CS Form No.

212
Revised 2017

PERSONAL DATA SHEET

WARNING: Any misrepresentation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s against the person
concerned.
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 PASAOL

FIRST NAME FEBE CLARIZE N/A

MIDDLE NAME PULOD

3. DATE OF BIRTH
(mm/dd/yyyy) 2/24/1992 16. CITIZENSHIP
Filipino Dual Citizenship
by birth by naturalization
4. PLACE OF BIRTH SINSUAT AVENUE, COTABATO CITY If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male Female

6 CIVIL STATUS Single Married

17. RESIDENTIAL ADDRESS 504 GENERAL LUNA ST.
House/Block/Lot No. Street
Widowed Separated
PUROK PAG-ASA RH.4
Other/s: Subdivision/Village Barangay
7. HEIGHT (m) l.62 m COTABATO CITY MAGUINDANAO
City/Municipality Province
8. WEIGHT (kg) 60 kgs. ZIP CODE 9600

9. BLOOD TYPE "O"

18. PERMANENT ADDRESS 504 GENERAL LUNA ST.
House/Block/Lot No. Street

10. GSIS ID NO. N/A PUROK PAG-ASA RH.4

Subdivision/Village Barangay

11. PAG-IBIG ID NO. 121185112360 COTABATO CITY MAGUINDANAO

City/Municipality Province

12. PHILHEALTH NO. 17-0255698438 ZIP CODE 9600

13. SSS / GSIS NO. 34-63381282 / 200-521-4859 19. TELEPHONE NO. N/A

14. TIN NO. 481-639-065 20. MOBILE NO. O926-1624942

15. AGENCY EMPLOYEE NO. SDOCOT007 21. E-MAIL ADDRESS (if any) febeclarize@gmail.comfcppasaol@usm.edu.ph

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME ALONZO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME JHEMSON N/A CZARIEL JHEMS P. ALONZO 3/3/2017

MIDDLE NAME CAYANONG CZAIERL JHEMS P. ALONZO 4/3/2021

OCCUPATION LINEMAN
EMPLOYER/BUSINESS NAME COTABATO ELECTRIC COOPERATIVE (COTELCO)

BUSINESS ADDRESS MATALAM, NORTH COTABATO

TELEPHONE NO. N/A

24. FATHER'S SURNAME PASAOL

FIRST NAME CARLOS JR.

MIDDLE NAME DEPOSITARIO

25. MOTHER'S MAIDEN NAME ALCAYDE

SURNAME PASAOL

FIRST NAME PERLA

MIDDLE NAME PULOD (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

HIGHEST LEVEL/
NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE SCHOLARSHIP/
26. PERIOD OF ATTENDANCE YEAR
ACADEMIC
LEVEL (Write (Write in full) UNITS EARNED GRADUATED
HONORS
in full) RECEIVED
From To (if not graduated)

ELEMENTARY SERO CENTRAL ELEMENTARY SCHOOL ELEMENTARY 1998 2004 GRADUATED 2004 DIPLOMA
COTABATO CITY NATIONAL HIGH
SECONDARY HIGH SCHOOL 2004 2008 GRADUATED 2008 DIPLOMA
VOCATIONAL / SCHOOL - MAIN CAMPUS
NOTRE DAME - RVM COLLEGE OF COMPUTER SYSMETS SERVICING
2017 2018 GRADUATED 2018 CERTIFICATE
COTABATO NCII
TRADE COURSE NOTRE DAME - RVM COLLEGE OF ASSOCIATE IN COMPUTER
2010 2013 GRADUATED 2013 DIPLOMA
COTABATO TECHNOLOGY
NOTRE DAME - RVM COLLEGE OF BACHELOR OF SCIENCE IN
COLLEGE 2013 2015 GRADUATED 2015 DIPLOMA
COTABATO INFORMATION TECHNOLOGY
NOTRE DAME - RVM COLLEGE OF BACHELOR OF ELEMENTARY
2018 2019 30 UNITS 2019 N/A
COTABATO EDUCATION
UNIVERSITY OF SOUTHERN
GRADUATE STUDIES MASTER IN INFORMATION SYSTEMS 2015 2018 GRADUATED 2018 DIPLOMA
MAGUINDANAO
(Continue on separate sheet if necessary)

