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 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 FERRANDO
NAME EXTENSION (JR., SR) N/A
FIRST NAME CHRISTIAN NIÑO

MIDDLE NAME BANATE

3. DATE OF BIRTH
(mm/dd/yyyy) 1/8/1993 16. CITIZENSHIP ✘ Filipino Dual Citizenship
? ✘ by birth by naturalization
4. PLACE OF BIRTH BAGANGA, DAVAO ORIENTAL If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘ Male Female

6 CIVIL STATUS
✘ Single Married 17. RESIDENTIAL ADDRESS HIGHWAY
✘ Widowed Separated House/Block/Lot No. Street
PUROK TAMBIS BACULIN
Other/s:
Subdivision/Village Barangay
BAGANGA DAVAO ORIENTAL
7. HEIGHT (m) 1.66 M
City/Municipality Province
8. WEIGHT (kg) 68 kls ZIP CODE 8204

18. PERMANENT ADDRESS HIGHWAY

9. BLOOD TYPE "B"
House/Block/Lot No. Street
PUROK TAMBIS BACULIN
10. GSIS ID NO. 9560821340019
Subdivision/Village Barangay
BAGANGA DAVAO ORIENTAL
11. PAG-IBIG ID NO. 1900-0065-5297
City/Municipality Province

12. PHILHEALTH NO. 16-000080157-4 ZIP CODE 8203

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

14. TIN NO. 466 20. MOBILE NO. 09156918461

15. AGENCY EMPLOYEE NO. 8321280 21. E-MAIL ADDRESS (if any) christianni.ferrnado@deped.gov.ph
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
N/A JESTONE B.FERRANDO
FIRST NAME N/A 5/91998

MIDDLE NAME N/A CHRISTIAN NIÑO B. FERRANDO 1/8/1993

OCCUPATION N/A JAYMAR B.FERRANDO 2/1/1988

EMPLOYER/BUSINESS NAME N/A JONNAR B.FERRANDO 2/1/1988

BUSINESS ADDRESS N/A MARIA PERNITA B. FERRANDO 1/26/1986

TELEPHONE NO. N/A RANDYM B. FERRANDO 10/3/1984

24. FATHER'S SURNAME FERRANDO RITCHIE B. FERRANDO 6/4/1982

FIRST NAME PERSIUS N/A

MIDDLE NAME FONTILLAS

25. MOTHER'S MAIDEN NAME

SURNAME BANATE

FIRST NAME NENITA

MIDDLE NAME LOPEZ (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

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

ELEMENTARY BACULIN ELEMENTARY SCHOOL GRADE VI 1998 2004 GRADUATED 2004 NA

SAINT MARYS ACADEMY OF

SECONDARY /
VOCATIONAL FOURTH YEAR 2004 2008 GRADUATED 2008 NA
BAGANGA
N/A N/A N/A NA N/A N/A N/A
TRADE
COURSE SAINT MARYS'S COLLEGE BAGANGA, BACHELOR OF SECONDARY
COLLEGE 2008 2012 GRADUATED 2012 N/A
INC EDUCATION MAJOR IN ENGLISH

GRADUATE STUDIES N/A N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)
SIGNATURE DATE February 06,2023 CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER SPECIAL DATE OF LICENSE (if applicable)
RATING
LAWS/ CES/ CSEE BARANGAY EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity

