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. (Do not fill up. For CSC use only)
I. PERSONAL INFORMATION
2. SURNAME MARIMON
NAME EXTENSION (JR., SR)
FIRST NAME DIOSDADO II
MIDDLE NAME REMORERAS
3. DATE OF BIRTH
(mm/dd/yyyy) 10/09/1994 16. CITIZENSHIP ✘ Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH IGACOS If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘ Male Female
OCCUPATION
EMPLOYER/BUSINESS NAME
BUSINESS ADDRESS
TELEPHONE NO.
SURNAME REMORERAS
FIRST NAME ALEJANDRA
MIDDLE NAME CARMELOTES (Continue on separate sheet if necessary)
WITH
ELEMENTARY SAN ISIDRO ELEMENTARY SCHOOL ELEMENTARY 2000 2006 GRADUATED 2006
HONORS
SECONDARY
VOCATIONAL / MATANOS NATIONAL HIGH SCHOOL SECONDARY 2006 2010 GRADUATED 2010 N/A
PHILIPPINE COLLEGE OF TECHNOLOGY FRONT OFFICE NC2 2017 2018 FINISHED 2018 N/A
TRADE
COURSE
COLLEGE HOLY CROSS OF DAVAO COLLEGE, INC. BSED-MATHEMATICS 2010 2015 GRADUATED 2015 N/A
SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF LICENSE (if applicable)
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity
LICENSURE EXAMINATION FOR TEACHERS 83% MARCH 20, 2016 ATENEO DE DAVAO UNIVERSITY 1473157 10/09/19
SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
INCLUSIVE DATES
29. NAME & ADDRESS OF ORGANIZATION
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To
8.0
The Art of Questioning, Making Syllabi and Classroom Management 06/15/2017 06/16/2017 16 TECHNICAL MS. MARIANNE LEKCHAROEN
Revitalizing Teaching for Next Generation Learning 01/13/2017 01/14/2017 16 MANAGERIAL MS. EDERLINA NOCON
Teaching Mathematics with Exploration 08/06/2016 08/06/2016 8 TECHNICAL MS. JOSEPHINE R. SACLUTI
Effective Senior High School Teaching Towards Global Competitiveness 01/30/2016 01/30/2016 8 TECHNICAL MR. MANUEL KOTAH
The 4R's of Teachers Professional Development 01/23/2016 01/23/2016 8 MANAGERIAL MR. ROBERT DEGOLACION
DepEd Order no. 8 and Classroom Management 07/09/2015 07/10/2015 16 SUPERVISORY DR. CARLO B. BEJARASCO
Maximizing the Use of Integrative Math Series 07/04/2015 07/04/2015 8 TECHNICAL PROF. RECHILDA VILLAME
N/A
SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 3 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 apppointed,
a. within the third degree? YES ✘ NO
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘ NO
If YES, give details:
________________________________
35. a. Have you ever been found guilty of any administrative offense? YES ✘ NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? 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
YES ✘ NO
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 phased If YES, give details:
out (abolition) in the public or private sector? FINISHED CONTRACT
________________________________
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except YES ✘ NO
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last YES ✘ NO
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
If YES, please specify ID No:
c. Are you a solo parent? YES ✘ NO
If YES, please specify ID No:
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.