PDS 2023

You might also like

Download as xlsx, pdf, or txt
Download as xlsx, pdf, or txt
You are on page 1of 8

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 VALOIS - BETONIO
FIRST NAME KAREEN JOY NAME EXTENSION (JR., SR) N/A
MIDDLE NAME DEL ROSARIO
3. DATE OF BIRTH ✘ Filipino ✘ by birth
16. CITIZENSHIP by
(mm/dd/yyyy) 09/03/1980
naturalization
Dual Citizenship
4. PLACE OF BIRTH LINEK, NALUS, KIAMBA, SARANGANI If holder of dual citizenship, Pls. indicate country:
please indicate the details.
5. SEX Male ✘ Femal
e
6 CIVIL STATUS Single ✘ Marri
17. RESIDENTIAL ADDRESS 271 LOPEZ
ed House/Block/Lot No. Street
Separated Widowed
N/A POBLACION
Other/s:
Subdivision/Village Barangay
7. HEIGHT (m) 1.53 KIAMBA SARANGANI
City/Municipality Province
8. WEIGHT (kg) 58 ZIP CODE 9514

9. BLOOD TYPE O
18. PERMANENT ADDRESS 271 LOPEZ
House/Block/Lot No. Street

10. GSIS ID NO. 2003941329 N/A POBLACION


Subdivision/Village Barangay

11. PAG-IBIG ID NO. 09-2330401-6 KIAMBA SARANGANI


City/Municipality Province
12. PHILHEALTH NO. 17-050086156-0 ZIP CODE 9514
13. SSS NO. 09-2330401-6 19. TELEPHONE NO. 0835081141
14. TIN NO. 925-796-959 20. MOBILE NO. 09477766130/09355061701
15. AGENCY EMPLOYEE NO. 4455482 21. E-MAIL ADDRESS (if any) kareenjoy.betonio@deped.gov.ph
II. FAMILY BACKGROUND
22. SPOUSE'S SURNAME BETONIO 23. NAME of CHILDREN (Write full name and list all) DATE OF BIRTH (mm/dd/yyyy)

FIRST NAME MELVIN NAME EXTENSION (JR., SR) N/A VINZ ABCDE VALOIS BETONIO 11/01/2002
MIDDLE NAME OBCENA REENA WYZ VALOIS BETONIO 04/25/2009
OCCUPATION SHIFT MANAGING/BUSINESSES THERICH HEART VALOIS BETONIO 02/23/2021
VANNACORE, INC./KLIQ DIGITAL SERVICES & THE KILQED
EMPLOYER/BUSINESS NAME
ACADEMY, INC.
BUSINESS ADDRESS POBLACION, KIAMBA, SARANGANI PROVINCE
TELEPHONE NO. N/A
24. FATHER'S SURNAME VALOIS
FIRST NAME RICARDO (+) NAME EXTENSION (JR., SR) N/A

MIDDLE NAME DEL ROSARIO


25. MOTHER'S MAIDEN NAME JIMENEZ
SURNAME VALOIS
FIRST NAME ABDULIA
MIDDLE NAME DEL ROSARIO (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 KIAMBA CENTRAL ELEMENTARY SCHOOL ELEMENTARY 1987 1993 GRADUATE 1993 FIRST HONORS
KIAMBA
ACADEMY
SECONDARY NOTRE DAME OF KIAMBA HIGH SCHOOL 1993 1997 GRADUATE 1997 SCHOLAR/
SALUTATORIAN
VOCATIONAL /

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

TRADE MAGNA CUM


COLLEGE
COURSE NOTRE DAME OF MARBEL UNIVERSITY BSED-MATHEMATICS 1997 2001 GRADUATE 2001
LAUDE

GRADUATE STUDIES MINDANAO STATE UNIVERSITY DIPLOMA IN MST - HS MATHEMATICS 2001 2006 GRADUATE 2006 N/A

COMPLETE
NOTRE DAME OF MARBEL UNIVERSITY/
GRADUATE STUDIES MAED-EDUCATIONAL MANAGEMENT 2012 2014 ACADEMIC N/A N/A
RAMON MAGSAYSAY MEMORIAL COLLEGES
REQUIREMENTS
(Continue on separate sheet if necessary)
SIGNATURE DATE 04/11/23
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

