DOE-AS-HRMD-QF-R01

Date Issued: 15 Sept 2018

Rev No. / Rev. Date:

DEPARTMENT OF ENERGY
Energy Center, Rizal Drive, Bonifacio Global City
1632 Taguig City, Philippines

CONTROL #: _________________

APPLICATION FOR EMPLOYMENT

Source :  Website Walk-in Jobfair Referral :

Position Applied For :

1st 2nd Please attach recent
ID picture
Choice SCIENCE RESEARCH SPECIALIST I Choice SCIENCE RESEARCH SPECIALIST I Salary Desired : PHP 20,000 3.5 cm x 4.5 cm
(passport size)

DE VILLA JOHN PAUL DE LA CRUZ PAU

(Surname) (First Name) (Middle Name) (Name Extension) (Nickname)

Present Address 46 CATAMBAY ST. BRGY. MAG-AMPON TANAY 1980

(No.) (Street) (Village/Town) (City) (Postal Code)

Provincial Address 46 CATAMBAY ST. BRGY. MAG-AMPON TANAY 1980

(No.) (Street) (Village/Town) (City) (Postal Code)

Contact Numbers N/A 0905-279-1579 devilla.johnpauldc@gmail.com

(Telephone Number) (Cellphone Number) (E-Mail Address)

Age 24 Birthdate #### Birthplace SARIAYA, QUEZON Sex MALE Height 170 cm Weight 70 kg
(mm/dd/yyyy)
SSS No. 34-6640566-0 Pag-ibig No. N/A TIN N/A
GSIS No. N/A Philhealth No. N/A Religion CATHOLIC
Civil Status  Single Married Annulled Separated Widowed
Pls Check One  Staying at own house Renting Staying with Relatives
Languages / Dialects Spoken ENGLISH, FILIPINO
Interests / Hobbies / Past time INNOVATIONS ON WIND TURBINE BLADE DESIGNS, LEARNING SOLIDWORKS/SWIMMING, PLANTING
Other Special Skills / Can operate or use (machines/eqpt/software) I can operate a lathe machine, has basic skills on SolidWorks and SketchUp
Other special qualifications, books published, article written Interest in innovations of power producing components, if it counts.
Are you willing to be assigned in the province?  Yes No If yes, indicate what preferred location ANYWHERE

EDUCATION
Name & Address of School Attended Course / Degree / Major Inclusive Date of Attendance Honors/Distinction Received
Elementary REAL CENTRAL ELEMENTARY SCHOOL N/A 2001-2007 1ST HONORABLE MENTION
Secondary SARIAYA INSTITUTE/ALS LEARNING CENTER N/A 2007-2010 N/A
College SOUTHERN LUZON STATE UNIVERSITY BACHELOR OF AGRI. TECHNOLOGY 2010-2011 N/A
College SOUTHERN LUZON STATE UNIVERSITY B.S. MECHANICAL ENGINEERING 2013-2018 N/A
Post Graduate
Study / Scholarship Grant

EMPLOYMENT HISTORY
(Start with your present or latest job)

A. Company N/A Nature of Business N/A

Address / Tel. # N/A Immediate Superior N/A
Employment Date: From (mm/dd/yyyy) N/A To (mm/dd/yyyy) N/A
Position at Start N/A Position at Leaving N/A
Status of Appointment N/A Monthly Salary N/A
Job Description N/A

Reason for Leaving N/A

B. Company N/A Nature of Business N/A

Address / Tel. # N/A Immediate Superior
Employment Date: From (mm/dd/yyyy) N/A To (mm/dd/yyyy) N/A
Position at Start N/A Position at Leaving N/A
Status of Appointment N/A Monthly Salary N/A
Job Description N/A

Reason for Leaving N/A

C. Company N/A Nature of Business N/A

Address / Tel. # N/A Immediate Superior N/A
Employment Date: From (mm/dd/yyyy) N/A To (mm/dd/yyyy) N/A
Position at Start N/A Position at Leaving N/A
Status of Appointment N/A Monthly Salary N/A
Job Description

Reason for Leaving N/A

If you need extra space to complete this form, use a separate sheet of paper.
Application Form . P2

