CS Form No.

212
Revised 2017

PERSONAL DATA SHEET

WARNING: Any misrepresentation made in the Personal Data Sheet and the Work Experience Sheet shall cause the filing of administrative/criminal case/s against the person
concerned.
READ THE ATTACHED GUIDE TO FILLING OUT THE PERSONAL DATA SHEET (PDS) BEFORE ACCOMPLISHING THE PDS FORM.
Print legibly. Tick appropriate boxes ( ) and use separate sheet if necessary. Indicate N/A if not applicable. DO NOT ABBREVIATE. 1. CS ID No. (Do not fill up. For CSC use only)

I. PERSONAL INFORMATION
2. SURNAME Pablo
NAME EXTENSION (JR., SR) N/A
FIRST NAME Sharlene Lynnette
MIDDLE NAME Espinoza
3. DATE OF BIRTH
(mm/dd/yyyy) 04/17/1991 16. CITIZENSHIP ✘ Filipino Dual Citizenship
by by
birth naturalization
4. PLACE OF BIRTH Brgy. Bagumbayan Llanera Nueva If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Female

6 CIVIL STATUS
✘ Single Married 17. RESIDENTIAL ADDRESS 324 Labiano
Widowe Separat House/Block/Lot No. Street

d ed Bagumbayan
Other/s: Subdivision/Village Barangay
7. HEIGHT (m) 1.49 Llanera Nueva Ecija
City/Municipality Province
8. WEIGHT (kg) 50 ZIP CODE 3126
9. BLOOD TYPE "A" 18. PERMANENT ADDRESS 324 Labiano
House/Block/Lot No. Street

10. GSIS ID NO. N/A Bagumbayan

Subdivision/Village Barangay

11. PAG-IBIG ID NO. N/A Llanera Nueva Ecija

City/Municipality Province

12. PHILHEALTH NO. N/A ZIP CODE 3126

13. SSS NO. N/A 19. TELEPHONE NO. (044)-958-6924
14. TIN NO. 741869385000 20. MOBILE NO. +639265735376
15. AGENCY EMPLOYEE NO. N/A 21. E-MAIL ADDRESS (if any) shyne.pablo@gmail.com
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME None 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME None None N/A
MIDDLE NAME None
OCCUPATION N/A
EMPLOYER/BUSINESS NAME N/A
BUSINESS ADDRESS N/A
TELEPHONE NO. N/A
24. FATHER'S SURNAME Pablo
NAME EXTENSION (JR., SR)
FIRST NAME Noemi
MIDDLE NAME Corpuz
25. MOTHER'S MAIDEN NAME Espinoza
SURNAME Pablo
FIRST NAME Miriam
MIDDLE NAME Moises (Continue on separate sheet if necessary)

III. EDUCATIONAL BACKGROUND

NAME OF SCHOOL HIGHEST LEVEL/ SCHOLARSHIP/
26. PERIOD OF ATTENDANCE YEAR
BASIC EDUCATION/DEGREE/COURSE UNITS ACADEMIC
LEVEL (Write in EARNED
GRADUATED
(Write in full) HONORS
full) (if not graduated) RECEIVED
From To

WITH
ELEMENTARY Llanera Central School Elementary 6/6/2005 7/4/2011 2011
HONORS

SECONDARY /
VOCATIONAL Llanera National High School High School 6/6/2011 03/27/2015 2015

N/A N/A N/A N/A

TRADE Bachelor of Secondary

COURSE
COLLEGE Wesleyan University-Philippines Education Major in 1/8/2016 01/24/2020 2020
Master English
of Arts in
GRADUATE STUDIES Wesleyan University-Philippines Education Major in 8/2/2021 Present 12
English
(Continue on separate sheet if necessary)

SIGNATURE DATE March 26, 2021

CS FORM 212 (Revised 2017), Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
27. CAREER SERVICE/ RA 1080 (BOARD/ BAR) UNDER DATE OF LICENSE (if applicable)
RATING
SPECIAL LAWS/ CES/ CSEE EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
(If Applicable) NUMBER Date of
BARANGAY ELIGIBILITY / DRIVER'S LICENSE CONFERMENT
Validity

N/A N/A N/A N/A N/A N/A

(Continue on separate sheet if necessary)

V. WORK EXPERIENCE
(Include private employment. Start from your recent work) Description of duties should be indicated in the attached Work Experience sheet.
GOV'T
28. INCLUSIVE DATES SALARY/ JOB/ PAY SERVICE
POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY GRADE (if
(mm/dd/yyyy) MONTHLY STATUS OF
(Write in full/Do not (Write in SALARY
applicable)& STEP
APPOINTMENT
(Format "00-0")/
abbreviate) full/Do not abbreviate) INCREMENT
From To
(Y/ N)

01/27/2020 present Junior and Senior High School Charles Angel Montessori School 5000.00 Full time Y

2/4/2019 present Online English Tutor Bibo Global Opportunity, Inc. 5000.00 Part time N

1/5/2017 04/25/2019 Online English Tutor 51Talk English International, Inc. 5000.00 Part time N

(Continue on separate sheet if necessary)