CIVIL SERVICE HONOR GRADUATE N/A N/A DAVAO CITY 10111325 N/A

BOARD OF PROFESSIONAL TEACHERS 83.80% 08/26/2001 GENERAL SANTOS CITY 0716897 3/9/2024

PRINCIPALS' TEST (NATIONAL QUALIFYING EXAMINATION FOR


85.50% 2017 KORONADAL CITY 0004990 N/A
SCHOOL HEADS)

CAREER EXECUTIVE SERVICE WRITTEN EXAMINATION (FIRST


81.59% 07/16/2022 DAVAO CITY N/A N/A
STAGE)
(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)

1/1/2023 PRESENT PRINCIPAL - 1 DEPARTMENT OF EDUCATION 52,096.00 19 - 2 PERMANENT Y

4/1/2022 12/31/22 PRINCIPAL - 1 DEPARTMENT OF EDUCATION 50,574.00 19 - 2 PERMANENT Y

2/1/2022 3/31/22 PRINCIPAL - 1 DEPARTMENT OF EDUCATION 48,835.00 19 - 1 PERMANENT Y

1/1/2022 1/31/22 PRINCIPAL - 1 DEPARTMENT OF EDUCATION 48,313.00 19 - 1 PERMANENT Y

1/1/2021 12/31/21 PRINCIPAL - 1 DEPARTMENT OF EDUCATION 48,313.00 19 - 1 PERMANENT Y

3/1/2020 12/31/20 PRINCIPAL - 1 DEPARTMENT OF EDUCATION 46,791.00 19 - 1 PERMANENT Y

1/1/2020 2/29/20 PRINCIPAL - 1 DEPARTMENT OF EDUCATION 45,269.00 19 - 1 PERMANENT Y

1/1/2019 12/31/2019 PRINCIPAL - 1 DEPARTMENT OF EDUCATION 42,099.00 19 - 1 PERMANENT Y

11/1/2018 12/31/2018 PRINCIPAL - 1 DEPARTMENT OF EDUCATION 42,099.00 19 - 1 PERMANENT Y

1/1/2018 10/31/18 HEAD TEACHER - 1 DEPARTMENT OF EDUCATION 25,290.00 14-1 PERMANENT Y

1/1/2017 12/31/17 HEAD TEACHER - 1 DEPARTMENT OF EDUCATION 25,290.00 14-1 PERMANENT Y

6/1/2016 12/31/2016 HEAD TEACHER - 1 DEPARTMENT OF EDUCATION 24,141.00 14-1 PERMANENT Y

1/1/2016 5/31/2016 TEACHER - 1 DEPARTMENT OF EDUCATION 19,496.00 11-2 PERMANENT Y

09/16/2015 12/31/2015 TEACHER - 1 DEPARTMENT OF EDUCATION 18,922.00 11-2 PERMANENT Y

1/1/2015 8/31/2015 TEACHER - 1 DEPARTMENT OF EDUCATION 18,735.00 11-1 PERMANENT Y

1/1/2014 12/31/2014 TEACHER - 1 DEPARTMENT OF EDUCATION 18,735.00 11-1 PERMANENT Y

1/1/2013 12/31/2013 TEACHER - 1 DEPARTMENT OF EDUCATION 18,735.00 11-1 PERMANENT Y

09/16/2012 12/31/2012 TEACHER - 1 DEPARTMENT OF EDUCATION 18,735.00 11-1 PERMANENT Y

6/1/2012 9/15/2012 TEACHER - 1 DEPARTMENT OF EDUCATION 18,549.00 11-0 PERMANENT Y

1/1/2012 5/31/2012 TEACHER - 1 DEPARTMENT OF EDUCATION 17,099.00 11-0 PERMANENT Y

6/1/2011 12/31/2011 TEACHER - 1 DEPARTMENT OF EDUCATION 17,099.00 11-0 PERMANENT Y

1/1/2011 5/31/2011 TEACHER - 1 DEPARTMENT OF EDUCATION 14,899.00 11-0 PERMANENT Y

6/1/2010 12/31/2010 TEACHER - 1 DEPARTMENT OF EDUCATION 14,899.00 11-0 PERMANENT Y

1/1/2010 5/31/2010 TEACHER - 1 DEPARTMENT OF EDUCATION 14,198.00 11-0 PERMANENT Y


09/16/2009 12/31/2009 TEACHER - 1 DEPARTMENT OF EDUCATION 14,198.00 11-0 PERMANENT Y

8/12/2002 9/16/2002 TEACHER - 1 DEPARTMENT OF EDUCATION 9,939.00 11-0 SUBSTITUTE Y

