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Application Form

National Youth Commission

Government Internship Program
Control No. Date of Application:

A. PERSONAL DATA

NAME: PADILLA MARK JUMIL TEÑAFLOR

(Last Name, First Name Middle Name)

ADDRESS: PUROK 2, BALUGO, IMELDA, ZAMBOANGA SIBUGAY, REGION IX, PHILIPPINES

BIRTHDAY: 25-Mar-98 BIRTH PLACE: MALANGAS POLYMEDIC HOSPITAL

AGE: 20 SEX: MALE CIVIL STATUS: SINGLE

RELIGION: TEL. / CP NO. 09556655014/09106947018

PWD: YES NO
EMAIL ADDRESS: codenamesoftdog@gmailc.com
If married:
Name of spouse: Occupation:

Children:

NAME AGE

FATHER'S NAME: RAMIL M. PADILLA AGE: DECEASED OCCUPATION:

MOTHER'S NAME: JUDY T. PADILLA AGE: 42 OCCUPATION: HOUSEWIFE

B. EDUCATION

Name of School Degree Earned Inclusive Dates

Elementary BALUGO ELEMENTARY SCHOOL

Secondary IMELDA NATIONAL HIGH SCHOOL

Vocational

College WESTERN MINDANAO STATE UNIVERSITY - IMELDA EXTERNAL STUDIES UNIT

C. WORK EXPERIENCE

Company / Office Position Monthly Salary Inclusive Dates

MSWDO SPES-GRANTEE
D. TRAININGS ATTENDED

TITLE PERIOD
N/A N/A

(Note: You may answer questions in Filipino)

1. What are your Special Skills?

I AM COMPUTER LITERATE AND INTERNET LITERATE. SOMEHOW, I CAN ALSO DANCE.

2. Are you currently enrolled right now? If yes, please check the days and indicate the time
schedule of your classes. _______
Monday Friday
Tuesday Saturday
Wednesday Sunday
Thursday

3. How did you come to know about the National Youth Commission (NYC)?

walk-in applicant media sources

referral, pls. specify others, pls. specify:
internet portals

4. What do yo expect to learn from the NYC?

I WOULD LOVE TO LEARN DIFFERENT THINGS THAT WOULD ENABLE ME TO TRANFORM MYSELF HOLISTICALLY.

5. If hired as trainee under the Government Internship Program (GIP), what can be your
contributions to NYC?
ALTHOUGH I AM RECENT COLLEGE GRADUATE, I CAN ONLY GIVE MY KNOWLEDGE, SKILLS AND COMMITMENT.

6. Have you been hired as GIP trainee before (YES) (NO)? If yes, please indicate office and
period/s?
NO

The undersigned hereby attest that the information and statement herein are true and accurate to the best of
my knowledge. It is my understanding that any falsification as may be found by the NYC shall disqualify my
application or cancel my participation in the Government Internship Program (GIP).

Moreover, the undersigned expressly authorizes the National Youth Commission or its representatives to use,
share and process my personal information (provided for official purposes) in this form/document/site as
they may be applicable.
Date Signature over printed name