SOCCSKSARGEN-GAD-Resource-Pool-Profile-Form 001

Republic of the Philippines
REGIONAL DEVELOPMENT COUNCIL (RDC) XII

REGIONAL GENDER AND DEVELOPMENT COMMITTEE (RGADC) XII
SOCCSKSARGEN GAD RESOURCE POOL (SGRP) PROFILE FORM
Prime Regional Government Center, Carpenter Hill, Koronadal City, 9506
Tel/Fax Nos.: (083)228-6660 • (083)228-1421 • Email: rgrp.rgadxii@gmail.com• Website: region12.dilg.gov.ph
ADMIN (083) 228-7960 • FINANCE (083) 228-7959 • LGMED (083) 877-2969 • LGCDD (083)877 2971
Instructions: This 6-page Gender Resource Pool (GRP) Profile Form is to be

filled out by the prospective members of the SOCCSKSARGEN GR Pool as one of
the requirements for application. All fields with asterisk (*) are required
information. The information gathered from this Profile Form are treated with 1.5 x 1.5 ID Picture
utmost confidentiality. Thank you very much.
I. BASIC INFORMATION
Name (First, MI, Last)

Sex * Birth date*
Title or Prefix Used TIN No.*
(i.e. Atty, Engr, Etc)
Ethnicity Religion
Contact Information
Current Address
Permanent
Address
Home Telephone Number
Cell phone Number*
Email Address*
Website (if any)
Office/Work Name
Designation
Office Address
Work Telephone Number
Fax Number
II. EDUCATIONAL BACKGROUND
Level Degree Name of Year Highest Inclusive Scholarships/

Course School Graduate Level/ Units Dates Academic
d Earned From To Honors
(If not Received
Graduated)
RGADC XII RPGRP Form No. 001 (adapted from PCW-TSRCD Form No. 006) Page 1 of 7
III. Work Experience ((Start with most recent work experience and include volunteer work)
Currently employed? ☐ Yes ☐ No If Yes, Sector: ☐ Public ☐ Private
Inclusive Dates Position Organization Type1 Status of Area(s)

From To Title Employment2 Specialized In
IV. PROFESSIONAL CERTIFICATIONS
Certification3 Rating Date of Place of License (if applicable)

