CS Form No.

212
Revised 2017

PERSONAL DATA SHEET

WARNING: Any misinterpretation made in the Personal Data Sheet and the work Experience Sheet shall cause the filing of administrative/criminal case/s against
the personal concerned.

READ THE ATTACHED GUIDE TO FILING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM. 1.CS ID No. (Do not fill up. For CSC use only
Print legibly. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE.

I.PERSONAL INFORMATION
2. SURNAME SALIGAN
NAME EXTENSION (JR, SR)
FIRST NAME SUKOR N/A

MIDDLE NAME SALI

3. DATE OF BIRTH FILIPINO Dual Citizenship
(mm/dd/yyyy) 02/ 21/1993 16. CITIZENSHIP
By birth by naturalization

4. PLACE OF BIRTH BADAK, GEN. SALIPADA K. PENDATUN,

MAG. If holder of dual citizenship, Pls. indicate country:
Male Female
5. SEX Please indicate the details.

Single Married 17. RESIDENTIAL ADDRESS N/A N/A

House/Block/Lot No. Street
6. CIVIL STATUS
Widowed Separated
N/A POB. BADAK
Other/s: Subdivision/Village Barangay
GEN. SALIPADA K. PENDATUN MAGUINDANAO
7. HEIGHT (m) City/Municipality Province
1.58 m

8. WEIGHT (kg) 9618

63 ZIP CODE

9. BLOOD TYPE “0” 18. PERMANENT ADDRESS N/A N/A

House/Block/Lot No. Street
N/A POB. BADAK
10. GSIS ID NO. BP 2005083830 Subdivision/Village Barangay
GEN. SALIPADA K. PENDATUN MAGUINDANAO
11. PAG – IBIG ID NO. 1211-8837-612 City/Municipality Province

12. PHILHEALTH NO.

17-050347945-4 ZIP CODE 9618

13. SSS NO. 19. TELEPHONE NO. N/A

09-3847574-9

14. TIN NO. 20. MOBILE NO. 09362582219

454-303-912

15. AGENCY EMPLOYEE NO. 1381061 21. E – MAIL ADDRESS (if any) sukor211993@gmail.com

II. FAMILY BACKGROUND

22. SPOUSE’S SURNAME 23. NAME OF CHILDREN (write full name and list all)
DATE OF BIRTH (mm/dd/yyyy)
N/A
NAME EXTENSION (JR, SR)
FIRST NAME N/A N/A

N/A N/A N/A

MIDDLE NAME

OCCUPATION N/A N/A N/A

EMPLOYER/BUSINESS NAME N/A N/A N/A

BUSINESS ADDRESS N/A N/A N/A

TELEPHONE NO. N/A N/A N/A

24. FATHER’S SURNAME SALIGAN

NAME EXTENSION (JR, SR)
FIRST NAME MAGUID N/A

MIDDLE NAME KABUGATAN

25. MOTHER’S MAIDEN NAME

SURNAME SALI
FIRST NAME
BAIDO
MIDDLE NAME
(continue on separate sheet if necessary)
MULOD
III. EDUCATIONAL BACKGROUND
PERIOD OF HIGHEST
26. ATTENDANCE SCHOLARSHIP/AC
BASIC EDUCATION/DEGREE/COURSE LEVEL/UNITS YEAR
NAME OF SCHOOL ADEMIC HONORS
LEVEL (write in full) EARNED GRADUATED
(write in full) FROM TO RECIEVED
(if not graduated)

BAI MALAIDA MANGELEN PENDATUN

ELEMENTARY CENTRAL ELEMENTARY SCHOOL PRIMARY EDUCATION 2000 2006 GRADUATED 2006 WITH HONORS

GEN. SALIPADA K. PENDATUN NATIONAL

HIGH SCHOOL HIGH SCHOOL 2006 2010 GRADUATED 2010 VALEDICTORIAN
SECONDARY
VMC ASIAN COLLEGE, INCORPORATED CARPENTRY – NATIONAL CERTIFICATE II
VOCATIONAL/TRADE (NC II) 2014 2014 COMPLETED 2014 N/A
COURSE
BACHELOR OF SECONDARY EDUCATION -ENGLISH
COLLEGE SULTAN KUDARAT STATE UNIVERSITY MAJOR IN ENGLISH 2010 2014 GRADUATED 2014 PROFECIENCY
-SERVISE AWARD
GRADUATE STUDIES MASTER OF ARTS IN TEACHING
SULTAN KUDARAT STATE UNIVERSITY ENGLISH 2014 PRESENT ON-GOING (39 N/A N/A
UNITS)
(continue on separate sheet if necessary)

