CAReeR eXeCUTIVe SeRVICe BOARD No. 3 Marcelino St., Holy Spirit Drive, Quezon City Tel. Nos. 951-9!1 or !5 "trun#line$ loc. 11! an% !3& Website" ###"cesboard"$ov"ph CES Written Examination Application Form IMPORTANT: '()D TH( *N+T,C( T+ )--.,C)NT/ 0(.+1 0(2+'( )CC+M-.,SH,N3 TH,S 2+'M D+ N+T )--.4 ,2 4+5 )'( N+T Q5).,2,(D.
NOTICE TO APPLICANT 1. )n applicant 6ust 7e a 2ilipino Citizen o8 9oo% 6oral c:aracter an% possesses t:e 8ollo;in9 re<uire6ents= A. Government Sector, Career Service ).1 He>s:e 6ust :ave 7een appointe% to a C(S position? or ).& He>s:e 6ust :ave 7een %esi9nate% in an )ctin9 Capacity or +88icer-,n-C:ar9e "+,C$ o8 a C(S position 8or at least si@ "A$ 6ont:s? or ).3 He>s:e 6ust :ave 7een appointe% to at least a Division C:ie8 position "S3-&$ an% possesses at least t;o "&$ years 6ana9erial e@perience. B. Government Sector, Non Career Service He>s:e 6ust :ave 7een appointe% to a non-career position ;:et:er un%er coter6inous or contractual status in any %epart6ent or a9ency o8 t:e 9overn6ent ;it: at least t:ree "3$ years 6ana9erial e@perience, an% :as serve% t:e 9overn6ent 8or t:e sa6e perio% at t:e ti6e o8 :is>:er application? provi%e% :e>s:e 6ust :ave 7een occupyin9 a position e<uivalent or :i9:er t:an a Division C:ie8 "S3-&$. C. Private Sector +utstan%in9 6en>;o6en 8ro6 outsi%e t:e 9overn6ent 6ay 7e allo;e% to ta#e t:e ;ritten e@a6ination? provi%e% :e>s:e 8alls un%er any o8 t:e 8ollo;in9 cate9ories= C.1 ) proprietor ;:o is per8or6in9 6ana9erial>supervisory 8unctions 8or at least t:ree "3$ years? an%, C.& )n incu67ent o8 a 6ana9erial position e@ercisin9 supervisory 8unctions, as %e8ine% un%er t:ese rules, 8or a 6ini6u6 perio% o8 t:ree "3$ years. &. The following oc!ment" "hall accom#an$ thi" a##lication form !#on filing: A. Co#$ of a##ointment #a#er to present position aut:enticate% 7y t:e o88ice personnel > a%6inistrative o88icer? B. Service recor aut:enticate% 7y t:e o88ice personnel>a%6inistrative o88icer? a C. Co#$ of the e"ignation orer %uly aut:enticate% 7y t:e o88ice personnel>a%6inistrative o88icer in case t:e applicant is presently %esi9nate% in an actin9 capacity or o88icer-in-c:ar9e o8 a C(S position 8or at least si@ "A$ 6ont:s? %. Organi&ational Chart s:o;in9 t:e applicant/s place in t:e or9anization an% %uly certi8ie% 7y t:e +88ice -ersonnel> )%6inistrative +88icer? '. Three ()* ientical #hotogra#h", ("i&e +, - +,* ;it: 8ull na6e ta9 t:at inclu%es t:e surna6e, 8irst na6e an% 6i%%le initial ta#en not 6ore t:an si@ "A$ 6ont:s 7e8ore t:e 8ilin9 o8 t:e application. +nly t;o "&$ o8 t:e t:ree "3$ &B @ &B p:oto9rap:s s:all 7e su76itte% upon 8ilin9 o8 t:e application. T:e applicant s:all #eep t:e t:ir% &B @ &B p:oto9rap: an% s:all 7rin9 t:e sa6e on t:e %ay o8 t:e e@a6ination 8or postin9 in t:e e@a6inee seat plan. -ictures t:at are scanne%, p:otocopie% or co6puter-en:ance% ;ill not 7e accepte%? .. Ami""ion fee of ON' T/O0SAN% P'SOS "P1,222.22$ eit:er in C)SH or in -+ST). M+N(4 +'D(' paya7le to t:e C)'((' (C(C5T,D( S('D,C( 0+)'D. P'RSONA3 C/'C4S 5I33 NOT B' ACC'PT'%6 G. Photoco#$ of a vali Ientification Car (I%* containin9 t:e applicant/s picture, si9nature, 7irt: %ate an% si9ne% 7y t:e )ut:orize% +88icial? /. Sel8-sta6pe% envelope ;it: co6plete 6ailin9 a%%ress? an%, I. .on9, 7ro;n envelope 3. -lease 6a#e sure t:is 8or6 is co6pletely 8ille% up. +nly applications ;it: co6plete re<uire6ents, i.e. ite6s ), 0, C, D, (, 2, 3, H an% , ;ill 7e processe%? . )pplications t:at ;ill 7e su76itte% a8ter t:e %ea%line ;ill auto6atically 7e inclu%e% in t:e 7atc: o8 applications t:at ;ill 7e processe% 8or t:e ne@t e@a6 sc:e%ule? an%,
