For Personnel Administration Department Use Only

Preliminary Screening by:

Date of Exam:
Place of Exam :

Result :

Level :

Given by :
Proficiency :
APPLICATION FOR EMPLOYMENT
File Code:
Instructions:
Applicant No.:
1. Please fill out the application form in your own handwriting. Please write legibly.
Expected Monthly Salary:
2. Indicate only work experience and trainings that can be authenticated/documented.
3. Attach the following:
a.Photocopy of Civil Service Eligibility/Board or Bar Rating.(Original to be presented.)
b.Photocopy of Transcript of Records/ (Original to be presented)
Recent 1X1 I.D. Picture
Position Applied For: Date Available for Employment:
How did you hear about us? (Please check one) Advertisement Family Friend Jobfair Jobstreet
Engr. Eduardo N. pReyes Jr.
LANDBANK Website Leaflets/Posters Employee Referral:______________ Others: _________________
Last Name First Name Middle Name Nickname: Civil Status:
Antonio Florence Villena Foren Married
Current Address: Permanent Address:
144 Dike Valdefuente, Cabanatuan City, Nueva Ecija 144 Dike Valdefuente, Cabanatuan City, Nueva Ecija
Place of Birth: Phone No.: Mobile No.: Gender: Religion:
Cabanatuan City 09334949377 09334949377 Male TCJCLDS(Mormons)
Citizenship: Email Address: Height: Weight:
Filipino Dual engrforenantonio@gmail.com 167 cm 75 kg
If Dual Citizenship, please indicate:____________________________

EDUCATION
Type Inclusive Year Name of School and Address Honors / Awards

1989 1995 Valdefuente Elementary School, Cabanatuan City Salutatorian

Elementary

High School 1995 1999 Nueva Ecija University of Science&Technology, Cabanatuan City

Inclusive Year Name of School and Address Degree / Major Course Honors / Awards
Nueva Ecija University of Science Bacheclor of Science in
College 1999 2004 and Technology , Cabanatuan City Mechanical Engineering

Graduate Studies

GOVERNMENT AND PROFESSIONAL EXAMINATION/S

CIVIL SERVICE PROFESSIONAL ELIGIBILITY

Date Place Rating

PROFESSIONAL LICENSE (PRC Board) Date Place Rating

Mechanical Engineer Board Examination April 2005 Metro Manila 74.5%

PROFESSIONAL CERTIFICATION
Date Place Rating
(CFA, CIA, CISA, CEFIMS, etc.)

EMPLOYMENT RECORD Present and Past Employment Record (in chronological order, last position first)
(Use additional sheets as necessary.) Dept./Unit of
Assignment / Major
Inclusive Dates Position Employer and Address Basic Salary Functions
Senior Mechanical JFE Techno Manila Incorporated, Logistics & Crane Division/
March 2010 present Design Engineer II San Antonio,Ortigas Center,Pasig City Php 47,000 Senior Design Engineer

December March South Plant Maintenance First in Colors Incorporated, D&L Industries, Maintenance & Project Engr.
2006 2010 Engineer/Supervisor Bagumbayan, Libis, Quezon City Php 15,000 Pollution Control Officer

May September Science Research Philippine Rice Research Institute, REMD, CAD
2006 2006 Analyst Maligaya, Nueva Ecija Php 12,000 Design Detailer
August April Lupao Machine Shop,
2005 2006 Technician Lupao Nueva Ecija Php 7,000 Repair Technician

TRAININGS Indicate all trainings/seminars attended, special studies taken, scholarships enjoyed
(Use additional sheets as necessary.)
Title of Seminar and Training Where When No. of Training Hours
Provincial Manpower
Auto Electricity Vocational Course and Training Center(TESDA) April 1-May 30, 2001 240 hours
Provincial Manpower April 1-May 30, 2002
Auto Engine Vocational Course and Training Center(TESDA) 240 hours
Provincial Manpower
Auto Underchassis Vocational Course and Training Center(TESDA) April 1-May 30, 2003 240 hours
Provincial Manpower
AutoCAD Advance and Training Center(TESDA) November -March 2003 160 hours
FAMILY BACKGROUND (Complete the following information.)
Father Mother
Leopoldo Casita Antonio
Name:___________________________________________ Anita Villena Antonio
Name:______________________________________________
63
Age: ___________ 62
Age: ___________
144 Dike Valdefuente, Cabanatuan City, Nueva Ecija 144 Dike Valdefuente, Cabanatuan City, Nueva Ecija
Present Address:___________________________________ Present Address:_____________________________________
Senior Agriculturist/Government Employee(Retired)
Occupation:_______________________________________ Senior Agriculturist/Government Employee(Retired)
Occupation:_________________________________________
Philippine Rice Research Institute,
Agricultural training Institute, Bataan
Employer and Address:_______________________________ Maligaya, Nueva Ecija
Employer and Address:________________________________
Bachelor of Science in Agriculture
College Degree:___________________________________ Bachelor of Science in Agriculture
College Degree:______________________________________
Central Luzon State University
College/University:_________________________________ Central Luzon State University
College/University:____________________________________
Science City of Munoz, Nueva Ecija
School Address:___________________________________ Science City of Munoz, Nueva Ecija
School Address:______________________________________
Employer and
Name Age Present Address Occupation
Spouse Address
Gemma Magallon Antonio 38 144 Dike Valdefuente, Cabanatuan City, Nueva Ecija Housewife

