VI.

VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S

NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES
29. NUM BER OF
(Write in full) (mm/dd/y y y y ) POSITION / NATURE OF WORK
HOURS
From To

ANCOP FOUNDATION PHILIPPINES 6/10/2013 PRESENT MEMBER

COUPLES FOR CHRIST-GLOBAL 6/4/2004 PRESENT CHAPTER HEAD

GIRLSCOUT OF THE PHILIPPINES 6/3/2019 PRESENT DISTRICT PRINCIPAL CONSULTANT

KABABAIHANG RIZALISTA 8/10/2013 6/6/2018 MEMBER

(Continue on separate sh eet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
(Start from the m ost recent L& D/training pro gram and include o nly the relevan t L& D/training taken fo r the last five (5) years fo r Division Chi ef/Executive/Manag erial posi tions)

INCLUSIVE DATES OF
Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ATTENDANCE NUM BER OF ( M anagerial/ CONDUCTED/ SPONSORED BY
(Write in full) (mm/dd/y y y y ) HOURS Supervisory/ (Write in full)
Technical/etc)
From To

International Seminar Workshop on Instructional leadership and Management 1/27/2017 1/29/2017 24.0 Managerial/ JAG Center for professional Devlopment
National Seminar-Workshop on Development of ICT- Based Instructional
9/28/2019 10/5/2019 24.0 Technical
Materials,Action Research, Innovations and Community-Based Program Pantas Training and Development Center
Temasek Foundation-Ateneo de Manila University Policy Governance and Capacity M anagerial/
5/29/2014 5/31/2014 24.0
Building Conference for Philippine Educators Supervisory/
Technical Temasek Foundation

M anagerial/
38th Principals Training and Development Program and National Board Conference 5/3/2019 5/5/2019 24.0 Supervisory/
Technical Philippine Elementary Schools Principals Assoc.

Regional Training on Pedagogical Retooling in Mathematics, Languages, &Science 9/11/2018 9/15/2018 40.0 Technical
DepEd National Capital Region

Regional Training on Language Strategies in Teaching Science 7/17/2018 7/19/2018 24.0 Technical
DOST/ Science Education Institute
Basic Education Sectpr Transformation/ Australian
Development of Mother Tongue- Based Teaching Learning Materials 5/25/2017 5/27/2017 24.0 Technical
Aid

M anagerial/
School Heads Development Program 10/21/2018 12/14/2018 168.0 National Capital Region
Supervisory/
Technical

(Contin ue o n sep arate sheet if necessary)

VIII. OTHER INFORMATION

NON-ACADEMIC DISTINCTIONS / RECOGNITION MEMBERSHIP IN ASSOCIATION/ORGANIZATION
31. SPECIAL SKILLS and HOBBIES 32. 33.
(Write in full) (Write in full)

Computer Literate, Writing Articles N/A ANCOP FOUNDATION PHILIPPINES

COUPLES FOR CHRIST-GLOBAL

GIRLSCOUT OF THE PHILIPPINES

KABABAIHANG RIZALISTA

CS FORM 212 (Revised 2017), P age 3 of 4

CS Form No. 212

PERSONAL DATA SHEET

Revised 2017

WARNING: Any misrepresentati on made in the Personal Data Sheet and the Work Experience Sheet shall cause the fili ng of admi ni strative/cri minal case/s against the
person concerned.
READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOM PLISHING THE PDS FORM .
Print legibly. Tick appropriate box es ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No. (Do not fill up. For CSC use only )

I. PERSONAL INFORMATION
2. SURNAME GALICIO
NAM E EXTENSION (J R., SR)
FIRST NAME JENNIFER

MIDDLE NAME GAN

3. DATE OF BIRTH
9/28/1978 16. CITIZENSHIP
Filipino Dual Citizenship
(mm/dd/y y y y )
by birth by naturalization
4. PLACE OF BIRTH CALOOCAN CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female

Single Married 17. RESIDENTIAL ADDRESS B lk.37 J Lo t 27 Ph.III F1, K au n lar an Vi ll ag e

6 CIVIL STATUS
Widowed House/Block/Lot No. Street
Separated
Kaunlaran Village 12
Other/s:
Subdivision/Village Barangay
Caloocan City Metro Manila
7. HEIGHT (m) 5'
City/Municipality Province
8. WEIGHT (kg) 110 lbs. ZIP CODE 1400

18. PERMANENT ADDRESS B lk.37 J Lo t 27 Ph.III F1, K au n lar an Vi ll ag e

9. BLOOD TYPE B+
House/Block/Lot No. Street
Kaunlaran Village 12
10. GSIS ID NO. 2002569525
Subdivision/Village Barangay
Caloocan City 12
11. PAG-IBIG ID NO. 1060-0204-1277
City/Municipality Province

12. PHILHEALTH NO. 190008568913 ZIP CODE Caloocan City Metro Manila

13. SSS NO. CRN-0111-0844263-7 19. TELEPHONE NO. N/A

14. TIN NO. 219-043-797 20. MOBILE NO. 09424571364

15. AGENCY EMPLOYEE NO.
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME
FIRST NAME
4179117 21. E-MAIL ADDRESS (if any ) jenniegangalicio@gmail.com
GALICIO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/y y y y )
NA M E EXTENSION (J R ., SR) ROJEN G. GALICIO
ROMANO 6/28/1999

MIDDLE NAME MONTERO ROFER G. GALICIO 6/21/2000

OCCUPATION BUSINESSMAN
EMPLOYER/BUSINESS NAME NA

BUSINESS ADDRESS NA

TELEPHONE NO. NA
24. FATHER'S SURNAME GAN ( deceased)
NA M E EXTENSION (J R ., SR)
FIRST NAME DEOGRACIAS
MIDDLE NAME RUADO

25. MOTHER'S MAIDEN NAME

SURNAME DULCE

FIRST NAME MARISSA

MIDDLE NAME TAMIDLES (Co n tinu e o n sep arate sheet i f n ecessary)

III. EDUCATIONAL BACKGROUND

P ERIOD OF HIGHEST LEVEL/ YEA R SC HOLARSHIP /
26. NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE
LEVEL A TTENDANCE UNITS EARNED GRADUA TE A CADEM IC
(Write in full) (Write in full) (if not graduated) D HONORS RECEIVED
From To

ELEMENTARY MORNING B REEZE ELEMENTARY SCHOOL E LE M E NT A R Y 6/6/1985 6/5/1991 1991

4TH
SECONDARY M.B . A SISTIO SR. HIGH SCHOOL SE C ONDA R Y 6/5/1991 6/4/1995 1995 HONORABLE
MENTION
VOCATIONAL /
TRADE COURSE

BA CHEL OR OF SECONDARY
CONSISTENT
COLLEGE UNIVERSITY OF CA LOOCAN CITY
EDUCATION
1999 DEAN'S LISTER
AND SCHOLAR
DOCTOR OF PHILOSOPHY MA JOR IN
GRADUATE STUDIES UNIVERSITY OF CA LOOCAN CITY 6/8/2016 6/8/2018 2018
EDUCATION MA NAGEMENT

(Co ntin u e on sep ar ate sheet if necessar y)

SIGNATURE DATE October 7, 2019

CS F ORM 212 (Revised 2017), P age 1of 4