AGENCY SCREENING CERTIFICATION FORM (SEC-C)

SENIOR EXECUTIVES CLASS DAP-PMDP-SEC, F3, Rev.0

 (To be filled-out by the Person-in-Charge of Scholarship /
HR or Admin Officer / Personnel)

CHRISTIAN HARVEY N. WONG

NAME OF NOMINEE

CONFIDENTIAL

This certifies that the nominee is considered high-performing and high potential and qualifies
DAP-PMDP-SEC, F3, Rev.0
based on the following criteria/requirements of the PMDP:

Criteria Qualifications
Position:
Nominee holds Date of Appointment: Salary Grade:
a permanent Division/Department:
position Office Address:
equivalent to Office Contact Info:
SG 25 and Is the position permanent / regular?  Yes  No
above Is the nominee designated to another role/function?  Yes  No
If yes, state Position: Salary Grade:
DAP-PMDP-SEC, F3, Rev.0
 Criteria Qualifications
Designation Date of Designation Order:
Information on Immediate Supervisor
Name:
Position:
Contact Details:
Nominee
satisfies Professional Eligibilities If pursuing 3rd Level
government Certifications  PD 907 eligibility, check stages
required  RA 1080 passed
DAP-PMDP-SEC, F3, Rev.0
 Criteria Qualifications
 PRC, specify  CS Professional
eligibility. area  Career Service Executive
 MATB
___________ Eligible
 Assessment Center
(Please check  Career Executive Service
 Validation
applicable  Bar Exams Eligible
 Panel Interview
boxes)  Career Executive Service Officer
state rank ______
Nominee is 55
yrs. old or Birthdate: ___________________ Age:
below mm / dd / yyyy
DAP-PMDP-SEC, F3, Rev.0
 Criteria Qualifications

Nominee holds Highest Degree and Year of School:

a Bachelor’s educational Specialization: Graduation:
degree attainment:

Nominee got (Indicate year, check applicable period and put rating)

DAP-PMDP-SEC, F3, Rev.0

 Criteria Qualifications
VS/ higher
Year: _____ Rating Year: _____ Rating Year: _____ Rating
PAR rating for
1st Semester _____ 1st Semester _____ 1st Semester _____
the past 2
2nd Semester _____ 2nd Semester _____ 2nd Semester _____
years

Total number of years of service in government? __________

Does the nominee have a record of habitual leaves (a maximum of 2 months/year)?  Yes  No
DAP-PMDP-SEC, F3, Rev.0
 Criteria Qualifications

Does the nominee have any pending administrative and/or criminal case?  Yes  No

Please cite other information that will

support nomination to PMDP.

DAP-PMDP-SEC, F3, Rev.0

The nominee must submit additional requirements such as Personal Data Sheet, copy of
Appointment Papers, copy of Transcript of Records and Nomination form signed by the head of
agency. As part of the screening process, the nominee will undergo an examination and an interview.

___________________________________________ ______________________
Name and Signature of Person Completing this Form Position

___________________________
Date Accomplished DAP-PMDP-SEC, F3, Rev.0