6/1/2005 9/15/2008 TEACHER THE QUANTUM ACADEMY, INC. 13,000.00 N/A PERMANENT N

6/1/2003 3/31/2005 TEACHER GENERAL SANTOS HOPE CHRISTIAN CENTER 8,410.90 N/A PERMANENT N

6/1/2001 3/31/2002 TEACHER KORONADAL SOUTHERN ELEMENTARY SCHOOL 3,900.00 N/A PERMANENT N

(Continue on separate sheet if necessary)

SIGNATURE DATE 04/11/23


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) NUMBER OF HOURS POSITION / NATURE OF WORK
(mm/dd/yyyy)
From To
KALAHI-CIDDS-KKB 11/20/10 08/19/2022 336 MEMBER, PROJECT PREPARATION TEAM
(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
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
Orienttion-Workshop on the DepEd Merit Selection Plan (MSP) and Guidelines on Recruitment, Selection and
01/10/2023 01/11/2023 16 Managerial Department of Education (Sarangani)
Appointment

Regional Reorientation on the Processes and Assessment of Senior High School (SHS) Implementation 12/14/2022 12/14/2022 8 Technical Department of Education (Region XII)

Training-Workshop on the Crafting of Enhanced School Improvement Plan 10/16/2022 10/17/2022 16 Managerial Department of Education (Sarangani)

Capability Building Workshop on the Utilization of Digital Technology on the Delivery of Instruction for Special
09/26/2022 09/30/2022 40 Technical Department of Education (Pilippines)
Program in Journalism (SPJ)

Orientation-Workshop on Division Education Development Plan (DEDP) for 2023-2028 cum School Improvement
09/26/2022 09/26/2022 8 Managerial Department of Education (Sarangani)
Plan

Regional Training of Trainers (RTOT) on Managing Distance Learning 08/23/2021 08/27/2021 40 Technical Department of Education (Region XII)

Online Training on Learning Delivery of K to 12 Basic Education Curriculum Content, Pedagogy, and Assessment for
08/12/2020 08/17/2020 48 Supervisory Department of Education (Sarangani)
All Learning Areas in the New Normal

Webinar on the Orientation of Rationale and Design of the Most Essential Learning Competencies in All Learning
07/07/2020 07/09/2020 24 Supervisory Department of Education (Sarangani)
Areas for School Heads and Teachers

Microsoft Office 365 Empowerment and Leadership Training-Workshop 01/23/2020 01/24/2020 16 Technical Department of Education (Sarangani)

Roll-Out of Procedural Guidelines on Management of Cash Advances for School MOOE and Program Funds 12/17/2019 12/17/2019 8 Technical Department of Education (Sarangani)

Moral Recovery Program and Gender Sensitivity Training 11/11/2019 11/11/2019 8 Technical Department of Education (Sarangani)

Re-Orientation of School Head on Teacher Induction Program Implementation in the School 11/05/2019 11/06/2019 16 Technical Department of Education (Sarangani)