Examination/ Examination/ Number Date of
Conferment Conferment Release
V. OTHER INFORMATION
Languages/Dialects Spoken:
Skills4 :
1
Organization Type: GO, NGO, Private, Academe
2
Indicate if permanent or contract-based
3
Civil Service Eligibility, Board or Bar Certification, etc.
4
Facilitating, Negotiating, Etc. Refer to Annex B: Skills. You may add if your skill is not in the list. Separate using commas.
AREA OF SPECIALIZATION (Please check all that applies and encircle the number that
corresponds to your knowledge and level of expertise on the selected areas)
1 Beginner; 2 – Advance; 3-Competent; 4-Proficient; 5-Expert
☐ Agriculture and Gender 1 2 3 4 5
☐ Anthropology and Gender 1 2 3 4 5
☐ Business and Entrepreneurship and Gender 1 2 3 4 5
☐ Civil Aviation and Gender 1 2 3 4 5
☐ Communication Development and Gender 1 2 3 4 5
☐ Community Development and Gender 1 2 3 4 5
☐ Culture Studies and Gender 1 2 3 4 5
☐ Disaster Risk Reduction and Management (DRRM) and Gender 1 2 3 4 5
☐ Economics and Gender 1 2 3 4 5
☐ Education and Gender 1 2 3 4 5
☐ Energy and Gender 1 2 3 4 5
☐ Environment and Gender 1 2 3 4 5
☐ Finance and Gender 1 2 3 4 5
☐ Gender and Development 1 2 3 4 5
☐ Governance and Gender 1 2 3 4 5
☐ Health and Gender 1 2 3 4 5
☐ Housing and Gender 1 2 3 4 5
☐ Human Rights and Gender 1 2 3 4 5
☐ ICT Management and Gender 1 2 3 4 5
☐ Information Technology and Gender 1 2 3 4 5
☐ Infrastructure and Gender 1 2 3 4 5
☐ International Relations and Gender 1 2 3 4 5
☐ Justice and Judicial Reforms and Gender 1 2 3 4 5
☐ Labor and Employment and Gender 1 2 3 4 5
☐ Law and Gender 1 2 3 4 5
☐ Legislative Advocacy and Gender 1 2 3 4 5
☐ Linguistics and Gender 1 2 3 4 5
☐ Management and Gender 1 2 3 4 5
☐ Media and Gender 1 2 3 4 5
☐ Music and Gender 1 2 3 4 5
☐ Military and Gender 1 2 3 4 5
☐ Nutrition and Gender 1 2 3 4 5
☐ Police and Gender 1 2 3 4 5
☐ Policy Advocacy and Gender 1 2 3 4 5
☐ Peace Studies and Gender 1 2 3 4 5
☐ Political Science/Public Administration and Gender 1 2 3 4 5
☐ Psychology and Counseling and Gender 1 2 3 4 5
☐ Religion Studies and Gender 1 2 3 4 5
☐ Taxation and Gender 1 2 3 4 5
☐ Transport and Storage and Gender 1 2 3 4 5
☐ Tourism and Gender 1 2 3 4 5
☐ National Security and Gender 1 2 3 4 5
☐ Social Welfare and Gender 1 2 3 4 5
☐ Sociology and Gender 1 2 3 4 5
☐ Statistics and Gender 1 2 3 4 5
Others, please specify: 1 2 3 4 5
VI. GAD Trainings and Seminars Received (In the Last 3 Years5)
Title of GAD Training Organized By Venue Inclusive Dates No. of
(start with most recent) (Use format M/D/Y) Hours
e.g. Levelling Session on Gender Department of Education Deped 10/28/18 10/30/2 20
Analysis and GA Tools Conference 018
Hall, Ortigas
1.
2.
3.
4.
VII. Trainings, Workshops or Seminars you conducted or served as resource person under your specified
field/s (In the last 10 years)
Training / Session Title6 Session Title Inclusive Dates No. of Organized
(start with most recent) (specific topic/s (Use format M/D/Y) Hours /Requested By
discussed)
Example: Gender and ● Concepts on Sex and 10/26/18 10/27/18 4 Department of
Development Towards Food Gender Agriculture
Security ● Gender mainstreaming
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
VIII. PROJECTS INVOLVED IN (In the Last 10 years)7
5
Please use additional sheet(s) if necessary
6
Please indicate session title(s) if you only conducted a particular session(s) in that training. Training title if you have conducted the entire
training. Please use additional sheet(s) if necessary
7
Indicate here projects that handled or involved in, i.e. GREAT Women Project, etc
Inclusive Dates
Organized For/ By or Role/ Position in
Project (Use format
Funded By Project
M/D/Y)
e.g. Lingap Kalusugan para sa Barangay
Quezon Province 8/14/15 Present Provincial Coordinator
program
IX. PUBLISHED WORKS
Title of work Published By Publication Date of Publication

e.g. The Situation of Rural UP Center for Women and Annual GAD Gazette 8th 2017
Women since RA 9710 Gender Studies Issue
X. SOCIAL MEDIA
Title of work Web Address or URL

e.g. “The Woman I am Today” DSWD FO2 Official Website
XI. AWARDS RECEIVED
Title of Award Awarded By Year Awarded

e.g. GAWAD Ala GAD PCW 2018
XII. MEMBERSHIP IN ORGANIZATIONS
Designation in
Organization Inclusive Dates of Membership
Organization
e.g. Philippine Statistics Association Since 2012 to date Founding member
XIII. PERSON TO CONTACT IN CASE OF EMERGENCY
Name Relationship
Address
Contact
Number
Signature over Printed Name
Dated signed:
By submitting this Profile Form, it is understood that the person gave the consent to share his/her information with the Regional
Gender and Development (RGADC) XII and are aware of his/her rights as data subjects in accordance to Republic Act 10173 or
the Data Privacy Act of 2012.

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Republic of the Philippines

REGIONAL DEVELOPMENT COUNCIL (RDC) XII

Instructions: This 6-page Gender Resource Pool (GRP) Profile Form is to be

Name (First, MI, Last)

II. EDUCATIONAL BACKGROUND

Level Degree Name of Year Highest Inclusive Scholarships/

Currently employed? ☐ Yes ☐ No If Yes, Sector: ☐ Public ☐ Private

Inclusive Dates Position Organization Type1 Status of Area(s)

IV. PROFESSIONAL CERTIFICATIONS

Certification3 Rating Date of Place of License (if applicable)

VIII. PROJECTS INVOLVED IN (In the Last 10 years)7

IX. PUBLISHED WORKS

Title of work Published By Publication Date of Publication

Title of work Web Address or URL

XI. AWARDS RECEIVED

Title of Award Awarded By Year Awarded

XII. MEMBERSHIP IN ORGANIZATIONS

XIII. PERSON TO CONTACT IN CASE OF EMERGENCY

Signature over Printed Name

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