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Uthman Bin Affan Foundation Academy Inc. Application Form

This document is an application form for Uthman Bin Affan Foundation Academy Inc. It contains personal information about the applicant such as name, date of birth, addresses, contact details, family background, educational attainment, work experience, references, and a certification statement signed by the applicant pledging that all information provided is accurate. The applicant is Shaira Micah Pacas who is applying with the goal of employment at the academy.

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Shaira MP
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152 views5 pages

Uthman Bin Affan Foundation Academy Inc. Application Form

This document is an application form for Uthman Bin Affan Foundation Academy Inc. It contains personal information about the applicant such as name, date of birth, addresses, contact details, family background, educational attainment, work experience, references, and a certification statement signed by the applicant pledging that all information provided is accurate. The applicant is Shaira Micah Pacas who is applying with the goal of employment at the academy.

Uploaded by

Shaira MP
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

UTHMAN BIN AFFAN FOUNDATION ACADEMY INC.

APPLICATION FORM

Application No.: ____________


I. PERSONAL INFORMATION

PACAS SHAIRA MICAH BARTOCES


Last name First name Middle name

APRIL 1, 1996 OROQUIETA CITY FEMALE SINGLE


Date of Birth Place of Birth Gender Civil Status

2ND FLOOR, ESG BUILDING, LLUCH ST., POBLACION, ILIGAN CITY, LANAO DEL NORTE, 9200

(Current Address) House no. Street Barangay City/ Municipal Province Zip code

BLK. 4 LOT 13, PHASE 1, TRANSVILLE VILLAFLOR, OROQUIETA CITY, MISAMIS OCCIDENTAL, 7200

(Permanent Address) House no./ street Barangay City/ Municipal Province Zip code

FILIPINO ISLAM CEBUANO N/A


Citizenship Religion Tribe Telephone No.

09954686036, 09103113727 micahpacas@[Link]


Mobile No. Email Address (if any)

II. FAMILY BACKGROUND


N/A N/A N/A N/A
Spouse’s Last Name First Name Middle Name Occupation

PACAS ROGELIO JR. DUHAYLUNGSOD


Father’s Last Name First Name Middle Name

BARTOCES JINKIE BARORO


Mother’s(Maiden) Last Name First Name Middle Name

III. EDUCATIONAL BACKGROUND

Period of
Attendace
Basic Year
Education/Degree/Course Graduated
Level Name of School
From To

Elementary ORQUIETA CITY NATIONAL SPECIAL SCIENCE 2003 2009 2009


ELEMENTARY SCHOOL PROGRAM

Secondary MISAMIS OCCIDENTAL SPECIAL SCIENCE 2009 2013 20013


NATIONAL HIGH SCHOOL PROGRAM

College MINDANAO STATE BACHELOR IN SECONDARY 2013 2017 2017


UNIVERSITY - ILIGAN EDUCATION major in
INSTITUTE OF TECHNOLOGY AND
TECHNOLOGY LIVELIHOOD EDUCATION

Graduate MINDANAO STATE LAW 2019 ONGOING N/A


Studies UNIVERSITY - ILIGAN
INSTITUTE OF
TECHNOLOGY

Others TESDA COOKERY (NCII) 2019 2019

Government /Licensing Exam Passed

LICENSURE FOR TEACHERS BOARD EXAMINATION


Professional Certifications

COOKERY NC II

Membership in Professional Organizations, Associations, etc.

RISALE-I NUR INSTITUTION (volunteer)

GPA (Grade Point Average)

2.05

IV. SCHOLASTIC INFORMATION

Academic achievements, honors, awards received in college/university

N/A

Have you ever been convicted of a felony?

[ ] YES [*] NO

V. WORK EXPERIENCE (Include private employment.)

Department/ Agency/ Office/ Company Position Employment Period Monthly Salary

(write in full)

CUSTOMER 2017-2018 15,000


SERVICE
TELEPERFORMANCE REPRESENTATIVE

APPLESEED MONTESSORI PRESCHOOL 2018 18,000


PRESCHOOL TEACHER

SILVER EDGE MEDIA SEO SPECIALIST 2019 15,000


VI. REFERENCES (Person not related by consanguinity or affinity to applicant/appointee)

Name Address Telephone. No.

ILIGAN CITY, LANAO DEL NORTE 09480653822

MA. JEANIFER TROCIO

JELLA MAE GARCIA QUEZON CITY, METRO MANILA 09773694014

OROQUIETA CITY, MISAMIS 09569329892


OCCIDENTAL
JINKIE B. PACAS

VII. CERTIFICATION

I hereby certify that I have read and fully understood all the instructions regarding my application for admission to
Uthman Bin Affan Foundation Academy Inc. and that the informations stated in this application form are correct and
complete. I understand that incomplete or inaccurate information could be prejudiced to my application. If accepted as an
employee of UBAFAI, I agree to abide all its policies and regulations.

11/20/2019
APPLICANT’S SIGNATURE DATE

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