SIGNATURE DATE June 15, 2020

IV. CIVIL SERVICE ELIGIBILITY
27. LICENSE (if applicable)
DATE OF
RATING
CAREER SERVICE/ RA 1080 (BOARD/ BAR) EXAMINATION/ PLACE OF EXAMINATION / CONFERMENT
(if applicable)
UNDER SPECIAL LAWS/ CES/ CSEE CONFERMENT DATE OF
BARANGAY ELIGIBILITY LICENCE N+UMBER
VALIDITY

LICENSURE EXAMINATION FOR TEACHERS 78.80 AUGUST 17, DAVAO CITY 1351445 07-06-2015
2014

(Continue on separate sheet if necessary)

V. WORK EXPERIENCE
(Include private employment. Start from your current work) Description of duties should be indicated in the attached Work Experience Sheet.

28. SALARY JOB/PAY

INCLUSIVE DATES GRADE (if
(mm/dd/yyyy) DEPARMENT / AGENCY / OFFICE / applicable) & GOV’T
POSITION TITLE MONTHLY STATUS OF
COMPANY STEP SERVICE
(Write in full/Do not abbreviate) SALARY APPOINTMENT
(Write in full/Do not abbreviate) (format “00- (Y / N)
From To 0”)/INCREMENT

Ministry of Basic, Higher and

SECONDARY SCHOOL Technical Education/ Bangsamoro 23,877 “11-1”” REGULAR/ Y
TEACHER 1 Autonomous Region in Muslim PERMANENT
1/1/21 Present
Mindanao/ Bai Tembabay National
High School

SECONDARY SCHOOL Ministry of Basic, Higher and 22,316 “11-1”” REGULAR/ Y

TEACHER 1 Technical Education/ Bangsamoro PERMANENT
1/1/20 12/31/20
Autonomous Region in Muslim
Mindanao/ Bai Tembabay National
High School

SECONDARY SCHOOL Department of Education / 20,754 “11-1”” REGULAR/ Y

1/1/19 12/31/19 TEACHER 1 Autonomous Region in Muslim PERMANENT
Mindanao/ Bai Tembabay National
High School

SECONDARY SCHOOL Department of Education / 20,179 “11-1”” REGULAR/ Y

1/1/18 12/31/18 TEACHER 1 Autonomous Region in Muslim PERMANENT
Mindanao/ Bai Tembabay National
High School

SECONDARY SCHOOL Department of Education / 19,620 “11-1”” REGULAR/ Y

1/1/17 12/31/17 TEACHER 1 Autonomous Region in Muslim PERMANENT
Mindanao/ Bai Tembabay National
High School

SECONDARY SCHOOL Department of Education / 19,077 “11-1”” REGULAR/ Y

5/2/16 12/31/16 TEACHER 1 Autonomous Region in Muslim PERMANENT
Mindanao/ Bai Tembabay National
High School

COLLEGE INSTRUCTOR HADJI DATU SAIDONA PENDATUN 10,000 N/A CONTRACTUAL N

7/08/15 4/ 9/ 16
FOUNDATION COLLEGE INC.

7/ 06/14 3/22/ 15 COLLEGE INSTRUCTOR VMC ASIAN COLLEGE 5,400 N/A CONTRACTUAL N
FOUNDATION, INC.

4/ 01/ 14 6/22/ 14 CALL CENTER AGENT 611 COMPANY 4,000 N/A CONTRACTUAL N

(Continue on separate sheet if necessary)

DATE June 15, 2020

SIGNATURE
VI. VOLUNTARY WORK OR INVOLMENT IN CIVIC / NON – GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
29.
INCLUSIVE DATES NUMBER
NAME & ADDRESS OF ORGANIZATION POSITION / NATURE OF WORK
(mm/dd/yyyy) OF HOURS
(Write in full)

N/A From To N/A

N/A N/A

N/A N/A

N/A N/A

N/A N/A

N/A N/A

N/A N/A

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
Start from the most recent L &D/training program and include only the relevant L&D/training taken for the last five years for Division Chief/Executive
30.
NUMBE
TITLE OF LEARNING AND DEVELOPMENT Type of LD CONDUCTED / SPONSORED BY
INCLUSIVE DATES OF ATTENDANCE R OF
INTERVENTIONS/TRAINING PROGRAMS (Managerial/Supervi (Write in full)
(mm/dd/yyyy) HOURS
(Write in full) sory/technical/etc.

