BOC Personal

Information Sheet
Bless Our Cops – Equip Our Churches – Bless Our Community – Transform Our Country – Bless the World

SUFFI
SURNAME FIRST NAME MIDDLE NAME SEX CIVIL STATUS
X
[ / ] Single [ ]
[/ ] Male
MALICDEM JAYSON MARTINEZ [ ] Female
Widower/Widow
[ ] Married [ ] Separated
IF MARRIED, WRITE MAIDEN NAME NAME OF SPOUSE OCCUPATION

DATE OF BIRTH MAY 6, 1989 PLACE OF BIRTH MANGALDAN, PANGASINAN

ADDRESS BRGY. TALOGTOG, MANGALDAN, PANGASINAN

E-MAIL ADDRESS malicdemjayson519@gmail.com CONTACT NUMBER 09465735327

NAME OF CHURCH Inmalog White Stone United Methodist Church, Brgy. Inmalog Sur, San Fabian, Pangasinan
AND ADDRES

MEMBERSHIP IN OTHER
ORGANIZATIONS

INCLUSIVE DATES OF HONORS

EDUCATION SCHOOL NAME
ATTENDANCE RECEIVED
ELEMENTARY TALOGTOG-BATENG ELEMENTARY SCHOOL
SECONDARY MANGALDAN NATIONAL HIGH SCHOOL
TERTIARY EDUCATION
INCLUSIVE
NUMBER OF UNITS HONORS
LEVEL SCHOOL NAME DEGREE EARNED DATES OF
COMPLETED RECEIVED
ATTENDANCE
VOCATIONAL MANGALDAN TECHNICAL INSTITUTE
BACHELOR OF
DON MARIANO MARCOS MEMORIAL
BACHELOR ELEMENTARY
STATE UNIVERSITY
EDUCATION
POST-BACCALAUREATE
POST-GRADUATE
MASTER OF
MASTERS WESLEYAN UNIVERSITY-PHILIPPINES
DIVINITY
DOCTORATE

REASON IN JOINING THIS TRAINING

TO LEARN SOMETHING NEW AND TO BE PART OF BOC FAMILY.

TO SERVE PEOPLE THROUGH THIS ORGANIZATION.

I DECLARE THAT THE ANSWERS GIVEN ABOVE ARE TRUE AND CORRECT.
Date Accomplished Signature
December 4, 2021