CS FORM 212 (Revised 2005)

PERSONAL DATA SHEET

Print legibly. Mark appropriate boxes q with "P" and use separate form if necessary. 1. CS ID No. (to be filled up by CSC)

I. PERSONAL INFORMATION
2. SURNAME VIOLA
FIRST NAME JOHN PHILIP
MIDDLE NAME DELA FUENTE 3. NAME EXTENSION (e.g. Jr., Sr.)

4. DATE OF BIRTH (mm/dd/yyyy) 07 / 07 1994 16. RESIDENTIAL ADDRESS

5. PLACE OF BIRTH Basco, Batanes House 016, Bungad, San Pablo, Isabela

6. SEX ✘ Male Female

7. CIVIL STATUS ✘ Single Separated ZIP CODE 3329

Married Widowed 17. TELEPHONE NO. 09161555319

Others specify:
Annuled 18. PERMANENT ADDRESS
________________________
8. CITIZENSHIP Filipino Fajardo St., Kayvaluganan, Basco, Batanes

9. HEIGHT (m) 175

10. WEIGHT (kg) 80 ZIP CODE 3900

11. BLOOD TYPE O 19. TELEPHONE NO. N/A

12. GSIS ID NO. N/A 20. E-MAIL ADDRESS (if any) jpviola87@gmail.com

13. PAG-IBIG ID NO. 121186101009 21. CELLPHONE NO. (if any) 09085589021

14. PHILHEALTH NO. 01-051890165-1 22. AGENCY EMPLOYEE NO. N/A

15. SSS NO. 01-2369025-8 23. TIN 317-332-367-000

II. FAMILY BACKGROUND

24. SPOUSE'S SURNAME N/A 25. NAME OF CHILD (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME N/A

MIDDLE NAME

OCCUPATION

EMPLOYER/BUS. NAME

BUSINESS ADDRESS

TELEPHONE NO.

(Continue on separate form if necessary)

26. FATHER'S SURNAME Viola 09/20/51

FIRST NAME Candido

MIDDLE NAME Abuyo

27. MOTHER'S MAIDEN NAME

SURNAME Dela Fuente 02/28/59

FIRST NAME Honorina

MIDDLE NAME Garillo (Continue on separate form if necessary)

III. EDUCATIONAL BACKGROUND YEAR

GRADUATED
HIGHEST GRADE/ INCLUSIVE DATES OF
28. NAME OF SCHOOL DEGREE COURSE SCHOLARSHIP/
LEVEL/ ATTENDANCE
LEVEL (Write in full) ACADEMIC HONORS
UNITS EARNED
(Write in full) From To RECEIVED
(if not graduated)

(if graduated)
ELEMENTARY Basco Central School 2006 2000 2006 w/ honors from Grade 1-6

SECONDARY Batanes National Science High School 2010 2006 2010 3rd Honorable Mention
VOCATIONAL /

N/A

COLLEGE TRADE COURSE

International School of Asia and the Pacific BSBA major in IB 2014 2010 2014 Academic Distinction

Leadership Award,
Outstanding Trainee

GRADUATE STUDIES
N/A

(Continue on separate form if necessary)

Page 1 of 4
IV. CIVIL SERVICE ELIGIBILITY
29. DATE OF LICENSE (if applicable)
CAREER SERVICE/ RA 1080 (BOARD/ BAR)
RATING EXAMINATION / PLACE OF EXAMINATION / CONFERMENT
UNDER SPECIAL LAWS/ CES/ CSEE NUMBER DATE OF
CONFERMENT
RELEASE

Career Service Professional 80.07% 4/6/2014 Tuguegarao City, Cagayan Valley 05/19/2014

(Continue on separate form if necessary)

V. WORK EXPERIENCE (Include private employment. Start from your current work) GOV'T
SERVICE
30. INCLUSIVE DATES POSITION TITLE DEPARTMENT / AGENCY / OFFICE / COMPANY SALARY GRADE
(mm/dd/yyyy) MONTHLY & STEP STATUS OF
SALARY INCREMENT APPOINTMENT
(Write in full) (Write in full) (Format "00-0")
From To
(Yes / No)
11/1/2014 7/25/2016 Field Task & Escalations Consultant Teleperformance USA Inc. P 18,000 Permanent NO

