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 DORADO
NAME EXTENSION (JR., SR) N/A
FIRST NAME LEILA

MIDDLE NAME GUTIERREZ

3. DATE OF BIRTH
12/8/1977 16. CITIZENSHIP
(mm/dd/yyyy) ✘ Filipino Dual Citizenship
by by
4. PLACE OF BIRTH MAGDALENA, LAGUNA If holder of dual citizenship, Pls. birth
indicate country: naturalization
please indicate the details.
5. SEX
Male ✘ Female
17. RESIDENTIAL ADDRESS
6 CIVIL STATUS Single ✘
Widowed Married
Separat
House/Block/Lot No. Street
BAANAN
Other/s: ed Subdivision/Village Barangay
7. HEIGHT (m) 1.57 MAGDALENA LAGUNA
City/Municipality Province
8. WEIGHT (kg) 72 ZIP CODE 4007
18. PERMANENT ADDRESS
9. BLOOD TYPE O+
House/Block/Lot No. Street

10. GSIS ID NO. 77081200648 BAANAN

Subdivision/Village Barangay

11. PAG-IBIG ID NO. 147000898115 MAGDALENA LAGUNA

City/Municipality Province

12. PHILHEALTH NO. 080504073665 ZIP CODE 4007

13. SSS NO. N/A 19. TELEPHONE NO. N/A

14. TIN NO. 211162813 20. MOBILE NO. 09261874122

15. AGENCY EMPLOYEE NO. 0005770 21. E-MAIL ADDRESS (if any) leila.dorado@deped.gov.ph
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME DORADO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)
NAME EXTENSION (JR., SR)
FIRST NAME MARIO N/A BART SEBASTHIEN G. DORADO 08/27/2010

MIDDLE NAME NUNAG MAX TIMOTHY G. DORADO 6/7/2021

OCCUPATION N/A

EMPLOYER/BUSINESS NAME N/A

BUSINESS ADDRESS N/A

TELEPHONE NO. N/A

24. FATHER'S SURNAME GUTIERREZ

NAME EXTENSION (JR., SR) N/A
FIRST NAME MAXIMO

MIDDLE NAME BORGONOS

25. MOTHER'S MAIDEN NAME

SURNAME SARAH

FIRST NAME ONOFRA

MIDDLE NAME BORDIN (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 ANANIAS LAICO MEM. ELEM. SCHOOL PRIMARY EDUCATION 1984 1990 GRADUATED 1990 N/A

SECONDARY
VOCATIONAL / LILIO ACADEMY HIGH SCHOOL 1990 1994 GRADUATED 1994 N/A

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

TRADE
LAGUNA STATE POLYTECHNIC BACHELOR OF SCIENCE IN INDUSTRIAL
COURSE
COLLEGE 1996 2000 GRADUATED 2000 N/A
UNIVERSITY EDUCATION
ADMINISTRATION AND SUPERVISION
GRADUATE STUDIES UNION COLLEGE 2011 2017 GRADUATED 2017 N/A

MASTER OF ARTS MAJOR IN HOME

LAGUNA STATE POLYTECHNIC UNIVERSITY
ECONOMICS
2002 2004 21 UNITS N/A N/A
(Continue on separate sheet if necessary)

SIGNATURE DATE JANUARY 05, 2023

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

LET - LICENSURE EXAMINATION FOR TEACHERS 77% August 27, 2000 UNIVERSITY OF THE EAST 0656944 12/8/2023

(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)
03/30/2021 To date MASTER TEACHER II DEPARTMENT OF EDUCATION/DIVISION OF LAGUNA Php52,417.00 19-1 PERMANENT YES
1/1/2021 To date
MASTER TEACHER I DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php524172.00 18-1 PERMANENT YES

1/1/2020 12/31/2020
MASTER TEACHER I DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php505908 18-1 PERMANENT YES

11/21/19 12/21/2019
MASTER TEACHER I DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php44159 18-1 PERMANENT YES

6/1/2016 PRESENT
TEACHER III DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.21436.00 13-1 PERMANENT YES

6/1/2015 6/1/2016
TEACHER III DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.21,436.00 13-1 PERMANENT YES

7/1/2014 5/31/2015
TEACHER III DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.21,436.00 13-1 PERMANENT YES

6/1/2014 6/1/2012
TEACHER II DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.19,940.00 12-1 PERMANENT YES

6/1/2011 5/31/2012
TEACHER II DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.18,333.00 12-1 PERMANENT YES

6/24/2010 5/31/2011
TEACHER II DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.16, 725.00 12-1 PERMANENT YES

7/1/2009 6/23/2010
TEACHER II DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.15,119.00 12-1 PERMANENT YES

6/1/2009 6/30/2009
TEACHER II DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.12,748.00 12-1 PERMANENT YES

7/1/2008 5/31/2009
TEACHER I DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.12,328.00 11-1 PERMANENT YES

7/1/2007 6/30/2008
TEACHER I DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.11,207.00 11-1 PERMANENT YES

1/1/2006 6/30/2007
TEACHER I DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.10,188.00 10-2 PERMANENT YES

