CS Form No.

212
Revised 2017 PERSONAL DATA SHEET
WARNING: Any misrepresentation 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 CANSING

FIRST NAME PACIANO NAME EXTENSION (JR., SR) JR.

MIDDLE NAME ALILI

3. DATE OF BIRTH 08/05/1990 16. CITIZENSHIP ✓

❒ Filipino ❒ Dual Citizenship

(mm/dd/yyyy) If holder of dual citizenship, ✓by birth

❒ ❒ by naturalization
4. PLACE OF BIRTH MAGSAYSAY, DAVAO DEL SUR please indicate the details. Pls. indicate country:

5. SEX ✓ Male ❒
❒ Female N/A

6. CIVIL STATUS ✓ Single ❒

❒ Married 17. RESIDENTIAL ADDRESS N/A PUROK 5
House/Block/Lot No. Street
❒ Widowed ❒ Separated
❒ Other/s: N/A GLAMANG
Subdivision/Village Barangay
7. HEIGHT (m) 5.8 MAGSAYSAY DAVAO DEL SUR
City/Municipality Province
8. WEIGHT (kg) 68 ZIP CODE 8004

9. BLOOD TYPE "AB+" 18. PERMANENT ADDRESS N/A PUROK 5

House/Block/Lot No. Street
10. GSIS ID NO. 02005986958 N/A GLAMANG
Subdivision/Village Barangay
11. PAG-IBIG ID NO. 1212-9153-8004 MAGSAYSAY DAVAO DEL SUR
City/Municipality Province
12. PHILHEALTH NO. 16-050466660-0 ZIP CODE 8004

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

14. TIN NO. 405-877-575 20. MOBILE NO. 0997-477-3123

15. AGENCY EMPLOYEE NO. 7238330 21. E-MAIL ADDRESS (if any) paciano.cansingjr@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)

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

MIDDLE NAME N/A

OCCUPATION N/A

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME CANSING

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

MIDDLE NAME SAMBONG

25. MOTHER'S MAIDEN NAME

SURNAME ALILI

FIRST NAME THELIA

MIDDLE NAME BAYANG (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

SCHOLARSHIP/
26. NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE PERIOD OF ATTENDANCE HIGHEST LEVEL/ YEAR ACADEMIC
LEVEL (Write in full) (Write in full) UNITS EARNED GRADUATED HONORS
From To RECEIVED

ELEMENTARY GLAMANG ELEMENTARY SCHOOL ELEMENTARY 1997 2003 GRADUATED 2003 N/A

SECONDARY BANGKAL NATIONAL HIGH SCHOOL HIGH SCHOOL 2003 2007 GRADUATED 2007 N/A

ADVENTURE COLLEGE OF TECHNOLOGY AND

VOCATIONAL / TRADE COURSE 2-YEAR COMPUTER SECRETARIAL 2007 2009 GRADUATED 2009 N/A
SCIENCES INC.
BACHELOR OF SECONDARY EDUCATION -
COLLEGE UNIVERSITY OF MINDANAO DIGOS COLLEGE 2014 2018 GRADUATED 2018 N/A
BIOLOGICAL SCIENCE

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 01, 2024 CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) RATING DATE OF LICENSE (if applicable)
UNDER SPECIAL LAWS/ CES/ CSEE (If Applicable) EXAMINATION/ PLACE OF EXAMINATION / CONFERMENT NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT Validity

RA 1080 87.40 09/30/2018 SAN PEDRO COLLEGE 1688990 08/05/2024

(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 SALARY/ JOB/ PAY
(mm/dd/yyyy) POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY MONTHLY GRADE (if STATUS OF GOV'T
(Write in full/Do not abbreviate) (Write in full/Do not abbreviate) SALARY applicable)& STEP APPOINTMENT SERVICE
(Format "00-0")/ (Y/ N)
From To INCREMENT

01/01/2024 PRESENT TEACHER I DEPARTMENT OF EDUCATION/MAGSAYSAY SOUTH P27,000 N/A PERMANENT Y

DEPARTMENT OF EDUCATION/MAGSAYSAY SOUTH

01/01/2023 12/31/2023 TEACHER I P27,000 - PERMANENT Y
DISTRICT

01/01/2022 12/31/2022 TEACHER I DEPARTMENT OF EDUCATION/MAGSAYSAY SOUTH P25,439 N/A PERMANENT Y

12/03/2021 12/31/2021 TEACHER I DEPARTMENT OF EDUCATION/MAGSAYSAY SOUTH P23,877 N/A PERMANENT Y

05/27/2021 09/01/2021 TEACHER I DEPARTMENT OF EDUCATION/MAGSAYSAY SOUTH P23,877 N/A SUBSTITUTE Y

06/03/2019 03/21/2020 LOCAL SCHOOL BOARD TEACHER DEPARTMENT OF EDUCATION P5,000 N/A CONTRACTUAL N

(Continue on separate sheet if necessary)

