Professional Documents
Culture Documents
212
Revised 2017
READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.
Print legibly. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No.
I. PERSONAL INFORMATION
2. SURNAME PULALON
NAME EXTENSION (JR., SR)
FIRST NAME MERIYAM
MIDDLE NAME
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
SURNAME HAJIJUL
SIGNATURE DATE
/s against the person concerned.
., SR)
Citizenship
irth by naturalization
country: PHILIPPINES
744
mail.com
N/A
if necessary)
SCHOLARSHIP/
YEAR GRADUATED ACADEMIC HONORS
RECEIVED
1ST
2010 HONORABLE
MENTION
2ND
2014 HONORABLE
MENTION
2019 N/A
2018 N/A
N/A N/A
V. WORK EXPERIENCE
(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet.
28. INCLUSIVE DATES SALARY/ JOB/
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY PAY GRADE (if
(mm/dd/yyyy) MONTHLY STATUS OF
(Write in full/Do SALARY
applicable)& STEP
APPOINTMENT
(Format "00-0")/
not abbreviate) (Write in full/Do not abbreviate) INCREMENT
From To
7/5/2019 8/3/2019 Grade 5 Substitute Teacher Tugbungan Elementary School 20754.00 SG 2 N/A
Don Gregorio Evangelista Memorial
8/5/2019 9/5/2019 Kindergarten Substitute Teacher 20754.00 SG 2 N/A
School
Don Gregorio Evangelista Memorial
10/25/2019 1/24/2020 Kindergarten Substitute Teacher 20754.00 SG 2 N/A
School
Date of
Validity
12/15/22
(Y/
N)
N/A
N/A
N/A
ENGLISH LANGUAGE AND CULTURE 1/7/2019 2/11/2019 100-hours TECHNICAL TESDA-ARMM LANGUAGE SKILL INSTITUTE
COMPUTER AND INFORMATION TECHNOLOGY 1/3/2018 3/28/2018 30-hours TECHNICAL CIT-SOUTHERN CITY COLLEGES
On Job Training as Assistant Student in
4/1/2018 4/29/2018 1 month TECHNICAL CIT-SOUTHERN CITY COLLEGES
Information Technology Crash Course Program
International Training Series On New Trends In SOUTHEAST ASIA INSTITUTE OF
10/11/2019 10/13/2019 3 days MANAGERIAL
Education EDUCATIONAL TRAINING,INC
35. a. Have you ever been found guilty of any administrative offense? Yes √ No
If YES, give details: ____________
_______________________________
36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or Yes √ No
regulation 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 If YES, give details: ____________
phased 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 Yes √ No
(except Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before Yes √ No
the last 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
c. Are you a solo parent? If YES, please specify ID No:
Yes √ No
If YES, please specify ID No: _
BALIWASAN, ZAMBOANGA
Ms.Pinky L. Alimuddin CITY
0935-048-5493
42. 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.
Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.) PLEASE INDICATE ID Number and
Date of Issuance
SUBSCRIBED AND SWORN to before me this August 6, 2019 , affiant exhibiting his/her validly issued government ID as indicated above.
Person Administering Oath
If YES, give details: ________________________________
________________________________
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