Академический Документы
Профессиональный Документы
Культура Документы
1. CS ID No.
I. PERSONAL INFORMATION
2. SURNAME FIRS NAME MIDDLE NAME 4. DATE OF BIRTH (mm/dd/yy) 5. PLACE OF BIRTH 6. SEX 7. CIVIL STATUS
B E B O S O E R N E S T Q U I J A N O
February 1, 1974 PAGADIAN CITY
16. RESIDENTIAL ADDRESS
J O Y
3. NAME EXTENSION (e.g. Jr., Sr.)
N/A
Male Single
7016 N/A
0235 LUMBIA DISTRICT, PAGADIAN CITY ZAMBOANGA DEL SUR REGION 9
/
8. CITIZENSHIP 9. HEIGHT (m) 10. WEIGHT (kg) 11. BLOOD TYPE 12. GSIS ID NO. 13. PAG-IBIG ID NO. 14. PHILHEALTH NO. 15. SSS NO.
Married Annulled
FILIPINO 1.75 METERS 89 KLG O N/A N/A N/A N/A ALCANO BEMIA SNOOKY RAAGING STUDENT N/A N/A N/A
(Coninue on separate sheet if necessary)
ZIP CODE 19. TELEPHONE NO. 20. E-MAIL ADDRESS (If any) 21. CELLPHONE NO. (If any) 22. AGENCY EMPLOYEE NO. 23. TIN
DAVE LAURENCE S BEBOSO N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
May 13, 1994 N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A
(Coninue on separate sheet if necessary) YEAR HIGHEST GRADE/ INCLUSIVE DATES OF SCHOLARSHIP/ CEGREE COURSE GRADUATED LEVEL/ ATTENDANCE ACADEMIC HONORS (Write in full) (If graduated) UNITS EARNED RECEIVED From To (If not graduated)
ZSSAT
N/A
TRADE COURSE
N/A
N/A
N/A
N/A
N/A
N/A
N/A
COLLEGE
BSAeE
1996
184 UNITS
SY 92-93 SY 95-96
N/A
GRADUATE STUDIES
N/A
N/A
N/A
N/A
N/A
N/A
N/A
CIVIL SERVICE FIRE OFFICER N/A N/A N/A N/A N/A N/A
V. WORK EXPERIENCE (Include private employment. Start from your current work)
30 INCLUSIVE DATES (mm/dd/yyyy)
From To
1-Jul-10 1-Jul-09 1-Apr-09 1-Jul-08 1-Jan-07 1-Jan-06 20-Jul-05 1-Jan-05 1-Jan-04 1-Jan-03 26-Aug-02 16-Apr-02 23-Jan-02 1-Jul-01
27-May-11 30-Jun-10 30-Jun-09 31-Mar-09 30-Jun-08 31-Dec-06 31-Dec-05 19-Jul-05 31-Dec-04 31-Dec-03 31-Dec-02 25-Aug-02 15-Apr-02 22-Jan-02
F02/DRIVER F02/DRIVER F02/DRIVER F01/DRIVER F01/DRIVER F01/DRIVER F01/DRIVER F01/DRIVER F01/DRIVER F01/DRIVER F01/DRIVER FO1/PSBRC TRAINEE FO1/DRIVER FO1/DRIVER
BFP, PAGADIAN FIRE STATION BFP, PAGADIAN FIRE STATION BFP, PAGADIAN FIRE STATION BFP, PAGADIAN FIRE STATION BFP, PAGADIAN FIRE STATION BFP, PAGADIAN FIRE STATION BFP, PAGADIAN FIRE STATION SANTIAGO FSS, PAGADIAN CITY SANTIAGO FSS, PAGADIAN CITY SANTIAGO FSS, PAGADIAN CITY SANTIAGO FSS, PAGADIAN CITY FNTI, CALAMBA, LAGUNA LUMBIA FSS, PAGADIAN CITY LUMBIA FSS, PAGADIAN CITY
13,785 12,210 10,466 9,466 8,605 8,605 6,695 6,695 5,987 5,775 5,775 5,775 5,775 5,775
I2-2 I2-2 1O-1 1O-1 1O-1 1O-1 1O-1 1O-1 1O-1 6-O 6-O 6-O 6-O 6-O
PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT
YES YES YES YES YES YES YES YES YES YES YES YES YES YES
1-Dec-00 10-Oct-00 1-Jan-00 10-Dec-99 1-Dec-99 2-Aug-99 N/A N/A N/A N/A N/A N/A
30-Jun-01 30-Nov-00 9-Oct-00 31-Dec-99 9-Dec-99 30-Nov-99 N/A N/A N/A N/A N/A N/A