SIGNATURE DATE
CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
RATIN
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER G LICENSE (if applicable)
SPECIAL LAWS/ CES/ CSEE (If DATE OF EXAMINATION / CONFERMENT PLACE OF EXAMINATION / CONFERMENT
NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE Applic
Validity
able)

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)

V. WORK EXPERIENCE
(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet. GOV'T
SALARY/ JOB/ SERVICE
28. INCLUSIVE DATES POSITION TITLE PAY GRADE (if
(mm/dd/yyyy) DEPARTMENT / AGENCY / OFFICE / COMPANY MONTHLY applicable)&
STATUS OF APPOINTMENT
(Write in full/Do not abbreviate) SALARY STEP (Format
"00-0")/
From To (Write in full/Do not abbreviate) INCREMENT
(Y/ N)
MINISTRY OF BASIC HIGHER AND TECHNICAL EDUCATION -
1/1/2021 PRESENT TEACHER II BARMM 26,052.00 12 PROVISSIONAL YES
06/16/2020 12/29/2020 TEACHER II DEPARTMENT OF EDUCATION - XII 24,495.00 12 PROVISIONAL YES

05/29/2019 May/15/2020 TEACHER II DEPARTMENT OF EDUCATION - XII 22,938.00 12 PROVISIONAL YES

05/16/2018 May/16/2019 TEACHER II DEPARTMENT OF EDUCATION - XII 22,149.00 N/A PROVISIONAL YES

05/15/2017 May/15/2018 TEACHER II DEPARTMENT OF EDUCATION - XII 21,367.00 12 PROVISIONAL YES

9/21/2016 12/31/2016 IT TECHNICAL STAFF DEPARTMENT OF AGRICULTURE - XII 8,000.00 N/A CONTRACTUAL YES

12/15/2015 05/30/2016 IT TECHNICAL STAFF DEPARTMENT OF AGRARIAN REFORM - ARMM 10,000.00 N/A CONTRACTUAL YES

06/01/2015 05/30/2016 IT INSTRUCTOR COTABATO CITY STATE POLYTECHNIC COLLEGE 6,500.00 N/A JOB ORDER YES

6/16/2014 06/28/2014 MODEL AMBASSADOR NESTLE' COTABATO 2,000/DAY N/A PART TIME NO

9,852

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
NUMBER OF
(Write in full) HOURS POSITION / NATURE OF WORK
(mm/dd/yyyy)
From To

TEAMSTRESS COTABATO 08/01/2015 PRESENT N/A MODELING ORGANIZER

PHILIPPINE SOCIETY OF INFORMATION TECHNOLOGY EDUCATORS 06/01/2015 PRESENT N/A MEMBER

SELECTED LOCAL ARTISTS OF COTABATO CITY 10/01/2014 PRESENT N/A MODELING COMMITTEE

GUARDIANS MAGIC GROUP INTERNATIONAL 06/01/2010 03/30/2015 N/A MEMBER

PHILIPPINE SOCIETY OF INFORMATION TECHNOLOGY STUDENTS 06/01/2010 12/31/2013 N/A MEMBER

YOUNG ADVOCATES FOR PEACE AND SOLIDARITY 1/5/2010 12/31/2011 N/A DEPUTY SECRETARY GENERAL

(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 (5) years for Division Chief/Executive/Managerial positions)
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS NUMBER OF ( Managerial/ CONDUCTED/ SPONSORED BY
(Write in full) HOURS Supervisory/ (Write in full)
(mm/dd/yyyy)
Technical/etc)
From To

TECHNICAL
SCHOOL IN-SET SEMINAR TRAINING 10/18/2019 10/20/2019 12 DATU AYUNAN NATIONAL HIGH SCHOOL

TECHNICAL
JDVP COORDINATOR SEMINAR TRAINING 07/22/2019 07/24/2019 16 COTABATO CITY SCHOOLS DIVISION

TECHNICAL
SCHOOL IN-SET SEMINAR TRAINING 12/10/2018 10/14/2018 12 DATU AYUNAN NATIONAL HIGH SCHOOL
MIS GRADUATE SEMINAR - WORKSHOP ON TRENDS AND UPDATES IN I.T., MIA
RESEARCH / CAPSTONE PROJECTS AND WEB FRAMEWORK AND DEVELOPMENT
3/17/2017 3/19/2017 24 TECHNICAL UNIVERSITY OF SOUTHERN MAGUINDANAO