10/14/2003 12/31/2005
TEACHER I DEPARTRMENT OF EDUCATION/DIVISION OF LAGUNA Php.9,939.00 10-1 PERMANENT YES

1/6/2002 1/9/2003
TEACHER LICEO DE SAN PABLO Php. 9,100.00 CASUAL NO

(Continue on separate sheet if necessary)

SIGNATURE DATE JANUARY 05, 2023

CS FORM 212 (Revised 2017), Page 2 of 4

 VI. VOLUNTARY WORK OR INVOLVEMENT IN CIVIC / NON-GOVERNMENT / PEOPLE / VOLUNTARY ORGANIZATION/S
INCLUSIVE DATES
NAME & ADDRESS OF ORGANIZATION
(Write in full) (mm/dd/yyyy) NUMBER OF HOURS POSITION / NATURE OF WORK
From To

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

(Continue on separate sheet if necessary)

VII. LEARNING AND DEVELOPMENT (L&D) INTERVENTIONS/TRAINING PROGRAMS ATTENDED
(Start from the most recent L&D/training program and include only the relevant L&D/training taken for the last five (5) years for Division Chief/Executive/Managerial positions)
INCLUSIVE DATES OF
ATTENDANCE Type of LD
TITLE OF LEARNING AND DEVELOPMENT INTERVENTIONS/TRAINING PROGRAMS NUMBER OF HOURS
( Managerial/ CONDUCTED/ SPONSORED BY
(Write in full) (mm/dd/yyyy) Supervisory/ (Write in full)
Technical/etc)
From To

3/26/2022 3/26/2022 8 TECHNICAL DEPARTMENT OF EDUCATION

RESULT-BASED PERFORMANCE MANAGEMENT SYSTEM (RPMS)-PHILIPPINE PROFESSIONAL STAN

03/17/2022 03/17/2022 8 TECHNICAL DEPARTMENT OF EDUCATION

MINHS SCHOOL-BASED LAC: CODE OF ETHICS FOR PROFESSIONAL TEACHER

2/2/2022 2/4/2022 24 TECHNICAL DEPARTMENT OF EDUCATION

INTER-SCHOOL LEARNING ACTION CELL

08/30/2021 3/9/2021 40 TECHNICAL DEPARTMENT OF EDUCATION

VIRTUAL IN SERVICE TRAINING FOR TEACHERS

06/22/20221 06/22/2021 8 TECHNICAL DEPARTMENT OF EDUCATION

DIVISION ORIENTATION ON TEACHER INDUCTION PROGRAM

05/14/2021 05/14/2021 8 TECHNICAL DEPARTMENT OF EDUCATION

DISTRICT FEST OF ACTION RESEARCH PROPOSAL FOR JUNIOR AND SENIOR
INFORMATION AND COMMUNICATIONS
03/15/2021 03/19/2021 40 TECHNICAL TECHNOLOGY SERVICES-EDUCATIONAL
VIRTUAL IN SERVICE TRAINING FOR PUBLIC SCHOOL TEACHERS
TECHNOLOGY UNIT
2/1/2021 2/1/2021 8 TECHNICAL DEPARTMENT OF EDUCATION
INTER-SCHOOL LAC GUIDELINES ON IMPLEMENTING RPMS FOR SY 2020-2021

12/14/2020 12/18/2020 40 TECHNICAL DEPARTMENT OF EDUCATION

1ST ONLINE SCHOOL BASED IN- SERVICE TRAINING
CAPABILITY BUILDING FOR TEACHERS AND SCHOOLS LEADERS FOCUSED ON THE
DEVELOPMENT UTILIZATION OF IDEA LESSON EXEMPLAR
'07/21-22- 24/20 12 TECHNICAL DEPARTMENT OF EDUCATION

