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APPLICATION FORM
(PLEASE USE CAPITAL LETTERS)
Position applied for: ENGLISH TEACHER
PERSONAL DATA
Name EUNICE JOY C. BALGANION
Place/Date of Birth CAUAYAN CITY, ISABELA / AUGUST 28, 1987
Sex Male Female
Address HARI’S JUNKSHOP, PUROK 1, WACAL, SOLANO, NUEVA VIZCAYA
City Postal Code 3709
Home Phone No. Mobile No. 0906-324-3327
E-mail
[email protected]Religion ROMAN CATHOLIC
Nationality FILIPINO
Marital Status Single Married Divorced
Foreign Language(s) 1. ENGLISH ● Oral: Excellent ● Written: Excellent
2. ● Oral: Excellent/Good/Poor ● Written: Excellent/Good/Poor
EDUCATIONAL BACKGROUND
Type of Duration Certificate
No. Institution & City Field of Study
Education From To Yes No
1. SD
2. SMP
3. SMA
4. Univ/Acad/ SAINTMARY’S UNIVERSITY BSED-ENGLISH 2004 2008
Undergr
5. Tertiary/Postgrad SAINT MARY’S UNIVERSITY MAT-ENGLISH 2012 2016
JOB-RELATED TRAINING
No. Title of Training Institution & City Duration Certificate
From To Yes No
CAPACITY BUILDING FOR SOLANO HIGH SCHOOL 1/31/2022 2/4/2022 YES
TEACHERS
REGIONAL TRAINING FOR REGION 2 DEPED 1/17/2022 1/21/2022 YES
DEAF AND MUTE
SPED TRAINING FOR SDO-NUEVA VIZCAYA 5/3/2018 5/7/2018 YES
GRADE SCHOOL
SPED TRAINING FRO SDO-NUEVA VIZCAYA 3/2/2018 3/5/2018 YES
SECONDARY
FAMILY DATA
Siblings: including yourself, if your siblings are more than 3, please insert row(s).
No. Family member Name Place/Date of Birth Occupation
1. Father PAQUITO L. CUNTAPAY REINA MERCEDES, NONE
ISABELA JUNE 11, 1963
2. Mother NATIVIDAD M. ZIPAGAN CAUAYAN ISABELA/ NONE
DECEMBER 24, 1953
3. Sibling 1 EUGENE ROSS Z. CUNTAPAY REINA MERCEDES, STORE MANAGER
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ISABELA/ MARCH 26, 1989
4. Sibling 2 EUMINA JEAN Z. CUNTAPAY REINA MERCEDES BUSINESS WOMAN
ISABELA/ JANUARY 12,
1995
5. Sibling 3
Numbers 6-11 are to be filled in if you are married. If you have more than 3 children, please insert row(s)..
No. Family member Name Place/Date of Birth Occupation
6. Spouse DINDO BALGANION BAGGAO, CAGAYAN / PNP
DECEMBER 19, 1985
7. Child 1 EUHARI DIN C. BALGANION BAYOMBONG, NUEVA
VIZCAYA/ NOVEMBER 17,
2017
8. Child 2
9. Child 3
10. Father-in-law
11. Mother-in-law
Contact persons in an emergency
No. Name Address and phone number Relationship
1. DINDO BALGANION SOLANO, NUEVA VIZCAYA 09167245303 HUSBAND
2.
3.
HEALTH HISTORY (Please record any serious illness you have had, e.g. malaria, typhoid, etc.)
No. Year Type of Sickness
1. NONE
2.
3.
Do you have any health problems that may affect your work? Yes/No
If yes, give details.
__________________________________________________________________________________________
EMPLOYMENT HISTORY (starting from the last position)
1. Company Name DEPED-NUEVA VIZCAYA
2. Address
SOLANO, NUEVA VIZCAYA
3. Position held 1. TEACHER III From To
2. From To
4. Last Salary 33, 596.00
5. Main Responsibility 1. HANDLE SPED LEARNERS.
2. FACILITATES SPED TECAHERS.
3. MONITORS TEACHING AND LEARNING
4.
6. Reason for Resignation GREENER PASTURE.
1. Company Name
2. Address
3. Position held 1. From To
2. From To
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4. Last Salary
5. Main Responsibility 1.
2.
3.
4.
6. Reason for Resignation
1. Company Name
2. Address
3. Position held 1. From To
2. From To
4. Last Salary
5. Main Responsibility 1.
2.
3.
4.
6. Reason for Resignation
CAREER PLANNING
Explain briefly the career you wish to pursue.
I WISH TO EXPLORE MY TECAHING STRATEGIES AND MORE OF MY POTENTIALS IN ORDER FOR ME TO
EMBRACE THE CALLING AND VOCATION OF HANDLING THE LESS FORTUNATE LEARNERS.
ORGANIZATIONAL ACTIVITIES & INTERESTS
a. Organizations
No. Name of organization/activities/political parties Duration (year...– year...) Position held
FACULTY AND EMPLOYEES ASSOCIATION
b. Hobbies
REFERENCES (Please give 2 names. Family/relatives CANNOT be used for a reference)
1. Name MELANY M. ASUNCION
Company DEPED
Position EPS-1
Address QUEZON, NUEVA VIZCAYA
Phone 09171871309
2. Name MENALYN SALVADOR
Company DEPED
Position SCHOOL PRINCIPAL 1
Address SOLANO, NUEVA VIZCAYA
Phone 09171145267
If applicable, please mention the name(s) of friends/relatives currently working for Sekolah Victory Plus.
No. Name Relationship Department
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POSSIBLE STARTING DATE
Please indicate the date you can start to work for SVP The data I have given in this form is true. If the data given
here is false, I agree that I will resign from my position
Signature
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