CS Form No. 212 Personal Data Sheet Revised
CS Form No. 212 Personal Data Sheet Revised
CS Form No. 212 Personal Data Sheet Revised
212
Revised 2017
I. PERSONAL INFORMATION
2. SURNAME FERRER
NAME EXTENSION (JR., SR)
FIRST NAME SHARMAINE CAMILLE
15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) [email protected]
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME N/A 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
OCCUPATION N/A
SURNAME CABALONA
ELEMENTARY CALAPANDAYAN ELEMENTARY SCHOOL ELEMENTARY GRADUATE 2002 2008 N/A 2008 N/A
SECONDARY /
VOCATIONAL SUBIC NATIONAL HIGH SCHOOL HIGH SCHOOL GRADUATE 2008 2012 N/A 2012 N/A
N/A N/A
TRADE
COURSE
COLLEGE SUBIC BAY COLLEGES, INC. BACHELOR OF SCIENCE IN CRIMINOLOGY 2013 2017 N/A 2017 N/A
1/9/2020 05/26/2022 PRODUCTION OPERATOR BUCHAN GLOBAL SERVICES, CO. 16,000 REGULAR N/A
ACHIEVERS MANPOWER MANAGEMENT
02/15/2020 06/17/2020 ADMIN SPECIALIST 12,000 CONTRACTUAL N/A
SERVICES, INC
ANTI-TERRORISM IN THE PHILIPPINES 07/29/2016 07/29/2016 8.0 DR. REYNALDO CASTILLO, PH. D
FIRST AIDER
BASKETBALL
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘
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
by any court or tribunal? YES ✘ NO
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? ________________________________
________________________________
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:
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:
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
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 filing of PHOTO
administrative/criminal case/s against me.
SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.