LICENSURE EXAM FOR TEACHERS 1/26/2014 UM-MATINA DAVAO CITY 1287793 1/12/2023
75.00%

(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
28. INCLUSIVE DATES SALARY/ JOB/ PAY SERVICE
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
(mm/dd/yyyy) MONTHLY STATUS OF
(Write in (Write in SALARY
applicable)& STEP
APPOINTMENT
(Format "00-0")/
full/Do not abbreviate) full/Do not abbreviate) INCREMENT
From To
(Y/ N)
SALARY
1/1/2022 PRESENT TEACHER I DEPARTMENT OF EDUCATION/PANTUYAN NATIONAL HIGH SCHOOL 27284.00 G11/STEP II PERMANENT YES
DEPARTMENT OF EDUCATION/PANTUYAN NATIONAL HIGH SALARY
1/1/2021 12/31/2021 TEACHER I SCHOOL
27284.00 G11/STEP II PERMANENT YES
DEPARTMENT OF EDUCATION/PANTUYAN NATIONAL HIGH SALARY
1/1/2020 12/31/2020 TEACHER I SCHOOL
27284.00 G11/STEP II PERMANET YES
DEPARTMENT OF EDUCATION/PANTUYAN NATIONAL HIGH SALARY
1/1/2019 12/31/2019 TEACHER I SCHOOL
27284.00 G11/STEP II PERMANENT YES
DEPARTMENT OF EDUCATION/PANTUYAN NATIONAL HIGH SALARY
1/1/2018 12/31/2018 TEACHER I SCHOOL
27284.00 G11/STEP II PERMANENT YES
DEPARTMENT OF EDUCATION/PANTUYAN NATIONAL HIGH SALARY
1/1/2017 12/31/2017 TEACHER I SCHOOL
27284.00 G11/STEP II PERMANENT YES
DEPARTMENT OF EDUCATION/PANTUYAN NATIONAL HIGH SALARY
1/1/2016 12/31/2016 TEACHER I SCHOOL
27284.00 G11/STEP II PERMANENT YES
DEPARTMENT OF EDUCATION/PANTUYAN NATIONAL HIGH SALARY
10/23/2015 12/31/2015 TEACHER I SCHOOL
27284.00 G11/STEP II PERMANENT YES

1/1/1982 12/31/1984
(Continue on separate sheet if necessary)
SIGNATURE DATE February 06, 2023 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) NUMBER OF HOURS POSITION / NATURE OF WORK
(mm/dd/yyyy)
From To

ASSISI DEVELOPMENTFOUNDATION INC 6/3/2012 5/28/2014 3086.0 Voluntary

(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
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) (mm/dd/yyyy) (Write in full)

From To
Undesrtanding and Utilizing Media in Teaching (UUMT) Integration of Media Literacy in the K-12
10/8/2018 10/10/2018 24 hours National Council for Children's Telivision
Curriculum Seminar- Workshop.

Two-Day School Based Teaching Enhancement Porgram 8/30/2019 8/31/2019 16 hours

DepEd/ Pantuyan National High Schoo l

National Inventory of Deped Public Schools Buildings for SY: 2019-2020 8/31/2019 8/31/2019 8 hours
Deped National
LITMAN: TANGHALAN NG MGA PANITIKANG LOCAL SA WIKANG MANDAYA SA DAVAO
4/24/2021 4/26/2021 24 hours
ORIENTAL Sentro ng wika at Kultura/ DORSU
3 DAY SIMULTAENEOUSDIVISION/TRAINING/WORKSHOP ON VIDEO RECORDING AND EDITING ANDON QUALITY ASSURERANVE VIS A VIS DIVISION YOUTUBE
CHANNEL FOR LEARNING RESOURCES 4/27/2021 4/29/2021 24 hours
Division of Davao Oriental/ Lrmds

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

Cooking N//A

Baking

Playing Volleyball

(Continue on separate sheet if necessary)

SIGNATURE DATE Ffebruary 06,2023 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:
________________________________
N/A

35. a. Have you ever been found guilty of any administrative offense? YES ✘ NO
If YES, give details:
________________________________
N/A
________________________________
b. Have you been criminally charged before any court? YES ✘ NO
If YES, give details:
________________________________
Date Filed: N/A
________________________________
Status of Case/s: N/A

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:
________________________________
N/A
________________________________
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? ________________________________
N/A
________________________________
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: N/A

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: N/A
39. Have you acquired the status of an immigrant or permanent resident of another country?
YES ✘ NO
If YES, give details (country):
N/A
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: Mandaya
b. Are you a person with disability? YES ✘ NO
If YES, please specify ID No: N/A
c. Are you a solo parent? YES NO
If YES, please specify ID No: N/A

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

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
ANGELINA M. DOLLESCO BACULIN, BAGANGA DAVAO ORIENTAL 9461242860 3.5 cm. X 4.5 cm
(passport size)

CRECEMSIO T.TILOS BACULIN, BAGANGA DAVAO ORIENTAL 9156378932 With full and handwritten
name tag and signature over
printed name
JAYFREY A. MANGUIOB BACULIN, BAGANGA DAVAO ORIENTAL 9186314527
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and complete or photocopied picture
is not acceptable
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 administrative/criminal case/s PHOTO
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: PRC I.D.

ID/License/Passport No.: 1287793

Signature (Sign inside the box)
February 06, 2023
Date/Place of Issuance: 01/12/2021
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