Orientation on Senior High School JDVP and Career Guidance Program 09/11/2019 09/11/2019 8 Technical Department of Education (Sarangani)

Orientation-Workshop on Results-Based Performance Management RPMS-IPCRF Data Collection 09/06/2019 09/06/2019 8 Technical Department of Education (Sarangani)

Peace Education Capacity Building 07/03/2019 07/03/2019 8 Technical Department of Education (Sarangani)

Training on Instructional Supervision cum Annual Implementation Plan and Office Performance and Commitment Supervisory/
05/24/2019 05/25/2019 16 Department of Education (Sarangani)
Review for School Heads Technical

Continuous Improvement (CI) Training Batch 2 01/07/2019 01/11/2019 40 Technical Department of Education (Sarangani)

Regional Training of Trainers (RTOT) on the Effective Implementation of School Learning Action Cell (SLAC) 01/03/2019 01/06/2019 32 Technical Department of Education (Region XII)

Teacher Induction Program (TIP) Focal Persons' Orientation 09/18/2018 09/19/2018 16 Supervisory Department of Education (Sarangani)

Results-Based Performance Management System (RPMS) Orientation 08/28/2018 08/29/2018 16 Supervisory Department of Education (Sarangani)

Philippine Professional Standards for Teachers (PPST) Orientation 08/27/2018 08/27/2018 8 Supervisory Department of Education (Sarangani)

Orientation of School-Based Tutorial Program 08/06/2018 08/06/2018 8 Technical Department of Education (Kiamba)

Learning Action Cell (LAC) of all Principals, Head Teachers, and School Testing Coordinators on Arts and Level of
07/12/2018 07/12/2018 8 Technical Department of Education (East Kiamba)
Questioning, Table of Specification (TOS), Test Construction, Item Analysis, and Lesson Planning

Regional Training of Grades 4-8 Reading Teachers on Care for Non-Readers (CNR) Program 06/17/2018 06/20/2018 32 Technical Department of Education (Region XII)

Teaching and Learning Excellence in School Leadership for Southeast Asia 02/19/2018 04/27/1018 P Technical Department of Education (Sarangani)

Orientation on Learning and Development (L&D) System and Continuous Professional Development (CPD)
03/13/2018 03/13/2018 8 Managerial Department of Education (Sarangani)
Accreditation through NEAP to PRC

Orientatin on the Conduct of NAT 6, NAT 10 and ELLNA 06/27/2018 06/27/2018 8 Technical Department of Education (Sarangani)

Capability Building of Secondary and Integrated School Heads and Administrative Staff 08/23/2017 08/24/2017 16 Managerial Department of Education (Sarangani)

Region-Wide Training on Developmentally Appropriate Practices in the Early Language Literacy and Numeracy
07/24/2017 07/30/2017 56 Technical Department of Education (Region XII)
(DAP-ELLN) Program

Validation of Contextualized Materials 03/05/2017 03/07/2017 24 Technical Department of Education (Sarangani)


Regional Roll-Out Training on Early Language Literacy and Numeracy 08/19/2016 08/19/2016 8 Technical Department of Education (Region XII)

Results-Based Performance Management System Re-Orientation Workshop 07/07/2016 07/08/2016 16 Supervisory Department of Education (Sarangani)

Capability Building of School Heads 05/18/2016 05/19/2016 16 Managerial Department of Education (Sarangani)

Municipal Training on Enhanced School Improvement Plan 03/09/2016 03/11/2016 24 Managerial Department of Education (Kiamba)

Orientation on School-Based Feeding Program 08/17/2015 08/17/2015 8 Technical Department of Education (Sarangani)

Orientation for Omnibus Guidelines in Kindergarten 08/01/2015 08/02/2015 16 Technical Department of Education (Sarangani)

Results-Based Performance Management System Monitoring and Coaching Seminar-Workshop 07/21/2015 07/21/2015 8 Supervisory Department of Education (Sarangani)

