DEPARTMENT OF SOCIAL WELFARE AND DEVELOPMENT

Field Office IV-A, Alabang Zapote Rd. Alabang, Muntinlupa City

APPLICATION FORM

PERSONAL DATA
Last Name First Names Middle Name Nickname

TARGA NUERIE JOY DEL ROSARIO NUERIE

Email Address Mobile No. 1 Mobile No. 2

tnuerie@gmail.com 09974959649

Present Address (if different from Permanent Address) Telephone No.

3160 PAG ASA STREET, SANTO ANGEL NORTE, SANTA CRUZ, LAGUNA

Office address (if different from Permanent Address) Telephone No.

o Male Age Date of Birth(mm/dd/yy) Name of Contact Person Telephone No.

Female 28 12/19/1993 LEA R. TARGA 09555120524

Citizenship Place of Birth Religion Civil Status

Filipino SANTA CRUZ ROMAN CATHOLIC Single
o Naturalized LAGUNA o Married
Filipino o Separated
TIN Number GSIS/SSS NO. Pag-ibig No. Philhealth No.
420-489-900-000 9173-3557-6795 08-025441316-3

Languages Spoken Dialect Spoken

(1) TAGALOG (2) ENGLISH (3) (1) TAGALOG (2) (3)

WORK EXPERIENCE AND REFERENCES (additional sheet if needed)
PRESENT PREVIOUS (1) PREVIOUS (2) PREVIOUS (3)
Name of Company
BONCHON PLEASANT VIEW TOTAL INFORMATION
N/A HOTEL MANAGEMENT
Industry
FOOD PROCESSING HOSPITALITY INDUSTRY HOSPITALITY INDUSTRY INFORMATION
INDUSTRY TECHNOLOGY
Job Title DINING AND
BUSINESS WOMAN CASHIER OFFICER ADMINISTRATIVE DATA ANALYST
(BAKER) IN-CHARGE OFFICER

Rank

Gross Monthly Salary

6000 10790 9100 13962

Inclusive Dates(mm/dd/yy) From 2/10/2018 From 4/26/2014 From 4/15/2013

From 05/01/2020

To PRESENT To 5/11/2022 To 10/9/2015 To 4/6/2014

Complete Mailing Address G/F SUNSTAR 7C96+4WC, NATIONAL 5600 SOUTH

3160 SANTO ANGEL MALL, NATIONAL HIGHWAY, SANTA CRUZ, SUPERHIGHWAY
NORTE, SANTA CRUZ, HIGHWAY, SANTA CRUZ, LAGUNA CORNER, ARELLANO ST.
LAGUNA LAGUNA MAKATI, METRO
MANILA

Contact Telephone No. 09232627557 09658728031 (02)8857 1846

 OTHER INFORMATION
Have you ever been discharge from previous o YES NO If yes, please state reason
employment? o
o

Have you ever been subjected to any company o YES NO If yes, please provide details
administrative or legal proceedings? o

Have you ever been charged, accused, indicted, o YES NO

or tried for violation of any laws, ordinances, rules, o
or regulations?
Are you suffering or have you suffered from any o YES NO If yes, please provide details
major ailments over the last 5 years? Please o
describe also any physical ailments that you may
have.
Do you have any unpaid bills (utilities, etc.) o YES NO If yes, please provide details
presently past due? o

Do you have any history of past due or cancelled o YES NO If yes, please provide details
credit cards, or past due loans? o

Have you previously applied or been employed o YES NO If yes, where? When?
with DSWD or any of its affiliated institutions? o

Do you have any relatives/friends employed with Relation If yes, please identify names in space
DSWD? COMMON provided: BUELA, JOHN ZORAB T.
Name (Last Name, First Name, Middle Name) LAW Office/Bureau/Service/Unit
BUELA, JOHN ZORAB T. PARTNER PPPPMO

CHARACTER REFERENCES
NAME OF REFERENCES (do not include COMPANY CONTACT NO. COMPLETE MAILING ADDRESS
relatives)
(Last Name, First Name, Middle Name)
BONCHON 09232627557 PILA LAGUNA
ANINAG, RUDY KING D.

DSWD 09227801892 PANGIL, LAGUNA

CINENA, MICHAEL ANGELO

DSWD 09395276557 PANGIL, LAGUNA

MARTINEZ VALDIRIV R.

PERSON TO NOTIFY INCASE OF EMERGENCY

NAME (Last Name, First Name, Middle Initial) Relation Landline No. Mobile No.
TARGA, LEA D. MOTHER 09056152137

CERTIFICATION

I hereby certify that the information given in my Application for Employment are true, complete, and correct. I understand that
employment in DSWD requires absolute honesty. I bind myself that if employed by DSWD, any false statement and/or dishonest
answer herein above–stated, or omission, if disclosed, shall result in disapproval of my application or shall constitute sufficient
cause for dismissal. I agree that I shall submit myself to physical and medical examinations, including the government-mandated
random drug-testing program, before and during employment. I hereby authorize DSWD to conduct inquiries about my scholastic
and employment records and verify all information stated in this application.

____________________________________________ ______________________
Applicant’s Signature over Printed Name Date

(Annex _____: Application Form)