PERSONAL DATA SHEET

WARNING: Any misrepresentation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal
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.
I. PERSONAL INFORMATION
2. SURNAME PASCUA

FIRST NAME JEMMAFIL

MIDDLE NAME DYSAM

3. DATE OF BIRTH
(mm/dd/yyyy) 11/12/1976 16. CITIZENSHIP

4. PLACE OF BIRTH Cebu City If holder of dual citizenship,

please indicate the details.

5. SEX

17. RESIDENTIAL ADDRESS N/A

6 CIVIL STATUS
House/Block/Lot No.
Purok Alauya
Subdivision/Village
Maco
7. HEIGHT (m) 1.52
City/Municipality

8. WEIGHT (kg) 39.91 ZIP CODE 8806

18. PERMANENT ADDRESS N/A

9. BLOOD TYPE O
House/Block/Lot No.
Purok Alauya
10. GSIS ID NO. N/A
Subdivision/Village
Maco
11. PAG-IBIG ID NO. 1670-0131-2430
City/Municipality

12. PHILHEALTH NO. 12-050153127-3 ZIP CODE 8806

13. SSS NO. 06-1651919-2 19. TELEPHONE NO. 084-817 1287

14. TIN NO. 903-634-844-000 20. MOBILE NO. 0922-946-5764

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) jemmafilp@gmail.com

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME Pascua 23. NAME of CHILDREN (Write full name and list all)
NAME EXTENSION (JR., SR) N/A Corinne Margaret D. Pascua
FIRST NAME Roan

MIDDLE NAME Astillo

OCCUPATION Teacher

EMPLOYER/BUSINESS NAME Masara Integrated School

BUSINESS ADDRESS Masara, Maco Davao de Oro

TELEPHONE NO. N/A

24. FATHER'S SURNAME Dysam

HEET
e the filing of administrative/criminal case/s against the person

NG THE PDS FORM.

1. CS ID No. (Do not fill up. For CSC use only)

NAME EXTENSION (JR., SR) N/A

Pls. indicate country:

N/A San Pedro St.

House/Block/Lot No. Street
Purok Alauya Binuangan
Subdivision/Village Barangay
Maco Davao de Oro
City/Municipality Province

8806

N/A San Pedro St.

House/Block/Lot No. Street
Purok Alauya Binuangan
Subdivision/Village Barangay
Davao de Oro
City/Municipality Province

8806

287

5764

@gmail.com

CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

e Margaret D. Pascua 11/2/2004

 NAME EXTENSION (JR., SR)
FIRST NAME Felipe N/A

MIDDLE NAME Yu

25. MOTHER'S MAIDEN NAME

SURNAME Dysam

FIRST NAME Emma

MIDDLE NAME Sevilla (Continue on separate sheet if

III. EDUCATIONAL BACKGROUND

26. NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE

LEVEL
(Write in full) (Write in full)
From

ELEMENTARY Tagbubunga Community School Elementary 1983

SECONDARY University of the Visayas Highschool 1989

VOCATIONAL /
TRADE COURSE
N/A N/A N/A

COLLEGE University of the Visayas Bachelor of Science in Accountancy 1993

Master of Arts in Education Major in

GRADUATE STUDIES Cebu Normal University
Social Studies
2017

(Continue on separate sheet if necessary)

SIGNATURE DATE
 (Continue on separate sheet if necessary)

HIGHEST SCHOLARSHIP/
PERIOD OF ATTENDANCE LEVEL/ YEAR
ACADEMIC
GRADUATE
UNITS EARNED HONORS
D
(if not graduated) RECEIVED
To

3rd Honorable
1989 Graduated 1989 Mention

Best in
1993 Graduated 1993
Math

N/A N/A N/A N/A

1996 Graduated 1996 Cum Laude

2019 33 Units N/A N/A

DATE 08/16/2021
CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable)
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT

License Professional Teacher 77.80) 03/20/2016 Cebu City

Civil Service Eligibility Honor Graduate 4/10/1997 Cebu City

(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.
28. INCLUSIVE DATES
(mm/dd/yyyy)
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY MONTHLY
(Write in full/Do not abbreviate) (Write in full/Do not abbreviate) SALARY
From To

Subject Teacher and Senior High School

06/01/2018 05/15/2020 St. Joseph's School of Mactan - 13,000.00-
Adviser
Subject Teacher and Grade School
06/01/2016 03/31/2018 Marie Ernestine School - 13,000.00-
Adviser
11/15/2010 05/23/2016 Junior Accountant Bigfoot Properties, Inc. - 15,000.00-

05/15/2006 01/01/2009 Finance Assistant Bigfoot Properties, Inc. - 13,300.00-

10/9/2003 05/13/2006 Accounting Assistant Isuzu Automotive Dealership, Inc. - 7,800.00-

Duracon Construction & Development

08/14/2000 10/08/2003 Junior Accountant - 7,000.00-
Corporation
Front Office & Restaurant Cashier and
08/19/1999 08/12/2000 Coral Reef Hotel - 5,000.00-
Internal Night Auditor
11/04/1996 08/14/1999 Accounting Assistant Basic Essentials Marketing, Inc. - 4,680.00-
 LICENSE (if applicable)
ATION / CONFERMENT
NUMBER Date of
Validity

bu City 1476738 11/12/2022

bu City 10070099 N/A

ached Work Experience sheet.

