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last YES NO
election to promote/actively campaign for a national or local candidate? If YES, give details:
39. Have you acquired the status of an immigrant or permanent resident of another country?
YES NO
If YES, give details (country):
40. 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 a person with disability? YES NO
If YES, please specify ID No:
c. Are you a solo parent? YES NO
If YES, please specify ID No:
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.