INTEGRATED PRORAM IMPLEMENTATION ON SBFP 4/7/2019 5/7/2019 16 MANAGERIAL DEPARTMENT OF EDUCATION

FIRST DISTRICT RESEARCH CONFERENCE 01/23/18 01/23/19 8 TECHNICAL DEPARTMENT OF EDUCATION

PARADIGM SHIFT of STUDENT ASSESSMENT of LEARNING with FOCUS on K to 12 CURRICULUM

ACROSS the DISCIPLINES
02/24/2017 02/26/2017 32 MANAGERIAL DEPARTMENT OF EDUCATION

TECHNICAL EDUCATION AND SKILLS DEVELOPMENT

TRAINERS METHODOLOGY CERTIFICATE I 08/15/2016 08/26/2016 76 TECHNICAL
AUTHORITY
DIVISION ORIENTATION-WORKSHOP ON THE DEVELOPMENT OF LEARNING RESOURCE DEPARTMENT OF EDUCATION-DIVISION OF
10/26/2015 10/30/2015 40 TECHNICAL
MATERIAL ON EPP/ TLE LAGUNA
DEPARTMENT OF EDUCATION-DIVISION OF
2014 DIVISION IN SERVICE TRAINING FOR GUIDANCE COUNSELOR 09/09/2014 09/11/2014 24 TECHNICAL
LAGUNA
DEPARTMENT OF EDUCATION-DIVISION OF
SENIOR HIGH SCHOOL CONFERENCE- WORKSHOP 02/10/2015 02/11/2015 16 TECHNICAL
LAGUNA
TECHNICAL EDUCATION AND SKILLS DEVELOPMENT
NATIONAL CERTICATE IN HOUSEKEEPING II 07/10/2015 02/14/2015 48 TECHNICAL
AUTHORITY
TECHNICAL EDUCATION AND SKILLS DEVELOPMENT
NATIONAL CERTICATE IN BREAD AND PASTRY PRODUCTION II 02/07/2015 02/11/2015 48 TECHNICAL
AUTHORITY
DEPARTMENT OF EDUCATION-DIVISION OF
2014 DIVISION IN SERVICE TRAINING FOR GUIDANCE COUNSELOR 09/09/2014 09/11/2014 24 TECHNICAL
LAGUNA
DEPARTMENT OF EDUCATION-DIVISION OF
2014 MID-YEAR INSET IN TLE 10/20/2014 10/24/2014 40 TECHNICAL
LAGUNA
DEPARTMENT OF EDUCATION-DIVISION OF
DIVISION TRAINING PROJECT SHEPERD LEADERSHIP 09/11/2014 09/12/2014 16 SUPERVISORY
LAGUNA
DEPARTMENT OF EDUCATION-DIVISION OF
DIVISION TRAINING PROJECT SENIOR HIGH SCHOOL IMPLEMENTATION PLANNING 09/22/2014 09/24/2014 24 TECHNICAL
LAGUNA

REGIONAL TRAINING OF GRADE 7 TEACHERS ON K TO 12 CURRICULUM 05/14/2012 05/19/2012 48 TECHNICAL DEPARTMENT OF EDUCATION-REGION IV-A

FOUR-DAY TRAINING OF FIRST YEAR TEACHERS ON THE 2010 SECONDARY EDUCATION

CURRICULUM
06/04/2010 06/07/2010 36 TECHNICAL DEPARTMENT OF EDUCATION-REGION IV-A

DEPARTMENT OF EDUCATION-DIVISION OF
2009 DIVISION SKILL TRAINING CUM DEMO FEST FOR TLE 05/04/2009 05/06/2009 16 TECHNICAL
LAGUNA
DIVISION TRAING/ WORKSHOP ON THE IMPLEMENTATION OF THE FOUR-H IN HOME DEPARTMENT OF EDUCATION-DIVISION OF
05/02/2007 05/05/2007 32 TECHNICAL
ECONOMICS LAGUNA
DEPARTMENT OF EDUCATION-DIVISION OF
SEMINAR WORKSHOP ON THE MANAGEMENT AND OPERATION OF SCHOOL CANTEEN 0 5/22/2006 05/25/2006 32 TECHNICAL
LAGUNA
DEPARTMENT OF EDUCATION-DIVISION OF
DIVISION SUMMER INSTITUTE FOR SECONDARY HOME ECONOMICS TEACHERS 05/30/2005 05/31/2005 16 TECHNICAL
LAGUNA
DEPARTMENT OF EDUCATION-DIVISION OF
DIVISION SUMMER INSTITUTE IN MAKABAYAN 06/08/2004 06/10/2004 24 TECHNICAL
LAGUNA
TECHNICAL EDUCATION AND SKILLS
NATIONAL CERTICATE IN BREAD AND PASTRY PRODUCTION 02/07/2015 02/11/2015 48 TECHNICAL
DEVELOPMENT AUTHORITY
TECHNICAL EDUCATION AND SKILLS
NATIONAL CERTICATE IN HOUSEKEEPING 07/10/2015 07/14/2015 48 TECHNICAL
DEVELOPMENT AUTHORITY
(Continue on separate sheet if necessary)

VIII. OTHER INFORMATION

MEMBERSHIP IN ASSOCIATION/ORGANIZATION
NON-ACADEMIC DISTINCTIONS / RECOGNITION
SPECIAL SKILLS and HOBBIES 32. 33. (Write in
(Write in full)
full)
LAGUNA HOME ECONOMICS TEACHERS
COOKING N/A
ASSOCIATION

(Continue on separate sheet if necessary)

SIGNATURE DATE JANUARY 05, 2022

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 ✘ NO
b. within the fourth degree (for Local Government Unit - Career Employees)? YES ✘ NO
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
by any court or tribunal? YES ✘ NO
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
Barangay election)?
YES ✘ NO
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
RUBY P. CASTILLO EdD. LILIW, LAGUNA 559-5740 3.5 cm. X 4.5 cm
(passport size)

TEOFILA V. TABULINA EdD. CIGARAS, MAGDALENA, LAGUNA 09173124771 With full and handwritten
name tag and signature over
printed name
JUANA A. ARVESU LILIW, LAGUNA 9367409663
Computer generated
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and or photocopied picture
is not acceptable
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: PROFESSIONAL REGULATION COMMISSION

ID/License/Passport No.: 0656944

Signature (Sign inside the box)
01/05/2023
Date/Place of Issuance: 10-27-200/LUCENA CITY
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