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 OLIDIANA
NAME EXTENSION (JR., SR)
FIRST NAME RYAN

MIDDLE NAME DARIANGAN

3. DATE OF BIRTH
(mm/dd/yyyy) 4/3/1992 16. CITIZENSHIP ✘ Filipino Dual Citizenship
by
by naturalization
birth
4. PLACE OF BIRTH BOGO, CEBU If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX ✘ Male Female

6 CIVIL STATUS
✘ Single Married 17. RESIDENTIAL ADDRESS LOVERSLANE
Widowed Separated House/Block/Lot No. Street
NAILON
Other/s:
Subdivision/Village Barangay
BOGO CITY CEBU
7. HEIGHT (m) 164 CM
City/Municipality Province
8. WEIGHT (kg) 54KG ZIP CODE

18. PERMANENT ADDRESS LOVERSLANE

9. BLOOD TYPE O
House/Block/Lot No. Street
NAILON
10. GSIS ID NO. 2005332763
Subdivision/Village Barangay
BOGO CITY CEBU
11. PAG-IBIG ID NO. 76452334
City/Municipality Province

12. PHILHEALTH NO. 120511977962 ZIP CODE

13. SSS NO. 19. TELEPHONE NO.

14. TIN NO. 343-868-114 20. MOBILE NO.

15. AGENCY EMPLOYEE NO. 6079024 21. E-MAIL ADDRESS (if any)

II. FAMILY BACKGROUND

22. SPOUSE'S SURNAME 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME

MIDDLE NAME

OCCUPATION

EMPLOYER/BUSINESS NAME

BUSINESS ADDRESS

TELEPHONE NO.

24. FATHER'S SURNAME OLIDIANA

NAME EXTENSION (JR., SR)
FIRST NAME ROMEO

MIDDLE NAME COMPRADO

25. MOTHER'S MAIDEN NAME

SURNAME DARIAGAN

FIRST NAME MA. LUISA

MIDDLE NAME PANES (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
HONORS
(Write in full)
full) (if not graduated) RECEIVED
From To

ELEMENTARY NAILON ELEMENTARY SCHOOL 1998 2004

SECONDARY /
VOCATIONAL ST. LOUISE DE MARILLAC COLLEGE OF BOGO 2004 2009

HOUSEKEEPING NCII 2018 2018

TRADE
COURSE
COLLEGE NORTHEN CEBU COLLEGES BSED-ENGLISH 2009 2013

GRADUATE STUDIES

(Continue on separate sheet if necessary)

SIGNATURE DATE
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

LICENSURE EXAMINATION FOR TEACHERS 78.6 9/1/2013 ABELLANA NATIONAL HIGH SCHOOL 1262309

(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
abbreviate) full/Do not abbreviate) (Format "00-0")/
INCREMENT
From To
(Y/ N)

2019 PRESENT TEACHER SIOCON NHS 25700.00 11-2 PERMANENT Y

DON POTENCIANO CATARAT MEMORIAL
2018 2019 TEACHER 21000.00 11 PERMANENT Y
NHS
2013 2017 TEACHER ARANETA LEARNING CENTER 8000.00 CONTRACTUAL N

(Continue on separate sheet if necessary)

SIGNATURE DATE
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

(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

TRAINING WORKSHOP ON SCRIPT AND VIDEO EDITING IN SIYENSIKULA 5/23/2022 5/25/2022 24 HRS. CITY OF BOGO DIVISION

DIVISION TRAINING AND WORKSHOP ON CAMPUS JOURNALISM 3/14/2022 3/18/2022 40 HRS. CITY OF BOGO DIVISION

SCHOOL-BASED MID-YEAR IN-SERVICE TRAINING FOR TEACHERS 2/3/2022 2/9/2022 40 HRS. CITY OF BOGO DIVISION

DIVISION VIRTUAL TRAINING ON SCIENCE INVESTIGATORY PROJECT 12/1/2021 12/3/2022 24 HRS. CITY OF BOGO DIVISION

DIVISION TRAINING ON MATHE MATICAL INVESTIGATIIONS AND MODELING 10/18/2022 10/23/2022 40 HRS. CITY OF BOGO DIVISION

ONLINE ORIENTATION WORKSHOP ON THE SUGGESTED HOME PROJECTS OF

9/28/2022 9/30/2022 24 HRS. CITY OF BOGO DIVISION
LEARNERS

ENGLISH PROFECIENCY PROGRAM FOR TEACHERS AND SCHOOL LEADERS 7/26/2021 7/30/2022 40 HRS. CITY OF BOGO DIVISION

IN-SERVICE TRAINING FOR TEACHERS 3/15/2021 3/19/2021 40 HRS. CITY OF BOGO DIVISION

IN-SERVICE TRAINING FOR TEACHERS 12/14/2020 12/18/2021 40 HRS. CITY OF BOGO DIVISION

DIVISION RE-ORIENTATION OF THE DIFFERENT PROGRAMS, ACTIVITIES AND PROJECTS 12/21/2020 12/23/2020 24 HRS. CITY OF BOGO DIVISION

CAPACITY BUILDING OF TEACHERS ON THE INTIGRATION OF COMPREHENSIVE

12/7/2020 12/9/2020 24 HRS. CITY OF BOGO DIVISION
SEXUALITY EDUCATION (CSE) IN THE K-12 BASIC EDUCATION CURRICULUM
CONFERENCE OF YOUTH FORMATION COORDINATORS AND VOLUNTEERS FOR THE
11/9/2019 11/13/2019 36 HRS. DEPED CENTRAL OFFICE
IMPLEMENTATION OF THE LAST MILE SCHOOL PROGRAMS

BASIC TRAINING COURSE FOR OUTFIT ADVISOR 10/7/2019 10/9/2019 24 HRS. CITY OF BOGO DIVISION

8TH ECHO FOLK DANCE WORKSHOP 7/19/2019 9/21/2019 24 HRS. CITY OF BOGO DIVISION

SENIOR HIGH SCHOOL MASS TRAINING OF TEACHERS (MTOT) FOR TECHNICAL

5/2/2018 5/4/2018 24 HRS. DEPED REGION VII
VOCATIONAL LIVELIHOOD (TVL) TRACK

3-DAY DIVISION BASIC TRAINING COURSE ON ALS COORDINATOR 3/22/2018 3/24/2018 24 HRS. CITY OF BOGO DIVISION

SENIOR HIGH SCHOOL MASS TRAINING (MTOT) FOR ACADEMIC TRACK (CORE AND
2/19/2018 02/24/208 40 HRS. DEPED REGION VII
SPEICIALIZED SUBJECT)

(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)

DANCING

SINGING

(Continue on separate sheet if necessary)

SIGNATURE DATE
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
REY IAN O. PELAEZ GAIRAN, BOGO CITY, CEBU 4.5 cm. X 3.5 cm
(passport size)

LEONARDO L. MALAIT GAIRAN, BOGO CITY, CEBU

Computer generated
or photocopied picture
THERESE ROUELLE A. YONSON COGON, BOGO CITY, CEBU 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: DRIVER'S LICENSE

ID/License/Passport No.: 0520005658

Signature (Sign inside the box)

Date/Place of Issuance: DANAO, CEBU

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