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 MAKILAN
NAME EXTENSION (JR., SR)
FIRST NAME MICHAEL

MIDDLE NAME SARTE

3. DATE OF BIRTH
(mm/dd/yyyy) 06/22/1988 16. CITIZENSHIP ✘ Filipino Dual Citizenship
by birth by naturalization
Sitio Kitakal, Malalag Cogon, Malungon,
4. PLACE OF BIRTH If holder of dual citizenship, Pls. indicate country:
Sarangani Province
please indicate the details.
5. SEX ✘ Male Female

6 CIVIL STATUS Single ✘ Married 17. RESIDENTIAL ADDRESS NA NA

Widowed Separated House/Block/Lot No. Street
Sitio Fatima Malalag Cogon
Other/s:
Subdivision/Village Barangay
Malungon Sarangani
7. HEIGHT (m) 1.65
City/Municipality Province
8. WEIGHT (kg) 80 ZIP CODE 8000

18. PERMANENT ADDRESS 6 NA

9. BLOOD TYPE "O"
House/Block/Lot No. Street
10. GSIS ID NO. Phase 3 Langub

Subdivision/Village Barangay
11. PAG-IBIG ID NO. 0111-1862654-0
Davao City Davao Del Sur

12. PHILHEALTH NO. 16-050348354-5 ZIP CODE City/Municipality Province

13. SSS NO. 0111-1862654-0 19. TELEPHONE NO. 8000

14. TIN NO. 267-028-865 20. MOBILE NO. 09057275006

15. AGENCY EMPLOYEE NO.
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME
FIRST NAME
21. E-MAIL ADDRESS (if any) michael_makilan@yahoo.com.ph
MAKILAN 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) MIKE KICHIROU E. MAKILAN
BONNA FE 12/20/2012

MIDDLE NAME ENGOC VONN MATHEW E. MAKILAN 03/23/2018

OCCUPATION House Keeper

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME MAKILAN

NAME EXTENSION (JR., SR)
FIRST NAME MATIDNAO

MIDDLE NAME BUAN

25. MOTHER'S MAIDEN NAME

SURNAME SARTE

FIRST NAME VICTORIA

MIDDLE NAME GEVEROLA (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
HONORS
(Write in full)
full) (if not graduated) RECEIVED
From To

ELEMENTARY Malalag Cogon Elementary School 10/6/1995 10/4/2001 Graduated 2001 N/A

SECONDARY Malalag Cogon National High School 9/6/2001 04/18/2005 Graduated 2005 N/A
University of Southeastern Philippines - Mintal, Davao Oplan
COLLEGE
City
Bachelor of Science in Community Development 10/6/2009 04/20/2013 Graduated 2013
Kaalam
University of Southeastern Philippines - Bo. Obrero,
GRADUATE STUDIES
Davao City
Master of Science in Development Administration 06/14/2014 04/22/2016 Graduated 2016 N/A
University of Southeastern Philippines - Bo. Obrero, Doctor of Philosophy Major Development Research 2016-
POST GRADUATE STUDIES
Davao City Administration
08/13/2016 12/17/2016 33 units N/A
presents
(Continue on separate sheet if necessary)

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

NONE

(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 full/Do not (Write in SALARY
applicable)& STEP
APPOINTMENT
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT
From To
(Y/ N)
Contract of
06/15/2018 Present Instructor 1 Davao Del Norte State College 22,000
Service
Monitoring Evaluation, Accountability And
11/01/2018 10/06/2018 Fundaccion Action El Hambre 36, 000 N/A Project Based NO
Learnng Officer (MEAL)
02/01/2017 12/31/2017 Environmental Extension Officer DENR - PENRO Alabel 23,000 N/A Job Order YES

