CS FORM 212 (Revised 2005)
Unique Applicant Number
PERSONAL DATA SHEET T15352566
1. CS ID
Print legibly. Mark appropriate boxes with " " and use separate sheet if necessary. No. (to be filled up by CSC)
I. PERSONAL INFORMATION
2. SURNAME PAPNA
FIRST NAME VEL YBONNE
MIDDLE NAME GARCIA 3. NAME EXTENSION (e.g. Jr., Sr.)
16. RESIDENTIAL ADDRESS Purok Pag-ibig, Sagasa, ESPERANZA, SULTAN
4. DATE OF BIRTH (mm/dd/yyyy) 08 / 10 / 1995
KUDARAT
5. PLACE OF BIRTH Cagayan De Oro City
6. SEX MALE FEMALE
7. CIVIL STATUS
Single Widowed ZIP CODE 9806
Married Separated
17. TELEPHONE NO.
Annuled Others, specify
_________ 18. PERMANENT ADDRESS Purok Pag-ibig, Sagasa, ESPERANZA, SULTAN
KUDARAT
8. CITIZENDSHIP Filipino
9. HEIGHT (m) 1.6256
10. WEIGHT (kg) 66 ZIP CODE 9806
11. BLOOD TYPE O+ 19. TELEPHONE NO.
12. GSIS ID NO. 20. EMAIL ADDRESS (if any) [email protected]
13. PAGIBIG ID NO. 1211-6913-3265 21. CELLPHONE NO. (if any) 9102547020
14. PHILHEALTH NO. 172514286316 22. AGENCY EMPLOYEE NO.
15. SSS NO. 09-4071253-9 23. TIN 484-499-203
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 Papna
FIRST NAME Bernard
MIDDLE NAME Pabilona
27. MOTHER'S MAIDEN NAME
MOTHER'S SURNAME Garcia
FIRST NAME Marivel
MIDDLE NAME Cabrera
III. EDUCATIONAL BACKGROUND
HIGHEST
GRADE/ INCLUSIVE DATES OF
YEAR ATTENDANCE SCHOLARSHIP/
LEVEL NAME OF SCHOOL DEGREE COURSE LEVEL/ UNITS
GRADUATED ACADEMIC HONORS
(Write in full) (Write in full) EARNED
(if graduated) RECEIVED
(if not
graduated) From To
ELEMENTARY Esperanza Central School 2006 2001 2006
Notre Dame of Esperanza
SECONDARY 2011 2006 2011
Incorporated
VOCATIONAL/ TRADE
COURSE
University of Southern
COLLEGE 2017 2011 2017
Mindanao-Kabacan
PAPNA, VEL YBONNE GARCIA - T15352566 CS FORM 212 (Revised 2005), Page 1 of 4
III. EDUCATIONAL BACKGROUND
HIGHEST
GRADE/ INCLUSIVE DATES OF
YEAR ATTENDANCE SCHOLARSHIP/
LEVEL NAME OF SCHOOL DEGREE COURSE LEVEL/ UNITS
GRADUATED ACADEMIC HONORS
(Write in full) (Write in full) EARNED
(if graduated) RECEIVED
(if not
graduated) From To
Bachelor of Science
in Secondary
Notre Dame of Kidapawan
GRADUATE STUDIES Education- 2018 21 2017 2018
College
Professional
Education
IV. CIVIL SERVICE ELIGIBILITY
29. LICENSE (if applicable)
DATE OF
CAREER SERVICE/ RA 1080 (BOARD/ BAR)
RATING EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
UNDER SPECIAL LAWS/ CES/ CSEE DATE OF
CONFERMENT NUMBER
RELEASE
LET (LICENSURE EXAMINATION FOR
84.60 09 / 30 / 2018 Kidapawan City
TEACHER)
V. WORK EXPERIENCE
30. INCLUSIVE DATES SALARY
(mm/dd/yyyy) GRADE &
DEPARTMENT / AGENCY / OFFICE / MONTHLY STATUS OF GOV'T SERVICE
POSITION TITLE (Write in full) STEP
COMPANY (Write in full) SALARY APPOINTMENT (Yes / No)
INCREMENT
From To
(Format "00-0")
06/18/2018 PRESENT Teacher Esperanza National High School 7,800 0-0 Job Order Yes
