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CS FORM 212 (Revised 2005)

Unique Applicant Number

PERSONAL DATA SHEET T15186837


Print legibly. Mark appropriate boxes with " " and use separate sheet if necessary. 1. CS ID No.
(to be filled up by CSC)

I. PERSONAL INFORMATION
2. SURNAME MONTALBAN
FIRST NAME PRECIOUS MAY
MIDDLE NAME JUMAWID 3. NAME EXTENSION (e.g. Jr., Sr.)

03 / 10 / 1996 16. RESIDENTIAL ADDRESS TAMBOAN, CARMEN, BOHOL


4. DATE OF BIRTH (mm/dd/yyyy)

5. PLACE OF BIRTH Marilao, Bulacan


6. SEX MALE FEMALE

7. CIVIL STATUS
Single Widowed ZIP CODE 6319
Married Separated
17. TELEPHONE NO.
Annuled Others, specify
_________ 18. PERMANENT ADDRESS Tamboan, CARMEN, BOHOL

8. CITIZENDSHIP Filipino
9. HEIGHT (m) 149
10. WEIGHT (kg) 45 ZIP CODE 6319
11. BLOOD TYPE O+ 19. TELEPHONE NO.

12. GSIS ID NO. 20. EMAIL ADDRESS (if any) preciousmaymontalban@yahoo.com


13. PAGIBIG ID NO. 21. CELLPHONE NO. (if any) 09070480833
14. PHILHEALTH NO. 22. AGENCY EMPLOYEE NO.

15. SSS NO. 23. TIN 334675173-0000


II. FAMILY BACKGROUND
24. SPOUSE'S SURNAME 25. NAME OF CHILD (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME

MIDDLE NAME

OCCUPATION

EMPLOYER/BUS. NAME

BUSINESS ADDRESS

TELEPHONE NO.

(Continue on separate sheet if necessary)

26. FATHER'S SURNAME Montalban

FIRST NAME Cornelio Jr.

MIDDLE NAME Quibon

27. MOTHER'S MAIDEN NAME

MOTHER'S SURNAME Jumawid

FIRST NAME Linda

MIDDLE NAME Calamba

III. EDUCATIONAL BACKGROUND


HIGHEST INCLUSIVE DATES OF
YEAR GRADE/
SCHOLARSHIP/
LEVEL NAME OF SCHOOL DEGREE COURSE LEVEL/ UNITS ACADEMIC HONORS
GRADUATED ATTENDANCE
(Write in full) (Write in full) (if graduated) EARNED RECEIVED
(if not
graduated) From To

2002-06- 2008-03-
ELEMENTARY Bagbaguin Elementary School 2008 TOP 5
04 28

Meycauayan National High 2011-03-


SECONDARY 3 2008-06
School 25

2011-06- 2012-03-
Saint Anthony's Academy 5th honors
2012 02 30

VOCATIONAL/ TRADE 2013-06- 2014-04-


Batuan Colleges Inc. Housekeeping NC II 2014 10 07
COURSE

Bachelor Secondary 2012-06- 2016-03- Cum Laude


COLLEGE Batuan Colleges Inc. Education 2016 04 16
MONTALBAN, PRECIOUS MAY JUMAWID - T15186837 CS FORM 212 (Revised 2005), Page 1 of 4
III. EDUCATIONAL BACKGROUND
HIGHEST
GRADE/ INCLUSIVE DATES OF
YEAR SCHOLARSHIP/
LEVEL NAME OF SCHOOL DEGREE COURSE LEVEL/ UNITS ATTENDANCE
GRADUATED ACADEMIC HONORS
(Write in full) (Write in full) (if graduated) EARNED RECEIVED
(if not
graduated) From To

GRADUATE STUDIES

IV. CIVIL SERVICE ELIGIBILITY


29.
CAREER SERVICE/ RA 1080 (BOARD/ BAR) DATE OF LICENSE (if applicable)
UNDER SPECIAL LAWS/ CES/ CSEE RATING EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
DATE OF
CONFERMENT NUMBER
RELEASE
LET (LICENSURE EXAMINATION FOR
81.6 09 / 25 / 2016 Cebu, City 2653481 12/20/2016
TEACHER)

V. WORK EXPERIENCE
30. INCLUSIVE DATES SALARY
(mm/dd/yyyy) DEPARTMENT / AGENCY / OFFICE / MONTHLY GRADE &
STATUS OF GOV'T SERVICE
POSITION TITLE (Write in full) STEP
COMPANY (Write in full) SALARY INCREMENT APPOINTMENT (Yes / No)
From To
(Format "00-0")

VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S


31. INCLUSIVE DATES
NAME & ADDRESS OF ORGANIZATION (mm/dd/yyyy) NUMBER OF POSITION / NATURE OF WORK
(Write in full) HOURS
From To

Mother Butler Mission Guilds Philippines Batuan Church 2015-09-20 Present 1 Mother Butler

VII. TRAINING PROGRAMS (Start from the most recent training.)


32. INCLUSIVE DATES OF
ATTENDANCE
TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES (mm/dd/yyyy) NUMBER OF CONDUCTED/ SPONSORED BY
(Write in full) HOURS (Write in full)
From To

Off-Campus Teaching 01 / 06 / 2016 03 / 30 / 2016 475 Camayaan National High School

Portable Learning Management Sytem 11 / 28 / 2015 11 / 28 / 2015 8 Batuan Colleges Inc.