TRAINING AND SEMINAR

Training and Seminar Attended Inclusive Period No. of Training Hours Conducted by

NC-I IN SHIELDED METAL ARC WELDING (SMAW) COURSE INCLUSIVE COURSE INCLUSIVE TESDA
NC-II IN SHIELDED METAL ARC WELDING (SMAW) COURSE INCLUSIVE COURSE INCLUSIVE TESDA

CIVIL SERVICE ELIGIBILITY (INCLUDING BAR OR BOARD EXAMINATION)

Examination Place Date Rating

MECHANICAL ENGINEERING BOARD EXAMINATION MANILA, PHILIPPINES AUGUST 25-26, 2018 76.8

FAMILY DATA
(Parents, Spouse, Children, Brothers and Sisters) Please put an "+" in the "age" column if family member is deceased.

BIRTH DATE PROFESSION /

FULL NAME AGE RELATION WHERE EMPLOYED
mm/dd/yyyy OCCUPATION
1 JUAN MAYUGA DE VILLA #### 57 FATHER FARMER SARIAYA, QUEZON
2 MERCEDES ESPINA DE LA CRUZ #### 54 MOTHER HOUSEWIFE TANAY, RIZAL
3 MARCIAL DE LA CRUZ DE VILLA #### 28 BROTHER FARM MACHINE OPERATOR JAPAN
4 JOAN DE LA CRUZ DE VILLA #### 26 SISTER CAREGIVER ISRAEL
5 JOHN DE LA CRUZ DE VILLA #### 16 BROTHER N/A N/A
6
7
8
9
10

MEDICAL HISTORY
Birth Mark N/A Allergies N/A Physical Defect/Major Surgery/Illness N/A

Blood Type AB (-) Do you wear glasses / contact lenses?  Yes No Grade 150

CHARACTER REFERENCES
Give at least three (3)

Name Position Company/Address Contact Number

1. ROBERTO ESPINA ENGINEER-SUPERVISOR ARMSCOR GLOBAL DEFENSE 0918-279-8251
2. JOHN E. TAN CHAIRPERSON-SLSU ME DEPARTMENT SOUTHERN LUZON STATE UNIVERSITY 0919-566-9935
3. RONNEL NOMBREFIA PROFESSOR SOUTHERN LUZON STATE UNIVERSITY 0928-391-0569

Please List down all relatives by consanguinity or affinity to any official or employees of the Department of Energy or any attached agency.
Name of Relative(s) Relation Company Occupation/Position
N/A N/A N/A N/A
N/A N/A N/A N/A
N/A N/A N/A N/A

Have you ever been accused of indicted/tried for the violation of any law, ordinance or regulations before any court or tribunal, or have you ever been accused/charged, or tried
for any breach of infraction of military, naval or constabulary discipline in an administrative action?

Yes  No (If yes, give the date and state the nature of offense and penalty)

Have you ever been previously retired or were you given separation pay?

Yes  No (If yes, please indicate amount ___________________ )

In case of emergency, who should we notify? Name: MERCEDES DE LA CRUZ DE VILLA Relation: MOTHER

Address: 46 CATAMBAY ST. TANAY, RIZAL Phone No. 0907-807-6288

ALL INFORMATION I HAVE SUPPLIED IN THIS APPLICATION ARE TO THE BEST OF MY KNOWLEDGE, TRUE AND CORRECT.
I UNDERSTAND THAT THIS AUTHORIZES THE MANAGEMENT OF THE DEPARTMENT OF ENERGY TO CONDUCT BACKGROUND CHECK / VERIFICATION RELATIVE
TO THIS APPLICATION. I UNDERSTAND FURTHER THAT ANY DELIBERATELY UNTRUE INFORMATION OR
FALSE STATEMENT GIVEN HERE WILL BE SUFFICIENT CAUSE OF DISQUALIFICATION OF MY APPLICATION AND CAN BECOME A BASIS FOR MY DISMISSAL (IF
AND WHEN HIRED).

DEVILLA, JOHN PAUL DE LA CRUZ

Printed Name and Signature Date