5. )cco6plis:e% application 8or6s 6ust 7e 8ile% %irectly ;it: t:e Career '-ec!tive Service Boar, No. 3 Marcelino St., Holy Spirit Drive, Dili6an, Quezon City eit:er personally or 7y 6ail. 2or in<uiries, you 6ay contact Tel. nos. 7819:7 ;1 or ;8 (Tr!n<line* local" 11; = ;)+
Note: A##licant" who fail to meet the c!t9off9"core ma$ >e allowe to reta<e the te"t onl$ after "i- (?* month" rec<one from the ate of hi"@her la"t e-amination. Recent 2 x 2 Photo THIS FOR IS NOT FOR SALE. REPRO!"CTION IS ALLOWE!. A. PERSONAL CIRC"STANCES 1" S%R&'ME F(RS) &'ME M(**+E &'ME 2" &ame of ,ffice a!d ,ffice 'ddress (please i!dicate the -ip code)
Forei$! 'ffairs Scie!ce A )ech!olo$y I. ELI)I#ILIT7 AC8"IRE! +Ci*il Ser*ice2#oar02#ar Examination& Pa&&e0/ )itle *ate )a;e! lace Rati!$ 4. ANA)EENT AN! SPECIAL TRAININ)2S ATTEN!E! )itle <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< Spo!sor <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< (!clusive *ates <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< @e!ue <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< )itle <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< Spo!sor <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< (!clusive *ates <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< @e!ue <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< $. OTHER INFORATION 2." /ave you ever bee! dismissed from a!y employme!t> forced to resi$!> or other#ise discipli!ed as a result of a! admi!istrative caseD (f EyesF> state the !ature of the char$e a!d pe!alty"
24" *o you have a!y pe!di!$ admi!istrative or crimi!al caseD <<<<< (f EyesF> state the !ature of the case a!d #here it is pe!di!$" 26" /ave you ever bee! arrested> accused or co!victed for a!y violatio! of la# or ordi!a!ce before a!y court> or have you bee! char$ed #ith or tried for a!y breach or i!fractio! of military> or police discipli!e before a!y tribu!al or authorityD (f EyesF> state the !ature of the char$e a!d pe!alty" 27" /ave you ta;e! the CES Writte! E3am beforeD <<<<<<<<< (f EyesF> please specify the date2s" <<<<<<<<<<<<<<<<<<<<<<<< TO B' .I33'%90P BA T/' /'A% O. P'RSONN'3@A%MINISTRATIB' %'PARTM'NT Note: .or tho"e e"ignate in an acting ca#acit$ or officer9in9charge of a C'S #o"ition. This is to certify that Mr./Ms. ____________________________ of this Agency/Office has been in an acting capacity or officer-in- charge of a Career Executive Service (CES position for at !east six (" #onths. EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE N)M( an% )DD'(SS +2 )3(NC4>+22,C( N)M( F -+S,T,+N +2 H()D +2 -('S+NN(.>)DM,N,ST')T,D( D(-)'TM(NT "Si9nature over -rinte% Na6e$ TO B' .I33'%90P BA T/' /'A% O. P'RSONN'3@A%MINISTRATIB' %'PARTM'NT Note: .or tho"e occ!#$ing %ivi"ion Chief (SG9+:* an other managerial #o"ition" in the career@non9career "ervice (government "ector* an tho"e in the #rivate "ector. This is to certify that Mr./Ms. ____________________________ of this Agency/Office has been perfor#ing supervisory/ #anageria! functions (i.e. $irecting % approving &or' outputs of e#p!oyees( $e!egating functions to the staff( #onitoring % rating e#p!oyees) perfor#ance base$ on $u!y approve$ perfor#ance targets( % supervising the unit/$ivision base$ on the staffing pattern/organi*ationa! structure+ an$ supervising/#anaging _____________ staff for ____________ years no&. (nu#ber of staff (nu#ber of years EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE EEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEEE N)M( an% )DD'(SS +2 )3(NC4>+22,C( N)M( F -+S,T,+N +2 H()D +2 -('S+NN(.>)DM,N,ST')T,D( D(-)'TM(NT "Si9nature over -rinte% Na6e$ L. NAE2S 5 POSITION OF S"PERIOR2S <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<