Residential and Business Faults

4/28/2014 10/30/2014 Teleperformance USA Inc. P 14,000 Permanent NO
Consultant

(Continue on separate form if necessary)

CS FORM 212 (Revised 2005), Page 2 of 4
VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
INCLUSIVE DATES
31. NAME & ADDRESS OF ORGANIZATION NUMBER OF
(Write in full) (mm/dd/yyyy) POSITION / NATURE OF WORK
HOURS
From To
Tuguegarao Metropolitan Water District ( Tree Planting Activity) Volunteer
1/30/2014 1/30/2014 5.0

Red Cross Youth-Cagayan Valley Chapter Blood Donor

8/1/2013 8/1/2013 3.0

(Continue on separate form if necessary)

VII. TRAINING PROGRAMS (Start from the most recent training.)

INCLUSIVE DATES OF ATTENDANCE
32. TITLE OF SEMINAR/CONFERENCE/WORKSHOP/SHORT COURSES NUMBER OF CONDUCTED/ SPONSORED BY
(Write in full) (mm/dd/yyyy) HOURS (Write in full)
From To
Junior Confederation of Finace Assoc. Phil./
3/2/2014 3/2/2014 16.0 ISAP
1st Regional JCFAP Finance Convergence
Orix Metro Leasing and Finance Corp.
1/4/2014 1/8/2014 100.0
On the Job Training (Local Level )
BIOLINK PHARMA
10/14/2013 12/13/2013 320.0
On the Job Training (National Level )
JCFAP Cagayan Valley Chapter
9/14/2013 9/14/2013 8.0
2nd JCFAP Regional Convention
Junior Finance Executive-USLT
8/17/2013 8/17/2013 8.0
4th Regional Finance Summit
MCNP-ISAP Office of The Sudent Services
7/26/2013 7/28/2013 16.0
Leadership Camp Year 5
BSP Tuguegarao Branch
2/21/2013 2/21/2013 4.0
Role of Bangko Sentral ng Pilipinas in the Philippines Economy
JCFAP Cagayan Valley Chapter
12/1/2012 12/1/2012 8.0
1st JCFAP Regional Finance Convention
MCNP-ISAP Office of The Sudent Services
8/12/2011 8/14/2011 16.0
Leadership Camp Year 4

(Continue on separate form if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN
NON-ACADEMIC DISTINCTIONS / RECOGNITION: ASSOCIATION/ORGANIZATION
33. SPECIAL SKILLS / HOBBIES: 34. 35.
(Write in full)
(Write in full)
Campus King 2011 ( Pageant Search for Campus King and Queen 2011 during
Customer Service,Sales and Marketing, General Clerical Works. N/A
MNCP-ISAP Founding Anniversary)

Reading Novels and Articles 2nd place ( Leadership Camp Year 3 ) Challenge Mode by MCNP-ISAP

MS Office Application Specialist and advanced knowledge on PC Lecturer ( Alternative Learning Experience ) during MCNP-ISAP Foundation
operation 2013

Leadership Skills Champion (advertisement making) 2nd Regional JCFAP Convention

Playing Badminton

(Continue on separate form if necessary)

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 If YES, give details:
has immediate supervision over you in the Office, Bureau or Department where you will be _____________________________________
__________________________________________________
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,
retirement, dropped from the rolls, dismissal, termination, end of term, finished contract, AWOL YES ✘ NO
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:
__ IVATAN TRIBE OF BATANES
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.

Rommel Taytay Caloocan City, Philippines 9179301546

ID picture taken within
the last 6 months
Juliebeth Bulan San Pablo, Isabela, Philippines 9367584223 3.5 cm. X 4.5 cm
(passport size)
Sheree Deterala SJDM City, Bulacan, Philippines 9322835689
Computer generated
43. I declare under oath that this Personal Data Sheet has been accomplished by me, and is a true, correct and or xerox copy of picture
is not acceptable
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the
Philippines.

I also authorize the agency head / authorized representative to verify / validate the contents stated herein. I trust
that this information shall remain confidential. PHOTO

COMMUNITY TAX CERTIFICATE NO.

ISSUED AT SIGNATURE (Sign inside the box)

ISSUED ON (mm/dd/yyyy) DATE ACCOMPLISHED RIGHT THUMBMARK

CS FORM 212 (Revised 2005), Page 4 of 4