Name Age Present Address School or Occupation (for those employed)

(Use additional sheets as necessary.)
Siblings Marie Ann Antonio Go 39 Toronto,Canada Central Luzon State University
Hazel Villena Antonio 36 Auckland , New Zealand University of the Philippines
Name Age Present Address School or Occupation (for those employed)
(Use additional sheets as necessary.)
Children Athena Magallon Antonio 10 144 Dike Valdefuente, Cabanatuan City, Nueva Ecija

Florenz Leopold Magallon Antonio 5 144 Dike Valdefuente, Cabanatuan City, Nueva Ecija

Are you related to any former and/or current official or employee of LANDBANK:
a.) within the third degree of consanguinity (i.e. mother/father, Have you ever been a respondent in any administrative
son/daughter,brother/sister, nephew/niece, uncle/aunt, case or accused of any criminal case? Yes No
grandparent, grandchild)? Yes No If yes, please provide specific details below or in a
If yes, give name/s of relative/s and relationship/s separate sheet.
_________________________________________________ ____________________________________________________
_________________________________________________ ____________________________________________________

b.) within the third degree of affinity (i.e mother-in-law/ ____________________________________________________

father-in-law, son-in-law/ daughter-in-law, brother-in-law/
sister-in-law)? Yes No
If yes, give name/s of relative/s and relationship/s
_________________________________________________
_________________________________________________
c.) other relative/s not specified in items a and b?
If yes, give name/s of relative/s and relationship/s
_________________________________________________
_________________________________________________
EXTRA-CURRICULAR / BUSINESS OR COMMUNITY INVOLVEMENT
(Use additional sheets as necessary.)
Position Organization / Event
____________________________________________________
____________________________________________________
Do you have any physical disability or previous sickness?
Yes No
If yes, please provide specific details below or in a
Yes No separate sheet.
____________________________________________________
____________________________________________________
____________________________________________________
Period

OTHER INFORMATION
SPECIAL TECHNICAL SKILLS:
AutoCAD Drawings Detail Design, Inventor 3D Modelling, Femap/Nastran Analysis Software Proficient, TEKLA Structures 3D Sotware Proficient, Icad 3D Software, Machines/Equipments Troubleshooting
___________________________________________________________________________________________________
SPORTS, HOBBIES AND INTERESTS: Badminton, Researching the internet, Stock Market Trading
___________________________________________________________________________________________________
APPLICANT UNDERTAKING & WAIVER
I understand that this application form does not constitute an offer of employment by the Land Bank of the Philippines and that any offer by the
Personnel Administration Department following submission of this application will be subject to verification of my personal information and sensitive
personal information, previous employment records, court records, community activities or dealings and will be contingent upon my satisfactorily passing
a physical examination by the Bank. Any false information given by me or concealment of relevant personal information or sensitive personal information
may be considered as material misrepresentation and will be a ground for the Bank to terminate my services in case I am employed. Furthermore, I
hereby hold the Bank free from any liability in any manner whatsoever for aggravation of any pre-existing medical condition whether disclosed or not that
may take place during my employment with the Bank.

I hereby knowingly, voluntarily and fully give my consent to the collection, recording, organization, storage, modification, retrieval, use, consolidation, and
such other processing that may be made by the appropriate authorities of the Bank of my personal information, sensitive personal information and/or
privileged information, including but not limited to my personal and family background, educational, employment and professional history, financial and
personal credit status, court and government records, medical findings and all other information that may be relevant to the determination of my physical,
mental and psychological fitness to be employed by, or remain employed in, the Bank and to undertake a particular task or activity inherent or necessary to
the nature of the work or position I may be considered for selection and placement as well as for future personnel movements.

21st
Witness my signature this _______day August
of ______________________ 20- , in the City of Manila
20____

Florence V. Antonio
_______________________________________________
Applicant's Signature Over Printed Name
Name:_______________________________________
APPLICATION FOR EMPLOYMENT (additional sheet)
EMPLOYMENT RECORD Present and Past Employment Record (in chronological order, last position first)
Dept./Unit of Assignment/
Inclusive Dates Position Employer and Address Basic Salary Major Functions

TRAININGS Indicate all trainings/seminars attended, special studies taken, scholarships enjoyed
No. of Training
Title of Seminar and Training Where When Hours

FAMILY BACKGROUND (Complete the following regarding your family.)

Name Age Present Address School or Occupation (for those employed)

Siblings

Name Age Present Address School or Occupation (for those employed)

Children

EXTRA-CURRICULAR / BUSINESS OR COMMUNITY INVOLVEMENT

Position Organization / Event Period