From To

RE-ECHO ON ICT LITERACY SKILLS TRAINING AND

01/23/2018 01/25/2018 24 HRS PARTICIPANT BAI TEMBABAY NATIONAL HIGH SCHOOL
DEVELOPMENT PROGRAM

TEACHERS INNOVATIVE TEACHING 03 – 29 - 2017 09 – 31- 2017 24HRS MANAGERIAL GANI L. ABPI COLLEGE, INC.

METHODS OF RESAERCH AND PSYCHOLINGUISTICS, 03 – 17 - 2017 03 – 19 - 2017 24HRS PARTICIPANT SULTAN KUDARAT STATE UNIVERSITY
SOCIOLINGUISTICS, AND ANTHROPOLINGUISTICS
FOUNDATION OF LANGUAGE TEACHING

FREE REVIEW SESSION IN GRAMMAR 02 – 11 - 2017 02-11-2017 8HRS SUPERVISORY SULTAN KUDARAT STATE UNIVERSITY

REGIONAL DIVISION TRAINING AND WORKSHOP FOR 10-22-2015 10-24-2015 14HRS PARTICIPANT ASSOCIATION OF SCIENCE EDUCATORS
NEWLY INVENTED EVENTS IN THE PHILIPPINES (ASEP) REGIONAL,
COTABATO CITY

NATIONAL CERTIFICATE II (CARPENTRY) 11 – 02 -2014 11-30-2014 60HRS PARTICIPANT VMC COLLEGE, INC.

YOUTH EDUCATORS SUMMIT 12/20/2013 12/20/2013 8HRS PARTICIPANT GENERAL SANTOS CITY

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

N/A 4 –H CLUB OF THE PHILIPPINES

DANCING

SINGING N/A

N/A
HOSTING

SURFING INTERNET N/A

(Continue on separate sheet if necessary)

SIGNATURE DATE June 15, 2020

CS FORM 212 (REVISED 2017), PAGE 1 OF 4

34. Are you related by consanguinity or affinity to the appointing or recommending authority, or to the chief of bureau or office or to the person who has
immediate supervision over you in the office, Bureau or Department where you will be appointed,

a. within the third degree?

b. within the fourth degree (for Local Government Unit – Career Employees)?

YES NO

YES NO

IF YES, give details:

35. a. Have you ever been found guilty of any administrative offense?

b. Have you been criminally charged before any court?

YES NO

IF YES, give details:

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 by any court or tribunal?

YES NO

IF YES, give details:

37. Have you ever been separated from the service in any of the following modes: resignation, retirement, dropped from the rolls, dismissal, termination,
end of term, finished contract or phased out (abolition) in the public or private sector?

YES NO

IF YES, give details:

38. a. Have you ever been a candidate in a national or local election held within the last year (except Barangay election)?

b. have you resigned from the government service during the three (3) – months period before the last election to promote/actively campaign for a
national or local candidate?

YES NO

IF YES, give details:

YES NO

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:

40. pursuant to: (a) Indigenous People’s Act (RA 8371); (b) Magna Carta for Disabled Person (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?

b. Are you person with disability?

c. Are you solo parent?

Government Issued ID (i.e. Passport, GSIS, SSS, PRC, Driver’s
License, etc.)
PLEASE INDICATE ID Number and date of Issuance

Government Issued ID: DEPED ARMM ID YES NO

IF YES, please specify:

ID/License/Passport No.: 138-053-2542

Date/Place of Issuance: 05-23-2017

YES NO

IF YES, please specify ID No.:

YES NO

IF YES, please specify ID No.:

41. REFERENCES ( Person not related by consanguinity of affinity to applicant / appointee)

ID picture taken within last 6 NAME

months 3.5 cm. X 4.5 cm
(passport size)
ADDRESS
With full and handwritten
name tag and signature over TEL. NO.
printed name

Computer generated or Xerox

copy of picture is not
acceptable ANORODIN S. UNTUA

RAMCOR, GEN. SALIPADA K. PENDATUN, MAG.

09366444120

BALUMOL D. SANDAY

GEN. SALIPADA K. PENDATUN, MAG.

09164650228

SUHARTO A. UGALINGAN

DIGAL, BULUAN , MAG.

09753559713

42. I declare under oath that I have personally accomplished this Personal Date 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 attachment shall cause the filling of administrative/criminal case/s against me.

SUBSCRIBED AND SWORN TO BEFORE ME THIS ________________________, affiant

Signature (Sign inside the box)
exhibiting his/her validly issued government ID as indicated above.
June 15, 2020

Right Thumb mark Date Accomplished