<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< NAES 5 POSITION OF S"#OR!INATES <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< <<<<<<<<<<<<<<<<<<<<<<<<<<<<<< NAE AN! POSITION OF HEA! OF PERSONNEL2 A!INISTRATI3E !EPARTENT (Signat!re over Printe Name* . TESTIN) CENTER PREFERENCE (ReGuest for cha!$e i! testi!$ ce!ter is !ot allo#ed) Ma!ila Cebu *avao *ate of E3ami!atio! I DECLARE UNDER THE PENALTIES OF PERJURY THAT THIS APPLICATION HAS BEEN ACCOMPLISHED IN GOOD FAITH, VERIFIED BY ME AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, IS A TRUE, CORRECT AND COMPLETE STATEMENT PURSUANT TO THE PROVISIONS OF PERTINENT LAWS, RULES AND REGULATIONS OF THE REPUBLIC OF THE PHILIPPINES. I LIKEWISE AGREE THAT I WILL SUBJECT MYSELF TO A VALIDATING EXAMINATION IN CASE THE TEST RESULTS IN MY PLACE OF EXAMINATION ARE FOUND TO BE STATISTICALLY IMPROBABLE. Appli!"#$% P&i"#'( N!)'* +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Bi&#,(!#'* ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ S'-* +++++++++++++++++++ Si."!#/&'* ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ DATE * ++++++++++++++++++++ + TIME* ++++++++++++++CENTER* +++++++++++++++++++++++++++ SCHOOL*+++++++++++++++++++++++++++ ADDRESS*+++++++++++++++++++++++++++++++++++++++ ROOM N0.++++
Si$!ature of 'pplica!t *ate Ri.,# T,/)1)!&2 S/1%&i1'( !"( %30&" #0 1'40&' )' #,i% ++++++++ (!5 04 ++++++++++++++++++ 6788. ADMINISTERING OFFICER POSITION/OFFICE (ri!ted &ame2Si$!ature) NOTE( )he 'dmi!isteri!$ ,fficer may be o!e of the follo#i!$1 O44i' P'&%0""'l 0& A()i"i%#&!#i9' O44i'&, L'.!l O44i'&, H'!( 04 A.'"5 0& N0#!&5 P/1li. :D0 "0# 4ill;/p #,i% p0&#i0". F0& P&0'%%0&/% 0"l5< 'C)(,& )':E&1 'R,@E* H I *(S'R,@E* H I *')E<<<<<<<<<<< <<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<<< ri!ted &ame a!d Si$!ature of rocessor A P P L I C A T I O N R E C E I P T :T,i% %'&9'% !% ! N0#i' 04 A()i%%i0"< Appli!#i0" N0. ++++++ R''i9'( #,' !ppli!#i0" 40& #,'* CES WRITTEN EXAMINATION P&i"#'( N!)' 04 P&0'%%0&* +++++++++++++++++++++++++ Si."!#/&' 04 P&0'%%0&* +++++++++++++++++++++++++++++ D!#' R''i9'(/P&0'%%'(* ++++++++++++++++++++++++++ ! a t e (
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Recent 2 x 2 Photo #RIN) THE FOLLOWIN) ON E%AINATION !A7( 9./ )his 'pplicatio! ReceiptJ 2./ @alid ,ffice (de!tificatio! Card ((*)J :./ e!cil (Mo!$ol &o" 2)J ;./ RulerJ <./ ,!e (1) 2F 3 2F photo$raphJ =./ Calculator (Calculators from Cellular ho!es> erso!al *i$ital 'ssista!t (*') a!d similar $ad$ets shall !ot be allo#ed)" REIN!ERS( 1" Examinee& are re>,ire0 to ?e at the examination *en,e ?' @A. )ardi!ess a!d2or failure of the applica!t to prese!t his2her applicatio! receipt #ill be a sufficie!t $rou!d to disGualify him2her from ta;i!$ the e3ami!atio!" 2. '! applica!t #ho fails to prese!t a valid ,ffice (de!tificatio! Card (("*") #ill !ot be allo#ed to ta;e the e3ami!atio!" :. ' Gualified applica!t #ho failed to receive his2her 'pplicatio! Receipt five (4) days before the date of e3ami!atio! should !otify the Career E3ecutive Service 5oard at &o" 0 Marceli!o St"> /oly Spirit *rive> *ilima!> Kue-o! City or may co!tact )el" &os" 941L.9 81 or 84 ()ru!;li!e) locals 118 A 802" ;. The Examination Fee o. P9-AAA.AA &hall ?e .or.eite0 i! case of !o!Lappeara!ce of the applica!t duri!$ the e3ami!atio! day" <. ReGuest for cha!$es must be made i! #riti!$ t#o (2) #ee;s before the e3ami!atio! schedule" =. lease bri!$ s!ac;s"