Department of Labor and


Employment and Bohol
Pre-Employment Orientation Seminar (PEOS) 09 / 22 / 2015 09 / 22 / 2015 8
Employment and Placement
Office

English Enhancement Seminar 02 / 25 / 2015 02 / 25 / 2015 8 Batuan Colleges Inc.

Teaching in the 21st Century 09 / 27 / 2014 09 / 27 / 2014 8 Batuan Colleges Inc.

The Wildlife in the Jungle 08 / 18 / 2014 08 / 18 / 2014 1 Batuan Colleges Inc.

K-12 Teaching Strategies and Assessment 01 / 25 / 2014 01 / 25 / 2014 8 Batuan Colleges Inc.

Department of Labor and


Employment and Bohol
Pre-Employment Orientation Seminar (PEOS) 08 / 08 / 2013 08 / 08 / 2013 8
Employment and Placement
Office

Housekeeping NC II 06 / 21 / 2013 04 / 07 / 2014 436 TESDA, DOLE

Catholic Educators Formation Seminar 03 / 09 / 2013 03 / 09 / 2013 8 Batuan Colleges Inc.

Basic School Paper Production Training 08 / 13 / 2012 08 / 14 / 2012 16 Batuan Colleges Inc.

Civil Welfare Training Service (CWTS 2) 06 / 01 / 2012 03 / 22 / 2013 1 Batuan Colleges Inc.

VIII. OTHER INFORMATION


33. 34. 35. MEMBERSHIP IN ASSOCIATION /
NON-ACADEMIC DISTINCTIONS / RECOGNITION:
SPECIAL SKILLS / HOBBIES: ORGANIZATION
(Write in full)
(Write in full)
Mother Butler Mission Guilds Philippines Batuan
Housekeeping NC II Skill 1st place in Gen. Info in 21st Foundation Anniversary of BCI
Church

dancing 1st place in Chess in 19th Foundation Anniversary of BCI


singing 1st place in Math Sci Quiz in Math-Sci day of BCI
MONTALBAN, PRECIOUS MAY JUMAWID - T15186837 CS FORM 212 (Revised 2005), Page 2 of 4
VIII. OTHER INFORMATION
33. 34. 35. MEMBERSHIP IN ASSOCIATION /
NON-ACADEMIC DISTINCTIONS / RECOGNITION:
SPECIAL SKILLS / HOBBIES: ORGANIZATION
(Write in full)
(Write in full)

playing basic flute 1st place in Mind Maze in Math-Sci day of BCI

ICT skill 3rd place in Gen. Info in 20th Foundation Anniversary of BCI

3rd place in Chess in 20th Foundation Anniversary of BCI

3rd place in Gen. Info in Buwan ng Wika of BCI

MONTALBAN, PRECIOUS MAY JUMAWID - T15186837 CS FORM 212 (Revised 2005), Page
3 of 4

36. Are you related by consanguinity or affinity to any of the following :

YES NO
1. Within the third degree (for National Government Employees):
appointing authority, recommending authority, chief of office/bureau/department or person who has
If YES, give details:
immediate supervision over you in the Office, Bureau or Department where you will be appointed?
_____________________________________
_____________________________________
_____________________________________
__________________ ___________________
__________________ _____________________________________
b. Within the fourth degree (for Local Government Employees): _
b. Have you ever been guilty of any administrative offense?
37. a. Have you ever been formally charged?
appointing authority or recommending authority where you
will be appointed?
If YES, give details: If YE
_____________________________________ If YES, give details: _____________________________________
_____________________________________ __________________ _____________________________________
any court YES NO ______________________
38.Have you ever been or _______________
convicted of any crime or tribunal? If YES, give details:
violation of any law, decree,
_____________________________________
ordinance or regulation by
any wing modes: resignation, retirement, public or YESgive details: _______
39.Have you ever of dropped from the rolls, dismissal, private sector? ___________________ _______
been separated the termination, end of term, finished __________________ ____
If YES,
from the service in follo contract, AWOL or phased out, in the ___________________
_____________________________________
s ( n n P
40. Have you ever been a candidate in a national or local election (except Barangay election)?
u t a d o e
41.P a o ) i u o
u n
If YES, give details: : g s p
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_____________________________________ I e l
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' M e a e t
a. Are you a member of any indigeno
s a d n l 8 h
g d f 9 e
A n P a 7 If YES, please
c a e ( r 2 f specify:____________________
t r c e ) o ___
C s ) , l b. Are you differently abled?
( a o A l
R r n S c p o
A t s o t l w If YES, please
a l e i specify:____________________
___
8 ( o o a n
3 f R f s g c. Are you a solo parent?
7 o A P e
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If YES, please
) 7 r 0 a t
specify:____________________
; D 2 e 0 n e
___
i 7 n 0 s m
( s 7 t w s 42. REFERENCES (Person not
b a ) s ( e : related by consanguinity or
) b ; R r affinity to applicant / appointee)
l Philippines.
a
Dr. Consolacion D. Vinluan,
w Ed.D.
I also authorize
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the agency
Mr. Nemesio B. Calacat, M.A.Ed.D.
,
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Brgy. Capt. Manuel L. Valentosauthorized
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29273087

COMMUNITY TAX CERTIFICATE NO.

Tamboan, Carmen, Bohol

ISSUED AT SIGNATURE (Sign inside the box)

2017-01-27 01 / 27 / 2017

ISSUED ON (mm/dd/yyyy) DATE ACCOMPLISHED RIGHT THUMBMARK

MONTALBAN, PRECI JUMAWID - T15186837