CS Form No.

212
Revised 2017
COMMON MISTAKE (not
misinterpretation) 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 SANTOS
NAME EXTENSION (JR., SR) N/A
FIRST NAME ARIANE

MIDDLE NAME ABAD

3. DATE OF BIRTH
2/8/1986 16. CITIZENSHIP
(mm/dd/yyyy) ✘ Filipino Dual Citizenship
by by
4. PLACE OF BIRTH Fd.Rd. # 3 Sto. Tomas, Davao If holder of dual citizenship,
birth naturalization
Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female
PRK 9 FD. RD # 3
6 CIVIL STATUS Single ✘ Married 17. RESIDENTIAL ADDRESS
House/Block/Lot No. Street
Widowed Separate
N/A TIBAL-OG
Other/s: d Subdivision/Village Barangay
STO. TOMAS DAVAO DEL NORTE
7. HEIGHT (m) 5'3"
City/Municipality Province
8. WEIGHT (kg) 48kg ZIP CODE 8112
18. PERMANENT ADDRESS PRK 9 FD. RD # 3
9. BLOOD TYPE B+
House/Block/Lot No. Street
N/A TIBAL-OG
10. GSIS ID NO. N/A
Subdivision/Village Barangay
STO. TOMAS DAVAO DEL NORTE
11. PAG-IBIG ID NO. 1210-9476-0000
City/Municipality Province
12. PHILHEALTH NO. 16-0200000000-4 ZIP CODE 8112

13. SSS NO. 09-2932000-7 19. TELEPHONE NO. N/A

14. TIN NO. 438-110-525-000 20. MOBILE NO. 099999599

15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) ariane@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME SANTOS 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR) N/A
FIRST NAME RICHARD N/A N/A

MIDDLE NAME LABAWAN

OCCUPATION N/A

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME ABAD

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

MIDDLE NAME CALIPUSAN

25. MOTHER'S MAIDEN NAME

SURNAME VISTAL

FIRST NAME YOLANDA

MIDDLE NAME SALAMANCA (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

HIGHEST
NAME OF SCHOOL BASIC EDUCATION/DEGREE/COURSE SCHOLARSHIP/
26. PERIOD OF ATTENDANCE LEVEL/ YEAR
ACADEMIC
LEVEL (Write in full) UNITS GRADUATED
HONORS
(Write in full) EARNED
From To RECEIVED
(if not graduated)
STO.TOMAS CENTRAL ELEMENTARY
ELEMENTARY
SCHOOL
ELEMENTARY 1993 1998 GRADUATED 1998 N/A
VOCATIONAL /
SECONDARY TEMPLE CHRISTIAN SCHOOL HIGH SCHOOL 1998 2003 GRADUATED 2003 N/A

N/A N/A N/A N/A N/A N/A N/A

BACHELOR OF SCIENCE IN HOTEL AND
COLLEGE TRADE UNIVERSITY OF MINDANAO 2003 2007 GRADUATED 2007 N/A
COURSE RESTAURANT MANAGEMENT

UNIVERSITY OF MINDANAO BACHELOR OF SECONDARY EDUCATION 2012 2012 27 UNITS N/A N/A
MASTER IN INTERNATIONAL HOSPITALITY
GRADUATE STUDIES UNIVERSITY OF MINDANAO
AND TOURISM MANAGEMENT
2015 2015 15 UNITS N/A N/A
(Continue on separate sheet if necessary)