SALARY/ JOB/ PAY
GRADE (if GOV'T
STATUS OF
SERVICE
applicable)& STEP
(Format "00-0")/ APPOINTMENT
(Y/ N)
INCREMENT

N/A Probationary N

N/A Probationary N

N/A Regular N

N/A Regular N

N/A Regular N

N/A Regular N

N/A Regular N

N/A Regular N
 (Continue on separate sheet if necessary)
SIGNATURE DATE 08/16/2021
CS FORM 212
08/16/2021
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

From To

One Voice Choir 4/10/2010 05/20/2020 N/A

Koro ni San Jose 03/14/2009 05/20/2020 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 (5) years for Division Chief/Executive/Managerial positions)

INCLUSIVE DATES OF
30. ATTENDANCE
TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS
(mm/dd/yyyy) NUMBER OF HOURS
(Write in full)

From To

Autodesk and Adobe Photoshop for Beginners 05/13/2020 05/15/2020 24.0)

CEAP-CeSSPA Teachers' Congress 11/15/2019 11/15/2019 8.0)

Division Math Fair 10/28/2019 10/29/2019 16.0)

Homeroom Guidance Program 06/25/2019 06/26/2019 16.0)

2019 Summer In-Service Training (INSET) for Junior High School 06/17/2019 06/19/2019 24.0)

Developing Classroom Management Skills 07/20/2018 07/21/2018 16.0)

2018 Summer DepEd-PEAC In-Service Training (INSET) for Senior High School
6/8/2018 6/10/2018 24.0)
Teachers in Private School

Continuing Professional Development: An Ethical and Professional Obligation 12/3/2017 12/3/2017 8.0)

Teaching for Meaning and Mastery: Interactive Teaching Strategies and Outcomes-
12/2/2017 12/2/2017 8.0)
Based Assessment for Analysis, Synthesis, Critical and Creative Thinking Skills

Diwa Innovators Congress 10/21/2017 10/21/2017 8.0)

Singapore Math - Ratio, Percentage, Fractions and Bar Modeling 11/19/2016 11/19/2016 8.0)

Beyond Curriculum: Lead, Teach and Learn 07/22/2016 07/22/2016 8.0)

Computer System Servicing NC-II / Basic Computer Network Installation and

7/1/2016 12/15/2016 280.0)
Administration / On-The-Job I.T. Technical Support
Y ORGANIZATION/S

POSITION / NATURE OF WORK

Member/Soloist

Member/Soloist

Chief/Executive/Managerial positions)

Type of LD
( Managerial/CONDUCTED/ SPONSORED BY
Supervisory/ (Write in full)
Technical/etc)

Technical
Republic of the Philippines Department of
Education

Technical
Catholic Educational Association of the
Philippines

Supervisory
Department of Education - Divison of Lapu-lapu
City

Technical Center for Educational Measurement, Inc.

Technical Private Education Assistance Committee (PEAC)

Technical Center for Educational Measurement, Inc.

Technical Private Education Assistance Committee (PEAC)

Technical Norphil Innovative Center of Education

Technical Norphil Innovative Center of Education

Supervisory
Diwa Learning Systems and Bato Balani
Foundation, Inc.

Technical EdCrisch International, Inc.

Technical Marie Ernestine Teaching Academy

Technical Logic Gate Technology Institute

 (Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

NON-ACADEMIC DISTINCTIONS / RECOGNITION

31. SPECIAL SKILLS and HOBBIES 32.
(Write in full)

Bookkeeping 5S Committee Awardee

Singing Perfect Attendance Awardee

Playing Volleyball

Reading

(Continue on separate sheet if necessary)

SIGNATURE DATE
 MEMBERSHIP IN ASSOCIATION/ORGANIZATION
33.
(Write in full)

Couple's for Christ

One Voice Choir

Koro ni San Jose

DATE 08/16/2021
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?
b. within the fourth degree (for Local Government Unit - Career Employees)?
If YES, give details:
________________________________
________________________________

35. a. Have you ever been found guilty of any administrative offense?
If YES, give details:
________________________________
________________________________

b. Have you been criminally charged before any court?

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?
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 If YES, give details:
out (abolition) in the public or private sector? ________________________________
________________________________
Resignation from my previous em

38. a. Have you ever been a candidate in a national or local election held within the last year (except
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the
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?
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?
.
If YES, please specify:
b Are you a person with disability?
.
If YES, please specify ID No:
c Are you a solo parent?
.
If YES, please specify ID No:
 ils:
_________________
_________________

ils:
_________________
_________________

ils:
_________________
_________________

ils:
_________________
_________________

ils:
_________________
_________________
n from my previous employer

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

NAME ADDRESS TEL. NO.

Municipal Councilor Maco, Davao de

Mr. Florante Astillo 09090735457
Oro
Directress St. Joseph's School of
Sr. Agnes Labitoria, SFIC Mactan, Airport Road Mactan Lapu-lapu 09227102510
City
Finance Head San Miguel Beer
Ms. Al Lyn Abrea 09178803569
Corporation, Highway Mandaue City
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and complete statement pursuant to the pr

PHOTO

Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of Issuance
Government Issued ID: Professional Regulation Commission

ID/License/Passport No.: 1476738

Signature (Sign inside the box)
08/16/2021
Date/Place of Issuance: 11/03/2016 / Cebu City
Date Accomplished Right Thumbmark

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

Person Administering Oath

CS FORM 212 (Revised 20

 PHOTO

Right Thumbmark

ed government ID as indicated above.

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