TRAINING - WORKSHOP ON ANDROID DEVELOPMENT 4/4/2016 5/4/2016 40 TECHNICAL UNIVERSITY OF SOUTHERN MAGUINDANAO

GRAPHIC STAR IMAGING CORPORATION SEMINAR 1/24/2015 1/24/2015 8 TECHNICAL GRAPHIC STAR IMAGING CORPORATION

WINWARD SOFTWARE PHILIPPINES SEMINAR 1/23/2015 1/23/2015 8 TECHNICAL WINWARD SOFTWARE PHILIPPINES

EPERFORMAX CONTACT CENTER AND BPO SEMINAR 1/22/2015 1/22/2015 8 TECHNICAL EPERFORMAX CONTACT CENTER AND BPO

INNODATA KNOWLEDGE SERVICES, INC. SEMINAR 1/21/2015 1/21/2015 8 TECHNICAL INNODATA KNOWLEDGE SERVICES, INC.

IT DEPARTMENT, NOTRE DAME - RVM COLLEGE

WEB DEVELOPMENT TRAINING (JOOMLA) 10/14/2014 10/15/2014 8 TECHNICAL
OF COTABATO
PSITES12, SULTAN KUDARAT STATE
DEVELOPER CONNECT (DEVCON) SEMINAR 9/26/2014 9/28/2015 16 TECHNICAL
UNIVERSITY

PERSONAL ENHANCEMENT AND CAREER COACHING SEMINAR - WORKSHOP 2/24/2014 2/24/2014 8 TECHNICAL NOTRE DAME - RVM COLLEGE OF COTABATO

KEY INDICATOR OF THE LABOR MARKET AND GLOBAL EMPLOYMENT TRENDS

11/22/2013 11/22/2013 8 TECHNICAL NOTRE DAME - RVM COLLEGE OF COTABATO
SEMINAR - WORKSHOP

LEADERSHIP TRAINING AND TEAM BUILDING SEMINAR 10/15/2013 10/15/2013 8 TECHNICAL NOTRE DAME - RVM COLLEGE OF COTABATO

COMPUTER TROUBLESHOOTING AND OPERATING SYSTEM SEMINAR IT DEPARTMENT, NOTRE DAME - RVM COLLEGE
2/23/2012 2/23/2012 8 TECHNICAL
WORKSHOP OF COTABATO

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

DANCING N/A TEAMSTRESS COTABATO

MODELING N/A SELECTED LOCAL ARTISTS OF COTABATO CITY

COMPUTER LITERATE N/A GUARDIANS MAGIC GROUP INTERNATIONAL

N/A N/A YOUNG ADVOCATES FOR PEACE AND SOLIDARITY

PHILIPPINE SOCIETY OF INFORMATION

N/A N/A
TECHNOLOGY STUDENTS
PHILIPPINE SOCIETY OF INFORMATION
N/A N/A
TECHNOLOGY EDUCATORS
(Continue on separate sheet if necessary)

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 N
O
b. within the fourth degree (for Local Government Unit - Career Employees)? YES NO N
O
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? ________________________________
________________________________
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 YES NO
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
.
If YES, please specify ID No:
c Are you a solo parent? YES NO
.
If YES, please specify ID No:

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

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
DR. JOHN PASCUAL DA-12, KORONADAL CITY 421-2098 3.5 cm. X 4.5 cm
(passport size)

DR. SAMSIA IBRAHIM CCSPC, COTABATO CITY 9273790219 With full and handwritten
name tag and signature over
printed name
ZALDY BOLORON DA-12, KORONADAL CITY 9998801219
Computer generated
42. or photocopied picture
I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and is not acceptable
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 PHOTO
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
Government Issued ID: TIN ID
ID/License/Passport No.: 481-639-065 Signature (Sign inside the box)

Date/Place of Issuance: 03/01/2016 Cotabato City Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.

Person Administering Oath

CS FORM 212 (Revised 2017), Page 4 of 4