SIGNATURE DATE March 26, 2021

CS FORM 212 (Revised 2017), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
INCLUSIVE DATES
29. NAME & ADDRESS OF ORGANIZATION
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

Department of Social Welfare and Development Home for Girls July 1, 2019 July 31, 2019 Alternative Learning System Tutor

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
INCLUSIVE DATES OF
ATTENDANCE Type of LD
30. TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS ( Managerial/ CONDUCTED/ SPONSORED BY
NUMBER OF HOURS
(Write in full) Supervisory/ (Write in full)
(mm/dd/yyyy)
Technical/etc)
From To

Helping teachers talk to parents: A2 Key, B1 Preliminary and B2 First - for Schools exams 03/23/2021 03/23/2021 1 hour Technical Cambridge Assessment English
Receiving and Responding to Workplace Communication 10/3/2021 10/3/2021 Technical
TESDA
ICTeach:"Information and Communications Technology Integration in Education 02/19/2021 02/28/2021 80 hours Technical
Chain Rinivarts Training Center
SEAMEO-Partners Lecture Series on Innovative Teaching Solutions 4/2/2021 4/2/2021 1 hr., 30 mins. Technical
SEAMEO
Introducing new Teacher Guides supporting learners with dyslexia 02/16/2021 02/16/2021 1 hour Technical
Cambridge Assessment English
ICTeach:"Information and Communications Technology Integration in Education 01/25/2021 3/2/2021 80 hours Technical
Chain Rinivarts Training Center
New year, new ideas: How to teach an exam class for Pre A1 starters, A1 Movers, A2 Flyers 01/16/2021 01/16/2021 1 hour Technical
Cambridge Assessment English
Developing self-access materials for your hybrid classroom 1/12/2020 1/12/2020 1 hour Technical
Cambridge Assessment English
2020 In-Service Training (INSET) for Senior High School Teachers on Teaching SHS Core
09/24/2020 09/26/2020 24 hours Technical
Subjects in a Flexible Class Private Education Assistance Committee
2020 In-Service Training (INSET) for Junior High School Teachers on Ensuring Enduring Student
Learning Outcomes with Online Distance Learning and Teaching of K-12 Standards in the Time of 09/21/2020 09/23/2020 24 hours Technical
COVID-19
Private Education Assistance Committee
Computer Literacy Training Program 1/7/2013 09/15/2013 32 hours Technical Unitech Educational Program Corporation

(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION
31. SPECIAL SKILLS and HOBBIES 32. 33. (Write in
(Write in full)
full)

Drawing and sketching One of the the active volunteers for ALS Tutorial N/A

Reading articles and journals

Writing poems

Playing guitar

Making DIY projects

Playing crime riddles

(Continue on separate sheet if necessary)

SIGNATURE DATE March 26, 2021

CS FORM 212 (Revised 2017), Page 3 of 4
 34. Are you related by consanguinity or affinity to the appointing or recommending authority, or to the
chief of bureau or office or to the person who has immediate supervision over you in the Office,
Bureau or Department where you will be apppointed,
a. within the third degree? YES ✘

b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘

If YES, give details:

________________________________

35. a. Have you ever been found guilty of any administrative offense? YES ✘ NO
If YES, give details:
________________________________
________________________________
b. Have you been criminally charged before any court? YES ✘ NO
If YES, give details:
________________________________
Date Filed:
________________________________
Status of Case/s:

36. Have you ever been convicted of any crime or violation of any law, decree, ordinance or regulation
YES ✘ NO
by any court or tribunal?
If YES, give details:
________________________________
________________________________
37. 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 or phased If YES, give details:
out (abolition) in the public or private sector? ________________________________
________________________________
38. a. Have you ever been a candidate in a national or local election held within the last year (except
YES ✘ NO
Barangay election)?
If YES, give details:
b. Have you resigned from the government service during the three (3)-month period before the last YES ✘ NO
election to promote/actively campaign for a national or local candidate? If YES, give details:
39. Have you acquired the status of an immigrant or permanent resident of another country?
YES ✘ NO
If YES, give details (country):

40. 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 a person with disability? YES ✘ NO
If YES, please specify ID No:
c. Are you a solo parent? YES ✘ NO
If YES, please specify ID No:

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

NAME ADDRESS TEL. NO.

ID picture taken within
the last 6 months
Melba Joy B. Talens Bongabon Senior High School 4.5 cm. X 3.5 cm
(passport size)

Computer generated
or photocopied picture
is not acceptable

42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the
Philippines. I authorize the agency head/authorized representative to verify/validate the contents stated herein.
I agree that any misrepresentation made in this document and its attachments shall cause the filing of PHOTO
administrative/criminal case/s against me.

Government Issued ID (i.e.Passport, GSIS, SSS, PRC, Driver's License, etc.)

PLEASE INDICATE ID Number and Date of
Issuance
Government Issued ID: TIN

ID/License/Passport No.: 741869385000

Signature (Sign inside the box)
March 26, 2021
Date/Place of Issuance: Talavera City, Nueva Ecija
Date Accomplished Right Thumbmark

SUBSCRIBED AND SWORN to before me this , affiant exhibiting his/her validly issued government ID as indicated above.

Person Administering Oath

CS FORM 212 (Revised 2017), Page 4 of 4