Regional Roll-Out of Integrated Monitoring & Evaluation and Plan Adjustment (MEPA) Technology (With new SIP
12/15/2014 12/17/2014 24 Managerial Department of Education (Region XII)
Process and Continuous Improvement Framework)

Capability Building for Teacher Leaders 12/12/2014 12/13/2014 16 Managerial Department of Education (Sarangani)

2nd Principals' Training and Development Program cum Regional Board Conferences (PTDP-RBC) 12/03/2014 12/05/2014 24 Managerial Department of Education (Region XII)

Regional Summer Refresher Course in School-Based Management for School Heads 06/24/2014 06/26/2014 24 Managerial Department of Education (Region XII)

National Training of Trainers of Grade 3 Teachers for K to 12 Basic Education program 04/27/2014 05/03/2014 56 Technical Department of Education (Sarangani)

Pre-Deployment and Seminar Workshop on ICT Integration Across Curriculum 01/23/2014 01/24/2014 16 Technical Department of Education (Philippines)

Capability Building on Training and Development System for District and School Heads T & D Core Teams 10/18/2013 10/19/2013 16 Managerial Department of Education (Sarangani)

Oral English Enhancement: The Art of Jazz Chanting, Correspondence and Public Speaking 09/18/2013 09/19/2013 16 Technical Department of Education (Philippines)

Strategic Planning Content and Process cum Formulation of FY 2015 Plans and Budget Proposals 08/15/2013 08/16/2013 16 Managerial Department of Education (Sarangani)

Regionwide National English Proficiency Program (NEPP) Training on English Language 11/21/2010 11/27/2010 56 Technical Department of Education (Region XII)

(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)
DIVISION ASSOCIATION OF PUBLIC SECONDARY SCHOOL
EMCEEING A PROGRAM REGION XII NQESH 2017 (Rank 5)
HEADS

ATHLETIC ASSOCIATION MEETS ANNOUNCER SARANGANI OUTSTANDING HEAD TEACHER 2017

SARANGANI OUTSTANDING TEACHER 2012

KIAMBAYANI 2009

THE QUANTUM ACADEMY PERFECT ATTENDANCE AWARDEE 2007-2008

NDMU LEADERSHIP AWARDEE 2001

AYALA YOUNG LEADERS' CONGRESS RECIPIENT 2010

TEN OUTSTANDING STUDENTS OF REGION XI (FIRST RUNNER-UP)

NOTRE DAME OF KIAMBA LEADERSHIP AWARDEE 1997

KIAMBA CENTRAL ELEMENTARY SCHOOL LEADERSHIP AWARDEE 1993

(Continue on separate sheet if necessary)

SIGNATURE DATE 04/11/23


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:


________________________________
________________________________
YES ✘ NO
b. Have you been criminally charged before any court?
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? ________________________________
RESIGNATION
________________________________
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:
YES ✘ NO
b. Have you resigned from the government service during the three (3)-month period before the last
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
MARIA M. AMADOR POBLACION, KIAMBA, SARANGANI 9194124352 the last 6 months
3.5 cm. X 4.5 cm
(passport size)
LEO R. HULIGANGA LAGUNDI, KIAMBA, SARANGANI 9197963709
With full and handwritten
TERESITA C. MACABACYAO LAGUNDI, KIAMBA, SARANGANI 9159306793 name tag and signature over
printed name
42. I declare under oath that I have personally accomplished this Personal Data Sheet which is a true, correct and
Computer generated
complete statement pursuant to the provisions of pertinent laws, rules and regulations of the Republic of the or photocopied picture
Philippines. I authorize the agency head/authorized representative to verify/validate the contents stated herein. is not acceptable
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: PRC Signature (Sign inside the box)
ID/License/Passport No.: 0716897
04/11/2023
04/11/2023
Date/Place of Issuance: 11/05/2021/GSC 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

You might also like