SIGNATURE DATE
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

LICENSURE EXAMINATION FOR TEACHERS 80.0 05/20/2021 DAVAO CITY 123456 3/8/2023

---NOTHING FOLLOWS---

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

1/5/2016 PRESENT SENIOR HIGH SCHOOL TEACHER HOLY CROSS COLLEGE OF SASA 4000.00 N/A CONTRACTUAL N

1/10/2009 04/30/2021 COLLEGE TEACHER HOLY CROSS COLLEGE OF SASA 4000.00 N/A CONTRACTUAL N

06/012015 03/20/2020 ASSESSMENT CENTER MANAGER HOLY CROSS COLLEGE OF SASA 13000.00 N/A REGULAR N

1/5/2009 03/30/2010 TEACHER MATS COLLEGE OF TECHNOLOGY 5000.00 N/A CONTRACTUAL N

1/5/2008 03/30/2009 TEACHER DAVAO WINCHESTER COLLEGE 5000.00 N/A CONTRACTUAL N

---NOTHING FOLLOWS---

(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
NAME & ADDRESS OF ORGANIZATION INCLUSIVE DATES
29. (Write in
full) (mm/dd/yyyy) NUMBER OF 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
TITLE OF LEARNING AND DEVELOPMENT ATTENDANCE Type of LD
30. ( Managerial/ CONDUCTED/ SPONSORED BY
INTERVENTIONS/TRAINING PROGRAMS NUMBER OF HOURS
Supervisory/
(mm/dd/yyyy) (Write in full)
(Write in full) Technical/etc)
From To
HOUSEKEEPING NCII 01/16/2021 03/26/2021 471 Technical Holy Cross College of Sasa
FOOD AND BEVERAGE SERVICES NCII 07/10/2020 09/01/2020 391 Technical Holy Cross College of Sasa
Facilitating eLearning Session (Region. XI) 07/31/2020 07/31/2020 8 hours Technical Virtual Conference
Practicing COVID-19 Preventive Measure in the 11/12/2020 11/12/2020 2 hours Technical Virtual Conference
Workplace
Orientation on the implementation of the JDVP-TVl for Apo View hotel, J. Camus Extension, Davao
SY 2019-2020 cum presentation of best practice a 12/19/2020 12/20/2020 16 hours Supervisory
City
benchmark for improvement
2020 admintrators conferecne cum Launching of national 10/3/2020 11/3/2020 16 hours Managerial Grand Regal Hotel, Davao City
Women's Month celebration
Competency Assesor's Orientation
4/2/2019 4/2/2019 8 hours Managerial TESDA City/Sur Provincial Office Davao City

Provincial Assesors and Trainers consultation/Forum 02/18/2019 02/18/2019 8 hours Managerial Waterfront Insular Hotel, Davao City
Co-cares for implementers of Assesment and Regional Training Center-KPVTC, Buhisan
11/28/2018 11/29/2018 16 hours Managerial
Certification process Tibungco, Davao City
Nationwide Information Caravan for RA 10931 2/5/2018 2/5/2018 8 hours Supervisory USEP gymnasium Bo. Obrero Davao City
2018 Administrators' Course cum Capability Building 05/21/2017 05/22/201 16 hours Managerial Marco Polo Davao
Deployment of new procedures Manual on Competency
12/5/2017 12/5/2017 8 hours Managerial Garden Oases, Obrero Davao City
Assessment and Certification (CAC)
Capability building on TVET reports preparation and
12/20/2017 12/20/2017 8 hours Managerial Garden Oases, Obrero Davao City
TVET capacity orientation workshop
2017 Admintrators' Conference and Capability Building
02/27/2017 02/28/2017 8 hours Managerial Eden Nature Park and Resort Davao City
cum GAD program
Assessment center Managers' Forum 08/25/2017 08/25/2017 8 hours Managerial Garden Oases, Obrero Davao City
Shaken and Stirred 01/27/2017 01/27/2017 8 hours Managerial Holy Cross College of Sasa
15th Human resource and skills Development
9/8/2016 11/8/2016 24 hours Managerial Philippine gateway Hotel, Surigao City
Conference
A Culinary and skills challenge 1/9/2016 2/9/2016 16 hours Managerial KCC Mall Conveniton Center
Seminar Workshop on Front Office Services 6/12/2016 6/12/2016 8 hours Managerial Holy Cross College of Sasa
Seminar Workshop on Housekeeping Services 11/17/2016 11/17/2016 8 hours Managerial Holy Cross College of Sasa
Seminar-Workshop on Event Management 01/23/2015 01/23/2015 8 hours Managerial Holy Cross College of Sasa
HOUSEKEEPING NCIII 08/08/2016 11/22/2016 391 Technical TECHNICAL SCHOOL
TRAINERS METHODOLOGY LEVEL 1 01/20/2014 01/13/214 160 hours Technical BELLMEC
---NOTHING FOLLOWS--

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION MEMBERSHIP IN

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

(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 ✘ 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
YES ✘ NO
regulation 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 If YES, give details:
phased out (abolition) in the public or private sector? ________________________________
Resignation
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year
YES ✘ NO
(except Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before YES ✘ NO
the last 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
a.
items:
Are you a member of any indigenous group?
YES ✘ NO
If YES, please specify:
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
GRETCHEN REYES DAVAO CITY 099999999 3.5 cm. X 4.5 cm
(passport size)

DEC VINCENT M. RAMOS DAVAO CITY 099999999 With full and handwritten
name tag and signature over
printed name
JIOSELBIO M. FLORES DAVAO CITY 099999999
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
is not acceptable
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 PHOTO
filing of 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: TIN

ID/License/Passport No.: 438-320-555-000

Signature (Sign inside the box)

Date/Place of Issuance: 07/11/2013

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