SIGNATURE DATE February 01, 2024 CS FORM 212 (Revised 2017), Page 2 of 4
 VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
29. NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES NUMBER OF
(Write in full) (mm/dd/yyyy) HOURS POSITION / NATURE OF WORK
From To

N/A N/A N/A N/A 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 Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ATTENDANCE NUMBER OF ( Managerial/ CONDUCTED/ SPONSORED BY
(Write in full) (mm/dd/yyyy) HOURS Supervisory/ (Write in full)
From To Technical/etc)

CHILD PROTECTION LEARNING COURSE FOR EDUCATORS 01/23/2024 01/24/2024 16 TECHNICAL STAIRWAY FOUNDATION INC.

ANJUAL EDUCATORS CONGRESS (AECON) 2024 01/19/2024 01/19/2024 8 TECHNICAL REX EDUCATION

DIVISION SPORTS TRAINING AND ACCREDITATION OF COACHES 2024 01/04/2024 01/07/2024 24 TECHNICAL DIVISION OF DAVAO DEL SUR

DOCUMENT EVALUATORS TRAINING AND SIMULATION ACTIVITIESBON THE IMPLEMENTATION OF THE GUIDELINES ON RECRUITMENT, SELECTION

06/05/2023 06/05/2023 8 TECHNICAL DIVISION OF DAVAO DEL SUR

AND APPOINTMENT FOR TEACHER 1 POSITION IN THE SCHOOLS DIVISION OFFICE OF DAVAO DEL SUR

SYMPOSIUM AND ORIENTATION FOR SCHOOL EMERGENCY RESPONCE TEAM 04/28/2023 04/28/2023 8 TECHNICAL LOCAL GOVERNMENT UNIT - MAGSAYSAY

INDUCTION PROGRAM FOR BEGINNING TEACHERS 03/22/2023 03/22/2023 8 TECHNICAL MAGSAYSAY SOUTH DISTRICT

2023 MAGSAYSAY SOUTH ATHLETIC MEET 02/18/2023 02/18/2023 8 TECHNICAL MAGSAYSAY SOUTH

SUSTAINING GROWTH AND SUSTAINABLE GROWTH ORLD FOR ALL 12/10/2022 12/10/2022 8 TECHNICAL GLAMANG ELEMENTARY SCHOOL

BRIGADAHAN SA ASBANG ELOK ELEMENTARY SCHOOL 12/02/2022 12/03/2022 16 TECHNICAL SCHOOLS DIVISION OF DAVAO DEL SUR

VIRTUAL IN SERVICE TRAINING FOR TEACHERS 3.0 08/08/2022 08/11/2022 32 TECHNICAL DEPARTMENT OF EDUCATION

TECHNICAL EDUCATION AND SKILLS

FOOD AND BEVERAGE SERVICES NATIONAL COMPETENCY II HOLDER 10/01/2018 01/30/2019 385 TECHNICAL
DEVELOPMENT AUTHORITY

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

31. SPECIAL SKILLS and HOBBIES 32. NON-ACADEMIC DISTINCTIONS / RECOGNITION 33. MEMBERSHIP IN ASSOCIATION/ORGANIZATION
(Write in full) (Write in full)

HOSTING N/A BSP

ICT SKILLS

(Continue on separate sheet if necessary)

SIGNATURE DATE February 01, 2024 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:

35. a. Have you ever been found guilty of any administrative offense? ❒ Yes ✓ No
❒
If YES, give details:

b. Have you been criminally charged before any court? ❒ Yes ✓ No

❒
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 ❒ Yes ✓ No
❒
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, ❒ 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?
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:

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:

39. Have you acquired the status of an immigrant or permanent resident of another country? ❒ Yes ✓ No
❒
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? ✓ Yes
❒ ❒ No
If YES, please specify: BLAAN
b. Are you a person with disability? ❒ Yes ✓ No
❒
If YES, please specify ID No:
c. Are you a solo parent? ❒ Yes ✓ No
❒
If YES, please specify ID No:

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

NAME ADDRESS TEL. NO.

JANNUEL V. PENONIA BALNATE, MAGSYASAY,DAVAO DEL SUR 09566234255

MARITES T. DUCO TACUL, MAGSAYSAY, DAVAO DEL SUR 09965689165

JAIME C. FERNANDEZ BANSALAN, DAVAO DEL SUR 09568956231

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 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

ID/License/Passport No.: 1688990

PACIANO A. CANSING JR.
Signature (Sign inside the box)
Date/Place of Issuance: 12/27/2018 - DAVAO CITY FEBRUARY 01, 2024
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