08/01/2015 11/30/2016 Monitoring and Evaluation Officer Plan International Inc. 38,000 N/A Project Based NO
Community
02/26/2014 07/31/2015 Development Plan International Inc. 31,000 N/A Project Based NO
Facilitator
Community
05/18/2013 02/15/2014 Development Plan International Inc. 31,000 N/A Project Based NO
Facilitator
04/12/2012 03/20/2013 Project Officer UCCP Pag-ugmad sa Kabataan Foundation 5,000 N/A Part Time NO

(Continue on separate sheet if necessary)

SIGNATURE DATE
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 POSITION / NATURE OF WORK
From To

KAMALAYAN DEVELOPMENT FOUNDATION INC. 7/2/2010 7/6/2014 Child Welfare Aid (CWA)

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

Face to Face an International Research Conference 10/12/2016 10/12/2016 12hrs Academic USeP- Research and Extension Division

Related Literature Review Workshop 12/11/2016 12/11/2016 8hrs Academic USeP- College of Governance & Business

Project Qualitative and Quantitative Evaluation 02/10/2016 05/10/2016 24hrs Technical Asian Disaster Preparedness Center (ADPC)

Basic DRRM Orientation (Resource Speaker) 07/29/2016 07/29/2016 8hrs Technical Malalag Cogon National High School

Project Stakeholders Sustainability Workshop 07/17/2016 07/18/2016 16hours Technical Plan International Inc

School Typhoon, Eartquake Drill (Evaluator) 07/01/2016 07/27/2016 8hours Supervisory DepEd Div. of DavaoOriental

ToT on Contingency Planning Development (Resource Speaker) 01/06/2016 03/06/2016 24hrs Technical MDRRMC - Baganga

Child Protection Policy Orientation 09/06/2016 11/06/2016 3days Technical Plan International Inc

Self Learning Kit (SLK) Evaluation and with LRMDS-XI 03/05/2016 8hrs Technical Plan International Inc

Training on Self Learning Kit Finalization 07/03/2016 11/03/2016 8hrs Technical Plan International Inc & DepEd

Midterm Project Evaluation and Learning Workshop 02/29/2016 05/03/2016 3days Managerial Asian Disaster Preparedness Center (ADPC)
School Improvementt Plan (SIP) Enhancement Training with Integration of DRR-CCA
01/12/2015 09/12/2015 9days Technical Plan International Inc & DepEd
Core Messages
Teachers Training on Self Learning Kit Development with an Integration of DRR-CCA
12/08/2015 08/16/2015 5days Technical Plan International Inc & DepEd
core messages in secondary Curriculum (Resource Speaker)
Water Search And Rescue Training (Facilitator) 11/23/2014 11/28/2014 24hours Technical Plan International Inc & LGU Baganga

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

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

Commuity Organizing and Public Speaking

Oral and Writing skils

Community Project Proposal Development,
Implementation, Monitoring and Evaluation
DRRM Training Organizer

Scientific (Qualitative and Quantitative) Researcher

Commputer literarte (Word, Excel, PPT)

Driving
(Continue on separate sheet if necessary)

SIGNATURE DATE
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 ✘

b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘

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? ________________________________
I finished project contract with Plan International Inc
________________________________
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: Tagaka-ulo Tribe
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.

ID picture taken within
the last 6 months
Angelo Hernan Melencio Cotabato City 9279451123
3.5 cm. X 4.5 cm
(passport size)
Ester Jean Pelayo, Ed.D Mati City, Davao Oriental 9127868325
With full and handwritten
Noel M. Pregon Lambajon, Baganga, Davao Oriental 9173194751 name tag and signature over
printed name
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
Computer generated
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the or photocopied picture
Philippines. I authorize the agency head/authorized representative to verify/validate the contents stated herein. is not acceptable
I agree that any misrepresentation made in this document and its attachments shall cause the filing of PHOTO
administrative/criminal case/s 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: 0111-1862654-0

ID/License/Passport No.: L03-14-000960

Signature (Sign inside the box)

Date/Place of Issuance: 06/20/2016 - Davao City

Date/Place of Issuance: 06/20/2016 - Davao City
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