FO1/NOZZLEMAN/DRIVER FO1/DRIVER FO1/ALT. DRIVER FO1/ALT. DRIVER FIRE OFFICER 1 FO1/ PSBRC ORIENTATION N/A N/A N/A N/A N/A N/A
LUMBIA FSS, PAGADIAN CITY LUMBIA FSS, PAGADIAN CITY KOLAMBUGAN FS,LDN KAPATAGAN FS, LDN ORFM, BFP R-9 BFP, NATIONAL OFFICE N/A N/A N/A N/A N/A N/A
(Continue on separate sheet if necessary)
5,500 5,500 5,500 5,000 5,000 5,000 N/A N/A N/A N/A N/A N/A
6-O 6-O 6-O 6-O 6-O 6-O N/A N/A N/A N/A N/A N/A
PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT PERMANENT N/A N/A N/A N/A N/A N/A
YES YES YES YES YES YES N/A N/A N/A N/A N/A N/A
N/A N/A N/A N/A N/A VII. TRAINING PROGRAMS (Start from the most recent training.)
32 TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES (Write in full)
NUMBER OF HOURS
36. Are you related by consanquinity or affinity to any of the following: a. Within the third degree (for National Government Employees): 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 appointed? YES NO
b. Within the fourth degree (for Local Government Employees): appointing authority or recommending authority where you will be appointed?
YES
NO
NO
N/A N/A
b. Have you ever been guilty of any administrative offense? YES If YES, give details NO
N/A N/A
38. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation by any court or tribunal? YES
NO
N/A
N/A
39. Have you ever been separated from the service in any of the following modes: resignation, retirement, dropped from the rolls, dismissal, termination, end of term, finished contract, AWOL or phased out, in the public or private sector? YES
NO
N/A N/A
40. Have you ever been a candidate in a national or local election (except Barangay election)?
YES
NO
N/A N/A
41. Pursuant to: (a) Indigenous People's Act (RA 8371); (b) Magna Carta for Disabled Persons (RA 7277); and Solo Parents Welfare Act of 2000 (RA 8972), please answer the following items: a. Are you a member of any indigenous group? b. Are differently abled? c. Are you a solo parent? YES YES YES
If YES, please specify: If YES, please specify: If YES, please specify: 42. REFERENCES (Person not related by consnquinity or affinity to applicant / appointee) NAME ADDRESS TEL. NO.
/ / /
NO
NO NO
ID picture taken within the last 6 months 3.5 cm. X 4.5 cm (passport size)
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 Philipiines.
Computer generated or xerox copy of picture is not acceptable
I also authorize the agency head / authorized representative to verify / validate the contents stated herein. I trust that this information shall remain confidential.
PHOTO
1094334
COMMUNITY TAX CERTIFICATE NO.
up by CSC)
/A
mm/dd/yyyy)
994
N/A
N/A
N/A
N/A
N/A
N/A
age 1 of 4
plicable)
DATE OF
RELEASE
YES YES YES YES YES YES YES YES YES YES YES YES YES YES
YES YES YES YES YES YES N/A N/A N/A N/A N/A N/A
age 2 of 4
WORK
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