Camfind Philippines Incorporated-
04/23/2016 06/16/2018 Image Analyst 15,000 0-0 Regular No
Kidapawan
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
ASSOCIATED COUNCIL OF COMPUTER ENGINEERING STUDENTS 06 / 01 / 2011 06 / 17 / 2017 Member
INSTITUTE OF COMPUTER ENGINEERS OF THE PHILIPPINES-
06 / 01 / 2011 06 / 17 / 2017 Member
SOCCSKSARGEN
VII. TRAINING PROGRAMS (Start from the most recent training.)
32. INCLUSIVE DATES OF
ATTENDANCE
TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES NUMBER OF CONDUCTED/ SPONSORED BY
(mm/dd/yyyy)
(Write in full) HOURS (Write in full)
From To
QUARTERLY INSET AND PROFESSIONAL DEVELOPMENT FOR
06 / 02 / 2018 06 / 03 / 2018 48 Esperanza National High School
SENIOR HIGH SCHOOL TEACHERS
University of Southern Mindanao-
SEMINAR ON ARDUINO 01 / 15 / 2016 01 / 15 / 2016 8
Kabacan
SEARCH FOR MR. AND MS. COLLEGE OF ENGINEERING AND University of Southern Mindanao-
12 / 23 / 2015 12 / 23 / 2015 8
COMPUTING PASKUHAN 2015- USM KABACAN Kabacan
SEARCH FOR MR. AND MS. INSTITUTE OF COMPUTER ENGINEERS
11 / 01 / 2015 11 / 01 / 2015 8 Notre Dame of Marbel University
IN THE PHILIPPINES-SOCCSKSARGEN
SEARCH FOR MR. AND MS. COLLEGE OF ENGINEERING AND University of Southern Mindanao-
09 / 11 / 2015 09 / 11 / 2015 8
COMPUTING -USM KABACAN Kabacan
SAMSUNG MYSTIC
ON THE JOB TRAINING 04 / 15 / 2015 05 / 23 / 2015 240 ELECTRONICS SERVICE
CENTER-DAVAO CITY
World of Adventures Travel and
SEMINAR IN PAG-ASA WEATHER FORECAST-MIS-LAPU-LAPU CITY 04 / 10 / 2015 04 / 10 / 2015
Tours
World of Adventures Travel and
SEMINAR IN PLDT INNOVATION LABORATORY-CEBU CITY 04 / 10 / 2015 04 / 10 / 2015 4
Tours
SEMINAR IN MANAGEMENT INFORMATION AND COMPUTER World of Adventures Travel and
04 / 09 / 2015 04 / 09 / 2015 4
SERVIES-GIS-CEBU CITY Tours
World of Adventures Travel and
SEMINAR IN PLDT INNOVATION LABORATORY-CEBU CITY 04 / 09 / 2015 04 / 09 / 2015 4
Tours
SEMINAR IN INNODATA KNOWLEDGE SERVICES INCORPORATED- World of Adventures Travel and
04 / 08 / 2015 04 / 08 / 2015 4
MANDAUE CITY Tours
SEMINAR IN NG KHAI DEVELOPMENT CORPORATION-MANDAUE World of Adventures Travel and
04 / 08 / 2015 04 / 08 / 2015 4
CITY Tours
Kings College of Isulan
COMPUTER SYSTEMS SERVICING NCII 280
Incorporated
VIII. OTHER INFORMATION
PAPNA, VEL YBONNE GARCIA - T15352566 CS FORM 212 (Revised 2005), Page 2 of 4
33. 34. NON-ACADEMIC DISTINCTIONS / RECOGNITION: 35. MEMBERSHIP IN ASSOCIATION / ORGANIZATION
SPECIAL SKILLS / HOBBIES:
(Write in full) (Write in full)
Computer Systems Servicing NCII Passer TESDA
Microsoft Office Expert Institute of Computer Engineers of the Philippines
PAPNA, VEL YBONNE GARCIA - T15352566 CS FORM 212 (Revised 2005), Page 3 of 4
36. Are you related by consanguinity or affinity to any of the following :
a. Within the third degree (for National Government Employees): YES NO
appointing authority, recommending authority, chief of office/bureau/department or person who
has immediate supervision over you in the Office, Bureau or Department where you will be If YES, give details:
appointed? _____________________________________
_____________________________________
_____________________________________
b. Within the fourth degree (for Local Government Employees): YES NO
appointing authority or recommending authority where you will be appointed?
If YES, give details:
_____________________________________
_____________________________________
_____________________________________
37. a. Have you ever been formally charged? YES NO
If YES, give details:
_____________________________________
_____________________________________
b. Have you ever been guilty of any administrative offense? YES NO
If YES, give details:
_____________________________________
_____________________________________
38. Have you ever been convicted of any crime or violation of any law, decree, ordinance or YES NO
regulation by any court or tribunal?
If YES, give details:
_____________________________________
_____________________________________
39. 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, AWOL
or phased out, in the public or private sector? If YES, give details:
_____________________________________
_____________________________________
40. Have you ever been a candidate in a national or local election (except Barangay election)? YES NO
If YES, give details:
_____________________________________
_____________________________________
41. 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 differently abled? YES NO
If YES, please specify:_______________________
c. Are you a solo parent? YES NO
If YES, please specify:_______________________
42. REFERENCES (Person not related by consanguinity or affinity to applicant / appointee)
NAME ADDRESS TEL. NO.
Dorothy Octina Kidapawan City 9073260582
Cliff Aires Capileno Tacurong City 9368134402
Vivian Silverio Isulan Sultan Kudarat 9552533752
43. I declare under oath that this Personal Data Sheet has been accomplished by me, and is a true, correct and complete
statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the Philippines.
X
I also authorize the agency head / authorized representative to verify / validate the contents stated herein. I trust that
this information shall remain confidential. PHOTO
31317076
COMMUNITY TAX CERTIFICATE NO.
Esperanza Sultan Kudarat
ISSUED AT SIGNATURE (Sign inside the box)
2019-01-31 01 / 31 / 2019
ISSUED ON (mm/dd/yyyy) DATE ACCOMPLISHED RIGHT THUMBMARK
PAPNA, VEL YBONNE GARCIA - T15352566 CS FORM 212 (Revised 2005), Page 4 of 4
